Naturopath in Burnaby and Virtual Care Across BC | Dr. Mélanie DesChâtelets, ND

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Is This Really PCOS? Teen Diagnosis, and Why It’s Different

By Dr. Mélanie DesChâtelets, ND · Naturopathic Doctor and Menopause Society Certified Practitioner · Burnaby and virtual care across BC

Maybe you were diagnosed with PMOS (formerly PCOS) as a teenager. Or maybe you’re under 19 right now and wondering how PCOS is even diagnosed at your age. Here’s the tricky part: diagnosing PCOS in teens is different. The same rules we use for adults don’t apply, and that trips a lot of people up. So if you’re 19 or under, or you were labeled as a teen and you’re older now, this matters… because you’ll want to make sure you actually would have met the adolescent criteria in the first place.

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Why is PCOS in teens diagnosed differently?

Because a teenage body is still finding its rhythm. In the years right after your first period, the communication between your brain and your ovaries is just getting started, so some things that look like PCOS in teens are actually normal for the stage. That’s also why PCOS can look so different from one person to the next… maybe you were given a diagnosis and you look at a friend with the same label and your symptoms barely overlap. Or you suspect you have it but you’ve never really been told what it should look like. To protect against over-diagnosing during a normal phase, the criteria are stricter before 20.

What are the two adolescent criteria?

In this age group, we don’t have a reliable way to assess ovarian morphology, so ultrasound and AMH are off the table. That means the adult “two out of three” rule becomes a stricter “two out of two.” You need both: irregular cycles (defined very specifically for teens, more on that below) and androgen signs, either symptoms or blood work. If you only have one of the two, it can be considered “PCOS at risk,” as long as other causes for those symptoms have been explored first.

What do high androgens look like in a teen?

First we look for the obvious symptoms: aggressive acne that doesn’t respond well to treatment or is very persistent as you get older, a certain kind of hair thinning where the parting line keeps getting wider, or excess hair on the face, tracking up toward the belly button or down the legs.

Here’s a big clinical pearl, though. In PCOS, high-androgen symptoms tend to come on slow and progressive. If excess facial hair shows up very suddenly and very severely, that can point to other causes, and it deserves a different workup. So if it’s fast, flag it… it’s worth raising clearly with your provider so the right testing gets done.

What counts as an irregular cycle for a teen?

This is the part that’s defined differently than in adults, and it all depends on how many years it’s been since your first period. In the first year, irregular cycles are normal. From one to under three years after your first period, cycles shorter than 21 days or longer than 45 days count as irregular. At three years and beyond, the window tightens to shorter than 21 or longer than 35. And at any point more than a year out from your first period, a single cycle of 90 days or more counts too. The cut-offs loosen early on for a reason… your body is still getting the conversation going.

Why doesn’t an ultrasound count under 19?

You may have had a pelvic ultrasound for other reasons, but for diagnosing PCOS, it isn’t reliable until it’s been about 8 years since your first period (which for many is around age 20). Before that, the ovaries normally show more follicles, so an ultrasound can look “polycystic” when nothing is actually wrong. So if you’ve been hanging your diagnosis on an ultrasound done as a teen, it’s worth reconsidering and checking whether you meet the other two criteria.

What does “PCOS at risk” mean, and when do you reassess?

Some teens have a few PCOS features but not quite enough for a clear diagnosis… maybe some irregular cycles but not much on the androgen side, or the reverse. Once other causes have been ruled out, that’s when we’d call it “PCOS at risk.” It’s not a “no,” and it’s not a “yes.” It’s a “let’s keep an eye on this.” The recommendation is to reassess for the first time once it’s been at least 8 years since your first period (which for many is around age 20), when ovarian morphology testing (ultrasound, or AMH if you’d rather not do an internal ultrasound) finally becomes accurate.

I spend a lot of time on this because clarity is everything. If you don’t get this first part right, it affects every decision after it. So whether the answer is a clear yes, a not-yet, or a “let’s watch,” knowing exactly where you stand is the whole point.

▶ Want the full walk-through, with all the age cut-offs explained? Watch the complete video here.

Is this you?

Shift Society is my community for women navigating PMOS (formerly PCOS) and metabolic health. Members get my Lab Clarity Mini-Series & Checklist to help you make sense of your bloodwork, plus the member resources from my videos. Real science, real talk. If that’s you, come join us and try it with the 7-day free trial.

Start your 7-day free trial

Ready to look at your own picture?

If you’re in BC, a Clarity Call is a free, up to 15 minute fit conversation, not a medical visit. We figure out whether working together makes sense, and I point you in the right direction either way.

