Functional Medicine for Polycystic Ovary Syndrome (PCOS)

What is PCOS?

PCOS is a condition that causes an imbalance in hormones. Women with PCOS have higher levels of androgens and may have lower levels of estrogen. Androgens are sometimes called "male hormones," but all women make small amounts of them. High androgen levels can get in the way of ovulation, when an ovary releases an egg. Ovulation may then happen only now and then, or not at all, which can cause irregular or skipped periods. Androgens also play a role in extra hair growth and acne.^{1, 4, 5, 7}

More than half of women with PCOS have insulin resistance. Insulin is a hormone that helps move sugar from the blood into cells, where it is used for energy. When cells don't respond normally to insulin, blood sugar rises and the body makes more and more insulin. To balance the high insulin, the body makes more androgens, which add to PCOS symptoms. This cycle is hard to break, which is one reason PCOS can be hard to treat.^{3, 4}

PCOS affects about one in eight women. It is most often diagnosed in women in their 20s or 30s, but it can also affect teenage girls. It tends to run in families. Your risk may be higher if you have obesity, or if your mother, sister or aunt has PCOS. The exact cause is not known, but research shows that genes and things in the environment both play a part.^{1, 2, 4, 7}

In May 2026, experts published a new name for the condition: polyendocrine metabolic ovarian syndrome (PMOS). The name came from a global process that included survey answers from 14,360 people with PCOS and health professionals. The experts said the old name was not accurate. It suggests the ovaries have harmful cysts, and it hides the hormone and metabolism problems that are part of the condition. In fact, many women with PCOS don't develop cysts. The new name reflects that the condition affects many systems in the body, not just the ovaries. The switch to the new name includes a transition period. On this page, we mostly use the name PCOS.^{1, 2}

Common symptoms of PCOS

PCOS is linked to other health problems. Women with PCOS are at higher risk for heart and blood vessel disease, type 2 diabetes, metabolic syndrome, depression and anxiety. They also have a higher risk of obstructive sleep apnea (pauses in breathing during sleep) and of endometrial (uterine) cancer. More than half of women with PCOS will have type 2 diabetes or prediabetes before their early 40s. About 25% to 45% of women with PCOS have metabolic syndrome. PCOS is also linked with fatty liver disease. Researchers do not know whether PCOS causes some of these problems, whether these problems cause PCOS, or whether something else causes both.^{1, 3, 7}

PCOS can cause symptoms in many parts of the body. Symptoms vary from person to person, and some people have no symptoms or only minor ones. Because the symptoms can seem unrelated, women and their health care providers may not suspect PCOS. Common symptoms include:^{1, 3}

• Irregular, skipped or missing periods, or very heavy periods³
• Trouble getting pregnant (infertility)⁷
• Extra hair growth on the face, chest, belly or upper thighs (hirsutism)³
• Severe, late-onset or long-lasting acne that does not respond well to usual treatments³
• Oily skin³
• Thinning hair or hair loss on the scalp⁷
• Weight gain or trouble losing weight, especially around the waist³
• Patches of thick, dark, velvety skin, often on the neck, armpits or groin (acanthosis nigricans)^{1, 3}
• Tiredness (fatigue)¹
• Anxiety or depression⁷

How PCOS is diagnosed and treated

There is no single test to diagnose PCOS. Your doctor will ask about your medical history and do a physical exam. This includes checking your blood pressure, body mass index (BMI) and waist size. Blood tests check your hormone levels and look for other conditions that can be mistaken for PCOS, such as thyroid disease. Your doctor may also test your blood sugar and cholesterol, and may use an ultrasound to look at your ovaries.^{1, 7}

There are different ways to diagnose PCOS, but most require two of three features. The features are irregular or absent ovulation, high androgen levels or signs of them, and clumps of follicles in the ovaries on ultrasound. Follicles are small, fluid-filled sacs where eggs grow. Other conditions are ruled out first. Current guidelines for diagnosis apply to adults, and there are no diagnostic criteria for PCOS in teens.^{4, 5, 7}

There is no cure for PCOS, but you can manage the symptoms. Treatment depends on your symptoms, overall health and plans for pregnancy. Some common PCOS treatments can prevent pregnancy or may harm a baby during pregnancy, so tell your doctor if you hope to have children.^{6, 7}

If you have overweight or obesity, losing a small amount of weight and being more active can ease many PCOS symptoms and related health issues. Weight loss can help make periods more regular and can improve insulin and cholesterol levels. A healthy diet, regular exercise and support for anxiety or depression are also important tools.^{1, 6}

Your doctor may prescribe birth control pills to make periods more regular and to help with acne and extra hair growth. Another option is metformin, a medicine that helps the body respond better to insulin. Anti-androgen medicines lower androgen levels or block their effects. Other medicines can help with weight loss or with releasing eggs. Many of these medicines are not FDA-approved specifically for PCOS, but your doctor may recommend them for its symptoms. Many women with PCOS can and do get pregnant.^{1, 3, 6}

How our care fits alongside your gynecologist or endocrinologist

Avicenna Functional Medicine does not replace your gynecologist, your endocrinologist or the treatment they prescribe. Our role is to add to your care, not to take its place.

In a functional medicine visit, we look beyond irregular cycles at factors that may contribute, such as insulin resistance, which is common in PCOS, and inflammation. NICHD notes that cutting back on foods that can cause or increase inflammation could be helpful for people with PCOS. We also look at nutrient status, nutrition and physical activity, alongside the care you already receive. Our aim is to understand the whole picture of your health and to build a plan that supports hormone health and your overall wellbeing.^{3, 6}

Please do not stop or change any prescribed medication without talking to the doctor who prescribed it. If you are pregnant or trying to get pregnant, tell your doctor before starting anything new, because some treatments for PCOS symptoms may harm a pregnancy.⁶

What to expect at Avicenna

All visits are by telehealth, for patients located in Florida and Texas. We are a cash-pay practice, and we accept HSA and FSA. Care usually follows these steps:

• A free, 30-minute discovery call to talk about your health and whether our approach is a good fit for you
• A full intake visit with our health coach, under clinician supervision, covering your history, symptoms, current treatment and goals
• Testing chosen for you, where it is likely to be useful
• A personalized plan, with follow-up visits to review how you are doing and adjust the plan as needed

When to get urgent care

Contact your doctor if you have symptoms of PCOS, such as irregular or missing periods, very heavy periods, or trouble getting pregnant. Also tell your doctor about low mood or anxiety, which are common with PCOS. If you become pregnant, let your prenatal care team know you have PCOS, because there is a higher risk of miscarriage, high blood pressure and gestational diabetes (diabetes during pregnancy).^{1, 3, 7}

Telehealth visits with our team are not for emergencies. Call 911 right away if you have warning signs of a medical emergency, such as:⁸

• Chest pain or pressure that lasts two minutes or more⁸
• Trouble breathing or shortness of breath⁸
• Sudden confusion, unusual behavior or trouble waking up⁸
• Fainting or passing out⁸
• Sudden dizziness, weakness or changes in vision⁸
• Being unable to speak⁸
• Severe belly pain, or sudden severe pain anywhere in the body⁸
• Coughing up or vomiting blood⁸
• Thoughts of suicide or of harming someone else (you can also call or text 988)⁸