Happy Wednesday! This piece is Part Five of my PCOS Diaries series, where I share my personal experience with PCOS alongside research-informed insights. If you’re new here, you can read it as a standalone essay or explore the rest of the series for more context. More info on this newsletter below.

PCOS is one of the most common endocrine disorders affecting women of reproductive age. Stress is not just a side effect of PCOS; it may be biologically tied to the condition through stress-related hormones and body composition changes. For women in high-stress careers, that matters because chronic pressure may intensify symptoms that are already difficult to manage.

The Stress Connection

A study published in the Journal of Reproductive Sciences reported increased salivary cortisol level and α-amylase activity in women with PCOS compared with age-matched controls, suggesting evidence of a sustained stress state. Cortisol, a key hormone in the hypothalamic-pituitary-adrenal (HPA) axis, which is the body’s primary stress response system, was elevated alongside α-amylase, a biomarker of sympathetic nervous system activation. The study also found associations between these markers, higher BMI, visceral adiposity, waist-hip ratio, and pulse rate in the PCOS group.

This suggests women with PCOS may experience a baseline state of heightened stress signaling, independent of external pressures.

Now Let’s Add in Career Stress and How That Can Make it Worse

High-stress careers often involve long hours, tight deadlines, irregular meals, sleep disruption, and limited time for recovery. I’ve had moments working in PR where I’ve had to respond to emails and prep at 4 am for a launch or drug approval or work at 11 pm on a project with a quick turn around. I try my best to avoid work environments that are like that 24/7, but in general it’s a very stressful industry, especially as a woman in the field. Conditions as such can make it harder to manage PCOS symptoms such as fatigue, weight changes, menstrual irregularity, and mood strain. These stress related factors are even linked to changes in body composition.

The same study noted significantly higher BMI and visceral fat in its PCOS participants, with α-amylase positively correlating to these measures. Stress doesn't just affect how you feel, it influences how fat is stored, creating a vicious cycle where job demands amplify physiological stress, and PCOS symptoms heighten mental load.

Why Does Body Composition Matter

Visceral fat isn't just aesthetic, it's metabolically active, fueling insulin resistance and hormone imbalance, core features of PCOS. When career stress elevates markers like cortisol and α-amylase, it may worsen fat distribution, making symptom control even harder. For women in demanding roles, that can create a feedback loop: stress worsens symptoms, symptoms increase stress, and the cycle continues.

Note: The subjects for this study were 100 women in the reproductive age (13–30 years) in the city of Kolkata and surrounding areas in West Bengal, India, with the primary complaints of menstrual irregularities with or without infertility and evaluated in detail for PCOS. PCOS symptoms and diagnosis can vary notably between women of color and those who are not.

Workplace Factors Matter Deeply for Your Health

Women with PCOS may find demanding work environments harder to sustain when stress is constant and rest is limited. The study does not prove that job stress causes PCOS, but it does support a strong link between PCOS and stress-related physiology. That makes workplace factors worth taking seriously, especially in careers where recovery time is scarce. Prioritize balance and rest!

Try incorporating flexible schedules, advocate for yourself at work, calendar-block meal breaks, and start a sleep routine to make symptom management more realistic. This is something that I am still working on as well. Balancing work and PCOS isn’t easy, but definitely possible.

The Importance of Recognizing and Acknowledging the Link

Stress alone does not cause PCOS, but it amplifies its impact. Women in high-pressure careers face heightened vulnerability as job demands intensify an already taxing condition. Recognizing the link can help women and employers treat PCOS as both a health and workplace issue.

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I was listening to Zayn’s new album, Konnakol while writing this. I thought it was decent, but not my favorite album of his!

April learnings post coming next week, and I’m working on a few interesting pieces for next month. Stay tuned!