Book a free Clarity Call

Virtual across BC · No pressure, ever

This article is educational, not medical advice or a diagnosis. If something here resonates, bring it to your healthcare team, who can look at it through the lens of your individual health.

If you were the teen who got that label years ago and never revisited it, I wrote this one for you: Diagnosed With PCOS as a Teen? Why It’s Worth a Second Look.

Main references
  1. Teede HJ, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023. PubMed

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Do I Really Have PCOS or Not? How Adult Diagnosis Works

By Dr. Mélanie DesChâtelets, ND · Naturopathic Doctor and Menopause Society Certified Practitioner · Burnaby and virtual care across BC

Do I really have PMOS (formerly PCOS)… or not? It’s one of the most common questions I hear. Sometimes you’re convinced you have it, but no one has ever actually diagnosed you. Other times you’ve been told you have it, and it just doesn’t feel right, or it looks nothing like the PCOS your friend has. And that’s the tricky part. A PCOS diagnosis isn’t as straightforward as it sounds, and if it isn’t done right, every decision after it can be off track. So here’s exactly how PCOS is diagnosed when you’re 20 or older.

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How is PCOS diagnosed in women 20 and older?

For adults, a PCOS diagnosis comes down to the Rotterdam criteria… the “two out of three” rule. You meet it when two of these three are present, after other causes have been ruled out: signs of high androgens, irregular cycles, or polycystic ovarian morphology (seen on ultrasound, or as an elevated AMH on blood work). Two of three. Not one. One quick nuance on the age line, though: what actually matters isn’t your birthday, it’s that it’s been about 8 years since your first period (which for most people is around age 20). Before that, the diagnostic rules are different. The ruling-out-other-causes part is its own important step, and a whole separate conversation. But the inclusion side starts here.

What counts as high androgens?

High androgens can show up as symptoms or on labs. The symptoms look like excess hair growth on the face, or tracking down toward the belly button or the thighs. Persistent acne that doesn’t let up after the teen years, or acne that’s more aggressive and treatment-resistant when you’re younger. Or female-pattern hair thinning, usually at the crown, where the parting line slowly widens.

And here’s the important part. If those symptoms are clearly present, that alone can count. You don’t always need blood work to confirm high androgens, because we can see them. When the symptoms are subtle or unclear, that’s when labs help. The main ones are total and free testosterone, and when free testosterone isn’t available, we can calculate it using the free androgen index. Sometimes we also look at DHEA-S, which comes from the adrenal glands but is still very androgenic.

Why can’t you test androgens while you’re on the pill?

Here’s a major quick pearl. If you’re on the combined oral contraceptive pill, it’s really hard to reliably measure your androgens. The pill raises sex hormone binding globulin and lowers your available androgens. So if your androgens were tested while you were on the pill, you can’t rely on those numbers. If testing is truly necessary, the guidelines suggest coming off the pill for at least three months, using another form of contraception during that time, and then testing.

What actually counts as an irregular cycle?

This one is defined pretty specifically… it’s not just being off by a couple of days. Irregular means cycles shorter than 21 days or longer than 35 days, or fewer than eight cycles a year. And if you’re more than a year past your first period and you’ve had a single cycle stretch past 90 days, that counts as irregular too.

Do you need an ultrasound to diagnose PCOS?

Not always. This is where the myths pile up. Myth one: everyone needs a pelvic ultrasound. Not true. If you already meet two of the three criteria, you don’t need one. Myth two: an ultrasound done as a teenager still counts. It doesn’t. A pelvic ultrasound isn’t reliable for diagnosing PCOS until it’s been about 8 years since your first period (which for most is around age 20). Before that, the ovaries normally show more follicles, so the scan can look “polycystic” when nothing is actually wrong. Myth three, the big one: polycystic ovarian morphology means ovarian cysts. It doesn’t. What we’re actually counting is follicles. In plain language, think of it as how many eggs are running the show. That’s a completely different thing from ovarian cysts.

And here’s the 2023 update worth knowing about. There’s now a blood test, AMH, that can stand in for the ultrasound. If AMH is elevated, it correlates with a high follicle count. This matters because not everyone has access to a pelvic ultrasound, and some people don’t feel comfortable with an internal one. So it opens a door to access.

Can one symptom on its own mean PCOS?

No. An irregular period on its own isn’t PCOS. High-androgen symptoms on their own aren’t PCOS. One ultrasound finding on its own isn’t PCOS. You need two of the three criteria, and you need the other causes ruled out. And if you’re 19 or younger, the diagnostic rules shift… that’s its own video.

