EYNTK about PCOS
Lucy Sarret speaks to Dr Hussain to break down how to know when to ask your doctor if you might have PCOS, and how to manage it in a healthy way long-term
vijith vijayan via Unsplash
PCOS (Polycystic Ovary Syndrome) is one of the most common hormonal conditions, yet it’s still wildly misunderstood. With one in eight women suffering from it in the UK alone, it’s safe to say most of us know someone who is personally affected.
If you’ve ever been told that losing weight will "fix" your symptoms, or that you should "just go on the pill", you're not alone.
But PCOS is so much more than irregular periods – it’s a whole-body condition that affects metabolism, hormones, mental health, and even your long-term heart health.
To break it all down, we spoke to Anne Hussain, author of The Period Literacy Handbook and a naturopathic doctor who specialises in PCOS (and has it herself). She explained what PCOS really is, why it looks different for everyone, and how to manage it without falling for outdated advice.
So, what is PCOS actually?
Essentially, PCOS affects how a biological woman’s ovaries work. “PCOS is a whole-body metabolic and hormonal condition that involves many organs in the body,” Hussain explains.
One of the key characteristics is insulin resistance, meaning the body struggles to regulate blood sugar, producing more insulin than usual. “This leads to sex hormone changes that affect menstrual health.”
It’s also lifelong. “PCOS comes with some risks that people without it don’t have, but we can manage it to support both current and future health,” she adds.
According to the NHS, you need at least two of these symptoms to be diagnosed with PCOS:
irregular periods – which means your ovaries do not regularly release eggs (ovulation)
excess androgen – high levels of "male" hormones in your body, which may cause physical signs such as excess facial or body hair
polycystic ovaries – your ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs (but despite the name, you do not actually have cysts if you have PCOS)
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How does PCOS affect your body?
Many people assume PCOS is only an issue if you're trying to get pregnant, as it impacts your ovaries, but it actually has effects on almost every part of your body.
“It increases the risk of heart disease, type 2 diabetes, gestational diabetes, hypertension, endometrial hyperplasia, and even uterine cancer,” says Hussain. It’s also linked to:
Hair loss, acne, and excess body hair due to high androgens (male hormones).
Mental health struggles –people with PCOS have higher rates of depression, anxiety, disordered eating, and body image distress.
Sleep issues –you’re nearly 10 times more likely to have obstructive sleep apnoea.
Digestive problems like IBS.
Vitamin deficiencies (especially vitamin D).
Higher rates of autoimmune thyroid disease.
Why does PCOS look so different for everyone?
One of the most frustrating things about PCOS is how varied the symptoms are. Factors like genetics, lifestyle, access to healthcare, childhood experiences, and even where you live all play a role.
“Because of this, PCOS presents differently in different people, and our strategies will need to be personalised”, Hussain explains.
That means treatment isn’t one-size-fits-all. While lifestyle changes (like nutrition, exercise, and stress management) are always part of the plan, other treatments depend on your specific symptoms and goals.
“PCOS presents differently in different people, so our strategies need to be personalised”
The best treatments for PCOS: what actually works?
There’s no cure for PCOS, but there are plenty of ways to manage symptoms. The best approach is a combination of lifestyle, supplements, and medication, tailored to your needs.
Birth control: helpful but not the only option
The combined pill is often the first thing doctors prescribe for PCOS because it reduces testosterone, regulates periods, and provides contraception. But it’s not for everyone.
“It doesn’t address the metabolic aspects of PCOS,” Hussain warns.
Read more: Finding The Best Type Of Contraception For Me
Metformin & GLP-1 medications
Metformin is commonly used for insulin resistance, and Hussain says GLP-1 medications (like Ozempic) are showing promise for weight management and metabolic health.
The best supplements for PCOS
There’s a lot of hype around PCOS supplements, but some actually have strong scientific backing:
Inositols: These are the most studied supplement for PCOS, according to Hussain. They help with ovulation, cycle regularity, acne, insulin resistance, and even pregnancy outcomes.
NAC: Supports ovulation and insulin sensitivity, though not as effectively as metformin.
Berberine: “Great for insulin resistance and cholesterol, but we don’t have long-term studies yet,” Hussain says.
Diet & PCOS: what to eat and what to avoid
Forget strict diets – PCOS nutrition should be about balance, not restriction. Instead of listening to that woman on your TikTok for you page that explains how she eats three green juices to manage her self-diagnosed PCOS, stick to what the experts tell you.
“We should encourage more grains, fruits, vegetables, proteins, nuts, seeds, fish, olive oil, and dairy,” says Hussain.
For insulin resistance and heart health, Hussain recommends you aim for:
Fibre: More than 25g per day
Healthy fats: Omega-3s from fish, nuts, and olive oil
Less saturated fat: Minimise butter and processed meats
Low sodium: Under 1500mg per day
And beware of ultra-processed foods –they’re often high in sugar and unhealthy fats but low in actual nutrients.
Read more: Why you don’t need a January diet
Sex, libido, and PCOS
If PCOS is messing with your libido, you’re not imagining it.
“PCOS can affect sex drive due to hormone imbalances, body image distress, fatigue, and irregular periods,” says Hussain. Vaginal dryness is also common, but she reassures, “There are over-the-counter and prescription options available to help.”
Can you still track your cycle with PCOS?
Absolutely. “Tracking is always a good practice,” says Dr. Hussain. “Log the start and end of each period, plus any other symptoms.” This helps identify patterns and flags when you might need medical support.
A big warning sign? Going more than three months without a period (unless you’re pregnant or on hormonal birth control). “This increases the risk of endometrial hyperplasia, so you should see a doctor to help shed the uterine lining.”
Do you have to lose weight to manage PCOS?
Short answer: No.
“PCOS affects people of all shapes and sizes, and discussions about weight can even cause harm due to disordered eating,” says Hussain.
While maintaining a healthy weight can help with symptoms, the focus should be on building muscle, managing insulin resistance, and preventing long-term health risks —not crash dieting.
Can you get pregnant with PCOS?
Another common myth is that PCOS makes pregnancy impossible.
“PCOS is the most common cause of anovulation, which means you’re not releasing an egg,” explains Hussain. That can make conception trickier, but not impossible.
If you’re trying to conceive, managing insulin resistance, vitamin D levels, and thyroid health can all improve your chances. However, even after getting pregnant, people with PCOS have higher rates of pregnancy loss and complications –so it’s important to have proper medical support.
The one thing everyone with PCOS should know
Hussain’s biggest piece of advice?
"Your PCOS is not your fault. There are factors you can influence and factors beyond your control. Find a healthcare team that listens, and don’t wait to start managing your symptoms."