If you’re new here and would like to learn a bit about me and this newsletter, see this piece: What I’m writing about in “The Realignment Room”

References to Peer-Reviewed Papers on the Link Between Stress and PCOS

1. Basu, B. R., Chowdhury, O., & Saha, S. K. (2018). Possible Link Between Stress-related Factors and Altered Body Composition in Women with Polycystic Ovarian Syndrome. Journal of human reproductive sciences, 11(1), 10–18. https://doi.org/10.4103/jhrs.JHRS_78_17

2. Benjamin, J. J., MaheshKumar, K., Radha, V., Rajamani, K., Puttaswamy, N., Koshy, T., Maruthy, K. N., & Padmavathi, R. (2023). Stress and polycystic ovarian syndrome—A case control study among Indian women. Clinical Epidemiology and Global Health, 22, Article 101326. https://doi.org/10.1016/j.cegh.2023.101326

3. Gül, Ö., Akkuş, M., & Akkuş, F. (2025). Depression, anxiety, and stress in polycystic ovary syndrome: understanding the impact of adult separation anxiety and uncertainty intolerance. BMC women’s health, 25(1), 377. https://doi.org/10.1186/s12905-025-03930-w

Happy Tuesday! It’s a calmer week than last week, and more interviews, yay :) This piece is Part Four of my PCOS Diaries series, where I share my personal experience with PCOS alongside research-informed insights. If you’re new here, you can read it as a standalone essay or explore the rest of the series for more context. Newsletter update below. Thanks for reading!

Polycystic Ovary Syndrome (PCOS) was formally identified over 90 years ago in 1935 by doctors Stein and Leventhal, who described enlarged ovaries with cysts in women with irregular periods and symptoms like excess hair growth or acne. Despite nearly a century of research, there’s still no cure, only symptom management. This frustrates many, especially when contrasted with Viagra - which was developed in the 1990s for heart disease. Its erectile dysfunction benefits were spotted in trials, leading to FDA approval in just four years. PCOS’s diverse nature prevents similar one-pill solutions.

So what’s causing the lack of a cure?

PCOS is complex! It’s heterogeneous phenotypes, diagnostic challenges, and chronic underfunding all prevent a “simple fix.” Here’s the medical consensus:

• Heterogeneous Nature: PCOS isn’t one disease but a syndrome with 4+ phenotypes (classic, ovulatory, non-androgenic, lean) this means it behaves differently in every person, requiring personalized treatment approaches. For example, what drives insulin resistance in medically overweight cases differs from lean androgen-dominant ones therefore genetics, environment, and triggers vary widely.

• Unknown Root Cause: Unlike Viagra’s clear PDE5 mechanism, PCOS lacks a single “spark.” Experts debate if hyperandrogenism, insulin resistance, or HPO-axis defects come first. It’s likely multifactorial (genetic predisposition + lifestyle + inflammation), blocking a universal fix.

• Secondary Forms: Some “PCOS” is reversible (thyroid issues, hyperprolactinemia), but primary PCOS persists as the ovaries retain polycystic morphology.

• Underfunding: The NIH allocates about $10M a year to PCOS vs. billions for rarer conditions. No FDA-approved PCOS-specific drug exists as pharma avoids it due to trial complexity across diverse patients.

What does treatment look like right now?

Treatment focuses on managing symptoms like hormonal imbalances, irregular periods, insulin resistance, and infertility through lifestyle changes and medications. You can tailor options to your goals whether that’s fertility, weight, or hair growth/loss.

Lifestyle First: Diet and Exercise Basics

Research shows that lifestyle changes restore ovulation in about 80% of cases with just 5-10% weight loss, even for lean PCOS. (For me personally, my cycle stopped coming due to a combination of significant weight loss and PCOS, but I have been told that my cycle should begin to self-regulate once my BMI is at a normal range for my body type. In the meantime, birth control has been regulating my menstruation.)

Mediterranean diets such as veggies, legumes, nuts, fatty fish have also been found to stabilize blood sugar better than low-fat or keto long-term. Aim for protein and fiber at every meal.

Daily exercise help symptoms significantly. This can include moderate walking or cycling plus resistance training 2-3x/week. Strength work lowers testosterone more than cardio alone while building muscle for insulin sensitivity.