Because here’s the thing I keep coming back to: with clarity comes power. When you actually understand what your PCOS diagnosis rests on, every decision after it gets a little easier… and a lot less frustrating.

▶ Want the full walk-through, with the examples and the nuance? Watch the complete video here.

Is this you?

Shift Society is my community for women navigating PMOS (formerly PCOS) and metabolic health. Members get my Lab Clarity Mini-Series & Checklist to help you make sense of your bloodwork, plus the member resources from my videos. Real science, real talk. If that’s you, come join us and try it with the 7-day free trial.

Start your 7-day free trial

Ready to look at your own picture?

If you’re in BC, a Clarity Call is a free, up to 15 minute fit conversation, not a medical visit. We figure out whether working together makes sense, and I point you in the right direction either way.

Book a free Clarity Call

Virtual across BC · No pressure, ever

This article is educational, not medical advice or a diagnosis. If something here resonates, bring it to your healthcare team, who can look at it through the lens of your individual health.

If you want to check your own diagnosis against the criteria, step by step, that’s over here: PCOS Diagnosis Criteria: How to Check Whether Yours Was Done Right.

Main references
  1. Teede HJ, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023. PubMed

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What Inflammation in PMOS · PCOS Actually Means (and How to Start Lowering It)

By Dr. Mélanie DesChâtelets, ND · Naturopathic Doctor and Menopause Society Certified Practitioner · Burnaby and virtual care across BC

“Inflammation” comes up constantly with PMOS (formerly PCOS), but what does it actually mean? Most people use the word casually for bloating, brain fog, or feeling puffy after a big meal. When we talk about inflammation in PCOS, we mean something more specific: a measurable biological process you can see in lab work. It’s real. It’s just not the thing most people picture. Let’s clear up what it is, why it shows up with PMOS · PCOS, and one practical place to start lowering it, no restriction or rigid rules required.

Quick note: this is educational, not medical advice, and it isn’t a stand-in for your own care team. Take notes and bring anything that resonates to them.

▶ Liked this video? Subscribe on YouTube.

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In this article

What does inflammation in PCOS actually mean?

It’s a measurable biological process, not a feeling. Inflammation isn’t “I feel bloated” or “I’m tired after lunch.” When we talk about inflammation in PCOS, we mean markers we can actually measure in your blood. Inflammation is how your body responds to injury, infection, or stress. Sometimes that’s one big inflammatory event. In chronic conditions, it’s more often a quiet, low-grade hum, sometimes not even high enough to get flagged on a standard panel, but still not as low as someone without PMOS.

Is inflammation in PCOS real, or just a wellness buzzword?

It’s real, and on average measurable. When you compare bloodwork, people with PMOS · PCOS tend to have more inflammation than people without it. That does not mean everyone with PCOS has high inflammation. Think of it as a spectrum: on one end, really high inflammation; on the other, the chronic low-grade kind, which is what we see more often with PMOS. The low-grade version is quiet, but it still matters. Even at a low hum, it quietly shifts a lot of other things in the background.

What is CRP, and should I test it for PCOS?

CRP is the most common inflammation marker, and it’s more of a smoke detector than a diagnosis. C-reactive protein (CRP) tells you there’s a signal, but not where it’s coming from. The alarm is going off, and you still have to find the source.

Testing it isn’t standard of care. The PCOS guidelines don’t say you have to test CRP, so it isn’t a must-have. My own take is a little more nuanced. The people who come to see me often want to be proactive and see where they sit on the spectrum, so with some of them we’ll test it. It’s relatively low-cost, and it can give a more objective read on how you specifically respond to lifestyle, supplements, or medication over time. It’s a conversation to have with your own care team, who can decide with you. The reason it’s not standard of care is simple: most people should shift toward inflammation-friendly eating anyway, so for many the test doesn’t change the plan.

Why does inflammation show up with PCOS?

Because it’s tangled up with the rest of PMOS, like the base of a soup. Studies suggest people with PCOS, even in smaller bodies, often run slightly higher CRP than people of similar size without it. It’s not always dramatic, but it’s there. I want you to think of inflammation as the base of your soup. It seems to throw off a lot of other things, with relationships to insulin resistance and higher androgens. Not everyone with PMOS has high inflammation, and high inflammation isn’t only a PCOS thing, but they do like to hang out together. Picture that base quietly nudging your hormone signaling and insulin sensitivity, and you’ve got the idea.

What is the best anti-inflammatory diet for PCOS?

Honestly, there’s no single “anti-inflammatory diet,” because the term has no standard definition. One influencer’s version looks nothing like the next one’s. There is one validated research definition, but it’s based on a scoring sheet you have to pay for, so it’s not much help in day-to-day life.