Core Medications

• Combined Oral Contraceptives (OCPs): Best for regulating cycles, reducing acne/hirsutism. Low-androgen pills (e.g., drospirenone, Yaz, Ortho-Cyclen) suppress ovarian hormones effectively. As always, consult with a medical professional.

• Metformin: Tackles insulin resistance, aids modest weight loss and ovulation. However, less ideal for folks like me with lean PCOS.

• Inositol: Matches metformin for hormone balance and fertility with up to 30% pregnancy rate boost without nausea.

• Anti-androgens like spironolactone pair with OCPs for persistent hair growth. I was also on spironolactone for most of my late teens/early twenties for acne management.

Personalizing and Monitoring

Layer lifestyle under medications and reassess labs (glucose, lipids, androgens) every 6-12 months. You can pair working with an endocrinologist and gynecologist. Combos work best. It helps track what shifts your symptoms. Every case is unique and individualized, just sharing a bit of my experience so far.

If you have any thoughts or personal experiences, would love to hear them. What’s one treatment that’s worked for your PCOS?

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I guess we’re going to make this a thing now! I was listening to this album Gold while writing this. Love me some Cleo Sol!

Newsletter Update: Thinking of doing a once a month reflection on the last Tuesday of the month. Share a bit of life updates, inspirations, curiosity sparks, maybe “day-in-the-life” photos? Format TDB, but I’ll try with the first one next week! Stay tuned :)

If you’re new here and would like to learn a bit about me and this newsletter, see this piece: What I’m writing about in “The Realignment Room”

This piece is Part Three of my PCOS Diaries series, where I share my personal experience with PCOS alongside research-informed insights. If you’re new here, you can read it as a standalone essay or explore the rest of the series for more context.

Living with PCOS can feel like running a marathon you never signed up for, on a course that keeps changing without warning. Between symptoms, appointments, diet changes, and everyone’s opinion about your body (in my case, unintended weight loss), the mental load alone can be exhausting. This is where mindfulness comes in.

PCOS Is More Than Just Hormones

PCOS gets framed as a reproductive or metabolic issue. It is, but there’s more. There’s an emotional side mainstream media often skips.

Research confirms that women with PCOS face 60% higher depression/anxiety risk, with two-thirds experiencing at least one mood issue and 30-40% showing severe symptoms. Fatigue, mood swings, sleep issues, and high stress aren’t “just in our heads.” They’re tied to hormonal chaos, chronic inflammation, body image stigma, infertility fears, and weight gain (or weight loss for lean PCOS).

This has nothing to do with us being “too sensitive.” It’s because we’re dealing with a chronic condition in a world that doesn’t really understand it.

While also juggling the feeling that our body isn’t doing what it’s “supposed” to do.

In the background of all this, the political landscape in the U.S. is relentlessly loud on women’s health, abortion bans, threats to IVF and fertility care, fights over basic reproductive autonomy, so if you’re living with PCOS and already carrying the quiet grief and stress of possible infertility, every headline feels personal. Mindfulness steps in here, making your body a refuge, not just a battleground.

(I've linked PCOS, women's health, and legislative resources below this piece (Allara, SWHR, Ms. Magazine) because we matter, and you deserve updates on care that affects your body and rights!)

So What Is Mindfulness

Mindfulness isn’t just serene yoga and green juice. It’s a lot more layered. It’s the skill of noticing what’s happening in the present moment in tune with your thoughts, emotions, body sensations, with acceptance, no judgment, or trying to fix it. To be fully engaged with the “now.”

For PCOS, this can look like chest tightness when opening your period app, anxiety spike stepping on the scale, or a wave of shame from an acne breakout before a big interview. (Here are safe cycle trackers without data-sharing/government subpoena risks.)

Mindfulness doesn’t erase PCOS. But it can make living with PCOS less punishing. It makes you more aware of your emotions, resulting in better management.

What The Research Says

Research shows that mindfulness-based interventions can help alleviate PCOS related stress symptoms. In one study, women with PCOS who completed an 8‑week mindfulness-based stress reduction (MBSR) program saw significant drops in worry and overall psychological distress compared with controls.

Programs that blend mindfulness with lifestyle education, such as “PCOS Kind Mind Program” which style intervention for adolescents and young adults with PCOS, have shown improvements in stress, mood, and quality of life, while also supporting habits around medication, nutrition, movement, and sleep.

It works because stress, sleep, and emotional eating can all feed into symptom flare-ups for women with PCOS. Mindfulness interrupts that loop.

PCOS in a World on Fire

Now layer in the current moment. You’re managing a lifelong condition while you’re doomscrolling war, elections, climate disasters, and economic uncertainty. It’s not just “a lot”; it’s designed to hijack your nervous system.

According to Forbes, women and young people are especially vulnerable to climate anxiety, with a meta‑analysis of 94 studies across 27 countries highlighting that they report more worry, guilt, and helplessness about the future. 75% in one 2025 survey said politics harmed their mental health.

If you already have PCOS your nervous system is probably already on high alert (I know mine is, I struggle with anxiety). The news isn’t just “out there.” It can hit your body causing sleep disruption, changes in appetite, blood sugar swings, inflammation, flare‑ups of anxiety or low mood.

Mindfulness can’t fix the world, but it can change the way your body and mind metabolize it. You can stay informed, but regulate your consumption based on your needs. Allocate a time of day to reading the news and follow evidence‑based, solution‑oriented sources focused on context rather than shock.

3 Daily Mindfulness Practices for PCOS

• 3-breath reset: Before news/scale/app, pause for 3 slow breaths

• PCOS body scan: Notice jaw/chest/belly tension (5 mins daily)

• Name-it-to-tame-it: Label flare emotions (”shame,” “fear”) to loosen their grip

Mindful Self-Compassion & Body Positivity

Body positivity hits different with PCOS, because the “body stuff” is real: weight fluctuations, hair growth/loss, or acne. It hurts emotionally and socially. A mindfulness‑based take isn’t “I love everything about my body,” it’s “I’m learning to accept and love this version of my body and be more kind to it.”

Mindfulness can help shift you from constant criticism toward a sense of partnership with your body.

Books recs: If you’re a book person (like me!), look for titles that combine mindfulness, body image, and self‑compassion. Seek intuitive eating/self-compassion books with real exercises including body meditations and inner dialogue prompt.

Here are some books on body positivity to celebrate your body, or tools to help you in the process! I’ve read The Body Is Not an Apology, by Sonya Renee Taylor years ago, and I am currently re-reading it.

Mindfulness won’t cure PCOS or fix headlines, but it helps pause spirals, speak kinder to your body, and pick one small next step. Try a 3-breath news break or gentler mirror talk as these build a life where you’re more on your own side.

If you have any best practices for PCOS and mindfulness, let me know below!

This essay is part of my PCOS Diaries series, where I’m writing about diagnosis, delay, research, and awareness. Read Part One and Part Two.

PCOS, Women’s Health & Legislative Resources (all free access):

• Allara Health PCOS Newsletter
  Research-backed metabolic protocols and hormone updates for PCOS management.
  allarahealth.com/blog

• SWHR (Society for Women’s Health Research)
  2026 Women’s Health Policy Agenda - tracks legislation affecting reproductive care, infertility, PCOS treatment access.
  swhr.org/policy

• Ms. Magazine
  Reproductive rights coverage (abortion bans, IVF threats, Planned Parenthood funding) impacting PCOS patients.
  msmagazine.com

• Resolve: National Infertility Association
  PCOS fertility policy updates + political threats to IVF/ART access.
  resolve.org

• Endocrine Society News
  Hormone science + legislative alerts.
  endocrine.org/news-and-advocacy