Here’s what is helpful. A lot of eating patterns lower inflammation, and they have far more in common than not, like the Mediterranean and DASH patterns. I focus on the Mediterranean pattern because it has the most research behind it for lowering CRP. At its base, that means higher-fiber carbs like beans and lentils, healthier fats like olive oil, nuts, and fish, less saturated fat, and lots of colorful produce.

The Mediterranean Diet Score is a simple yes/no self-check. As your score goes up, your risk goes down, and a higher score is associated with lower cardiovascular disease and all-cause mortality. Rate yourself honestly, celebrate your wins, then spot your gaps:

  • Is olive oil your main cooking fat?
  • Do you use more than 4 tablespoons of olive oil a day?
  • 2 or more servings of vegetables a day?
  • 3 or more servings of fruit a day?
  • Less than 1 serving of red or processed meat a day?
  • Less than 1 serving of butter, margarine, or cream a day?
  • Less than 1 sugar-sweetened soda a day?
  • 3 or more servings of legumes a week?
  • 3 or more servings of fish or seafood a week?
  • Fewer than 3 commercial sweets or pastries a week?
  • At least 1 serving of nuts a week?
  • Poultry routinely instead of red meat or sausage?
  • Cooking with garlic, tomato, onion, or leek a couple of times a week?

One honest note. The original validated form also asks about wine. Newer research links alcohol to higher cancer risk, so if you don’t drink, or you drink less, I’m not recommending you start. I expect future versions of this tool to update that question. And a fair caveat: the PCOS guidelines don’t name the Mediterranean diet specifically, they point to general population guidance. But there’s far more overlap than difference, so the score is a practical way to see the factors that matter.

How do I start lowering inflammation with PCOS?

Pick one “no” from that list and turn it into a “yes.” That’s the whole first step. Every “no” you flip nudges your score in the right direction, and you don’t need to overhaul your life or give up your culture to do it. My job is to translate research into real-world strategy without telling you to eat like an influencer.

The part that actually moves the needle isn’t more information, it’s doing the thing, not just thinking about it or consuming about it. Set one small, sustainable change as a goal this week. Then, if you want a more objective read over time, that’s where a conversation with your care team about something like CRP can fit. Information is useful. Action is what changes the soup.

Want the full walk-through in my own words? Watch the full video here, and if it lands, subscribe to my YouTube channel for more like it.

Is this you?

Shift Society is my community for women navigating PMOS (formerly PCOS) and metabolic health. Members get my Lab Clarity Mini-Series & Checklist to help you make sense of your bloodwork, plus the member resources from my videos. Real science, real talk. If that’s you, come join us and try it with the 7-day free trial.

Start your 7-day free trial

Ready to look at your own picture?

If you’re in BC, a Clarity Call is a free, up to 15 minute fit conversation, not a medical visit. We figure out whether working together makes sense, and I point you in the right direction either way.

Book a free Clarity Call

Virtual across BC · No pressure, ever

This article is educational, not medical advice or a diagnosis. If something here resonates, bring it to your healthcare team, who can look at it through the lens of your individual health.

And if the food side is where you want to start, I got specific about it here: The Anti-Inflammatory Diet for PCOS: What Actually Helps.

Main references
  1. Teede HJ, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023. PubMed

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PCOS and High Cholesterol: The Heart Risk Most Women Get Told to Shrug Off

By Dr. Mélanie DesChâtelets, ND · Naturopathic Doctor and Menopause Society Certified Practitioner · Burnaby and virtual care across BC

You’re young, you’re active, and maybe your cholesterol is just a little bit high, so it gets shrugged off. Or you live in a larger body and get told “just lose weight,” with little thought given to the fact that you have PMOS (formerly PCOS). Here’s the part most people miss: if you have PMOS · PCOS, that little number might be your heart’s early warning system. So let’s talk about high cholesterol with PCOS. What gets overlooked, why it happens, and what you can actually do about it.

Quick note before we go further. This is educational, not medical advice, and I’m not your naturopathic doctor. Think of it as the version with popcorn. Binge responsibly, take notes, and loop in your own healthcare team.

▶ Liked this video? Subscribe on YouTube.

Want this kind of straight talk in your inbox? One short email a week on PMOS / PCOS and metabolic health. No spam, unsubscribe anytime.

In this article

Does PCOS cause high cholesterol?

PMOS · PCOS changes how your body produces, transports, and clears cholesterol. Picture a complicated transport system. With PCOS, that system tends to shift, so more people with PMOS run higher cholesterol than people of the same age and size who don’t have it.