References to Peer-Reviewed Papers

PCOS and Mental Health

• Surabhi Yadav, Olivia Delau, Adam J Bonner, Daniela Markovic, William Patterson, Sasha Ottey, Richard P Buyalos, Ricardo Azziz (2023) Direct economic burden of mental health disorders associated with polycystic ovary syndrome: Systematic review and meta-analysis eLife 12:e85338 https://doi.org/10.7554/eLife.85338

• Alnaeem, L., Alnasser, M., AlAli, Y., Almarri, F., Al Sultan, A. A., Almuhaysin, F. A., Boubshait, N. A., & Almulhim, L. A. (2024). Depression and Anxiety in Patients With Polycystic Ovary Syndrome: A Cross-Sectional Study in Saudi Arabia. Cureus, 16(1), e51530. https://doi.org/10.7759/cureus.51530

• Gül, Ö., Akkuş, M., & Akkuş, F. (2025). Depression, anxiety, and stress in polycystic ovary syndrome: understanding the impact of adult separation anxiety and uncertainty intolerance. BMC women’s health, 25(1), 377. https://doi.org/10.1186/s12905-025-03930-w

PCOS and Mindfulness

• Salajegheh, Z., Ahmadi, A., Shahrahmani, H., Jahani, Y., Alidousti, K., Nasiri Amiri, F., & Salari, Z. (2023). Mindfulness-based stress reduction (MBSR) effects on the worries of women with poly cystic ovary syndrome (PCOS). BMC psychiatry, 23(1), 185. https://doi.org/10.1186/s12888-023-04671-6

• Young, C. C., Monge, M., Minami, H., Rew, L., Conroy, H., Peretz, C., & Tan, L. (2022). Outcomes of a Mindfulness-Based Healthy Lifestyle Intervention for Adolescents and Young Adults with Polycystic Ovary Syndrome. Journal of pediatric and adolescent gynecology, 35(3), 305–313. https://doi.org/10.1016/j.jpag.2021.10.016

This piece is Part Two of my PCOS Diaries series, where I share my personal experience with PCOS alongside research-informed insights. If you’re new here, you can read it as a standalone essay or explore the rest of the series for more context.

For years, I was told nothing was wrong with me. I didn’t match the image most people, doctors included, associate with polycystic ovary syndrome (PCOS). I didn’t “look” like I had PCOS, so the idea was quietly ruled out before it was ever seriously considered. However, this bias is dangerous. It delays diagnosis, prolongs frustration, and often prevents people from getting the care they need.

PCOS is one of the most common hormonal disorders among women worldwide, impacting roughly 1 in 10 women and more than 5 million in the U.S. alone. Despite its prevalence, no two experiences look the same. Symptoms, severity, diagnosis timelines, and treatment approaches vary widely.

However, most medical literature and public awareness focus on weight gain, difficulty losing weight, and metabolic complications such as prediabetes or Type 2 diabetes commonly driven by insulin resistance and elevated androgen levels. In the U.S., some studies report up to 80% of women with PCOS are classified as overweight or obese using BMI criteria. As a result, body size and easily visible metabolic signs often become the default cues for diagnosis.

But what happens when none of those markers apply? When someone’s body type doesn’t raise red flags, their initial screenings look normal, or their symptoms don’t match the textbook definition of a PCOS patient? A meaningful subset of the PCOS population are left out.

When PCOS Doesn’t Fit the Stereotype

This is the case for people with lean PCOS. I didn’t even know this was a term before doing extensive research since my diagnosis. Lean PCOS impacts approximately 10-30% of people with PCOS, typically those with a BMI of less than 25. These individuals may have a normal or low BMI, yet still experience hormonal imbalances that disrupt ovulation, fertility, menstrual cycles, and mental health. Note: Lean PCOS is not a different condition from “regular” PCOS; it is the same syndrome. The term simply refers to individuals who have PCOS but do not fit the typical higher weight or BMI profile.

The misconception that lean PCOS is a “milder” form of the condition couldn’t be further from the truth. The absence of visible or expected signs doesn’t mean the condition is any less real, it just makes it less obvious and harder to recognize and take seriously. Because weight is so often used as a proxy for health, lean patients can fall through the cracks. Their symptoms are treated separately: birth control for irregular cycles, antibiotics for acne, antidepressants for anxiety and depression. All of this without anyone stepping back to look at the full hormonal picture.

That’s exactly what happened to me.

The result is fragmented care for a condition that requires a holistic approach - all because we don’t “look” the part.

The Cost of Being Missed

The cost of not fitting the textbook PCOS patient shows up quietly but accumulates over time. In my case, it was doctors telling me that I would “grow out of it” or my symptoms were due to stress or anxiety. Eventually, you start to doubt your own instincts. I started doing my own research and then advocated for myself. I changed doctors, went for a second, a third, and fourth opinion. When you are constantly dismissed, you start to lose trust in yourself too.

There’s a particular kind of gaslighting that happens when your labs are borderline, your body looks “fine,” and your symptoms are persistent but hard to quantify - yet you know something feels off. The number of times I’ve been told that I don’t have a health condition because “I’m skinny” is absurd. Body type does not exempt anyone from illness.

Finally receiving a diagnosis didn’t fix everything overnight, but it did validate my experience. It gave me permission to stop minimizing what I was feeling.

Understudied and Undervalued

Lean PCOS highlights a deeper issue. It exposes how often women’s health is misunderstood, underfunded, and understudied. While researching, I was only able to find a handful of peer-reviewed papers or scholarly articles on lean PCOS. I linked them below this piece if you’d like to check them out. Across the 315 medical conditions that receive federal support from the National Institutes of Health (NIH), PCOS ranks near the bottom, with about $10 million allocated for research in 2024. It was so underfunded that, until 2022, PCOS did not even appear as its own line item on the NIH funding list.

The underinvestment echoes a broader pattern. Women’s health has long been shaped by a historical system built on the male body as the default. Women are underrepresented in clinical trials, their symptoms dismissed, and their conditions like chronic pain, endometriosis, menopause, and PCOS remain persistently underdiagnosed. The consequences are higher misdiagnosis rates, longer delays in care, and less effective treatments.

Redefining What Health “Looks” Like

Lean PCOS forced me to confront how easily we equate appearance with health. It challenges us to rethink what illness should look like. Medicine must evolve beyond visual shortcuts and checklists to embrace nuance, complexity, and individualized care.

This experience exposes the limits of one-size-fits-all medicine and the risks of relying on appearance to guide belief or treatment. It perpetuates the misconception that PCOS is a predominately weight-related condition. It makes me wonder how many people are overlooked simply because they don’t “look” like they have PCOS.

If you don’t look the diagnosis, you still deserve one.

If this resonates with you, or if you have similar experiences, I’d love to hear them!

This essay is part of my PCOS Diaries series, where I’m writing about diagnosis, delay, research, and awareness. You can read Part One here: My Diagnosis, What Comes Next, and the “Swiss‑Cheese” Ovary

References to Peer-Reviewed Papers and Scholarly Articles on Lean PCOS

1. Elnashar, A. (2024). Lean polycystic ovary syndrome: A narrative review. Clinical and Experimental Obstetrics & Gynecology, 51(6), 142. https://doi.org/10.31083/j.ceog5106142

2. Toosy, S., Sodi, R., & Pappachan, J. M. (2018). Lean polycystic ovary syndrome (PCOS): an evidence-based practical approach. Journal of diabetes and metabolic disorders, 17(2), 277–285. https://doi.org/10.1007/s40200-018-0371-5

3. Whooten, R. C., Rifas-Shiman, S. L., Aris, I. M., Perng, W., Chavarro, J. E., Oken, E., & Hivert, M.-F. (2025). Adolescent “lean PCOS” is characterized by higher insulin levels and an unfavorable cardiometabolic profile. The Journal of Clinical Endocrinology & Metabolism. Advance online publication. https://doi.org/10.1210/clinem/dgaf606

4. Zhang, Y., Liu, X., Wang, J., Chen, L., Li, H., & Zhao, Q. (2025). Analyzing and evaluating the metabolic and endocrine characteristics between lean and obese patients with polycystic ovary syndrome (PCOS): A systematic review and meta-analysis. Frontiers in Endocrinology, 16, 1680685. https://doi.org/10.3389/fendo.2025.1680685

“Your left ovary looks like Swiss cheese,” said my gynecologist. “What does that mean?” I replied. Puzzled because I am slightly lactose intolerant! “It’s PCOS,” she confirmed.

I’ve had hormonal issues for years. I’ve struggled with acne my entire life. I remember getting bullied in junior high school because I was very thin and had noticeable breakouts. On the morning of my undergrad commencement, I had a breakdown in the bathroom because I had a horrible breakout. I didn’t want to walk across the stage because of how bad it was. After a quick pep talk from a friend and a pound of foundation later, I kept my chin up and was good to go. I ran to the line-up minutes later because I was late.

For years, I’ve had irregular menstrual cycles. When I was in college, I was told it was stress induced. I was an engineering and neuroscience double major. Looking back, it was a lot of academic rigor to manage at the time on top mental health struggles. However, doctors always brushed it off and told me I was young, that it would regulate eventually, that I would grow out of it. But I never did.

After graduating, acclimating into adulthood, and starting my career in corporate, my cycles continued to change. I was given birth control to band-aid the issue, but I felt like no one was listening to me. Birth control definitely helped with the symptoms, and I was so grateful, however I felt that we weren’t getting to the root of the problem. A few years ago, I had 2 years of horrendous periods. The first two days of my cycle were so painful I would almost pass out. I couldn’t even function, much less work at my job. I thought I had endometriosis, but doctors said it wasn’t that. Thankfully, I was remote at the time, but I know many women aren’t able to have that luxury.

Then one day, everything stopped….literally. About a year ago, my cycle started coming every 3 weeks. But the pain was gone. Disappeared. (Yay! But also something is up with my body.) At my annual gynecologist appointment, I brought it up along with my other symptoms of increased acne, weight fluctuation, mood changes, anxiety, and hair loss. My blood work showed elevated levels of androgens, which is a key indicator of PCOS. (I also had extreme dehydration and thought I had diabetes. PCOS actually increases the risk of developing Type 2 diabetes due to insulin resistance. Women with PCOS often have prediabetes or Type 2 diabetes.) However, my pelvic ultrasounds were normal, and I’ve always been naturally thin and petite. Because PCOS is often associated with weight gain and a different body type, my doctors initially ruled it out.

A few months later, my cycle stopped altogether. I wasn’t menstruating at all. I went back to my gynecologist and had another pelvic ultrasound. “Your left ovary looks like Swiss cheese…..it’s PCOS,” she confirmed. PCOS ovaries appear similar to the appearance of “Swiss cheese” or a “string of pearls” on an ultrasound, hence the name. This is the result of the accumulation of numerous small, immature, fluid-filled sacs, known as follicles.

I asked her why it didn’t show up in any of my other scans. She said that sometimes it doesn’t show, but it was now showing for me. I had a moment to gather myself in the office because there was finally visible evidence. It was palpable. We had an official diagnosis. I was sad but felt more relief. Finally, an answer. Then, my gynecologist followed with the suggestion of fertility specialists whenever I was ready to conceive - which wasn’t something I was even thinking about at the time. That has always been kept in the back of my mind as something I would do down the line, but when someone tells you that the possibility will be slightly more difficult, it makes you rethink everything. All of a sudden, I am mourning a life I don’t even have yet.

There is no cure for PCOS, but symptoms are manageable through lifestyle changes, diet, exercise, and medications. It has made me more health conscious, and I have embarked in this new health journey. I’ll be sharing a bit of that and some educational content through this PCOS Diaries series as I learn more. Stay tuned!