Look a little deeper, at the ratios, and another pattern shows up. People with PCOS more often carry the atherogenic type of cholesterol. That’s the type that likes to slip under the endothelial cells lining your blood vessels and form plaques. The drivers are partly genetic and partly hormonal, things like higher testosterone and insulin resistance. Here’s my analogy for it: imagine your delivery trucks are broken or poorly routed. The whole delivery system ends up working against you instead of for you. And this can show up even at a healthy body weight, even when your diet is pretty on point. It isn’t a willpower problem.

This metabolic side of things is so central that it’s one of the big reasons the condition is being renamed PMOS, Polyendocrine Metabolic Ovarian Syndrome. The new name pulls the metabolic piece (blood sugar, insulin, cholesterol, your heart) out of the shadows and puts it front and centre, where it belongs.

Why does cholesterol matter if I’m young and active?

Because lifetime exposure matters more than any single test. One cholesterol reading is a snapshot, a photo, not the whole story.

For someone getting their cholesterol checked later in life, that snapshot run through a risk calculator gives a decent estimate. But those calculators aren’t accurate for people who’ve had high cholesterol from a young age, or who carry genetic factors. The research now points to cumulative exposure over decades as a big contributor to risk. Picture two women with the exact same cholesterol number today, both in their 60s. One has had it running high since her 20s; the other developed it only recently. Same number on the page, but the first woman carries the higher lifetime risk, because her body has been exposed to it for decades longer. The snapshot is identical. The story behind it isn’t.

It’s the length of the movie that matters. Start early, and your movie is really long. That’s a lot more screen time for poor cardiovascular health to build. Which is exactly why catching this early is such a powerful position to be in.

Should I get a cholesterol test if I have PCOS?

Yes, and the guidelines back this up. The 2023 international PCOS guideline (Teede HJ et al.) recommends that everyone gets a full lipid panel at diagnosis. All bodies. Regardless of size, age, or symptoms.

This gets missed a lot, because people being diagnosed with PCOS are often young and not on anyone’s radar for cholesterol screening. We forget that the PCOS diagnosis is itself the reason to look. So when you’re diagnosed, we want to know where you’re starting from.

What happens after that first panel is more nuanced, and it’s a conversation with your provider. Very low risk at the first screen? Maybe it’s not checked often. Higher end out of the gate? Then you’re on a path of closer monitoring and support, lifestyle plus possible other interventions. A fair question to bring to your next appointment: “Have I had a full cholesterol panel?”

What LDL level should be screened for familial hypercholesterolemia?

There’s a separate genetic condition worth knowing about: familial hypercholesterolemia (FH), high cholesterol present from birth. People with PCOS are more likely to run higher cholesterol and get flagged sooner, but if we just blame PCOS and never look closer, we can miss FH. And the risks with FH are even higher, so it’s worth screening for if you’ve had a high reading.

These are LDL thresholds worth a conversation, worth screening for. They are not diagnostic. They’re a signal to look closer with your provider, nothing more:

  • Age 40 and up: LDL greater than 5.0 mmol/L (193 mg/dL)
  • Ages 18 to 39: LDL greater than 4.5 mmol/L (174 mg/dL)
  • Under 18: LDL greater than 4.0 mmol/L (155 mg/dL)

Suspicion goes up if you have family-history red flags too: several first-degree relatives with high LDL, or early heart disease (men having heart attacks before 55, women before 65). If any of this sounds like you, that’s a reason to loop your provider back in. It’s an added wild card in the deck, not a diagnosis.

Can I lower my cholesterol with PCOS?

This can feel like a lot. PCOS symptoms are already plenty, and now the heart is in the conversation too. So here’s the good news, and it’s genuinely good: the evidence-backed eating patterns for blood sugar and inflammation are the same ones that support heart health. The solutions converge. What helps one tends to help the others.

There’s positive research for heart health behind the Mediterranean diet, the portfolio diet, getting adequate fiber, movement that fits your life (aiming for 150 to 300 minutes a week), and quality sleep. The solutions pile onto a similar theme, which makes this less overwhelming, not more.

The real point is awareness. This shouldn’t get shrugged off. When you know your cholesterol runs higher earlier in life, you’re in a powerful position to work with it: lifestyle first, possibly targeted nutrients, possibly medication, all in partnership with your care team. Information is power. Small steps now means a huge compounding difference later.

The short version

PMOS · PCOS isn’t only about hormones. Your heart is part of the story. Everyone diagnosed deserves a full lipid panel at diagnosis. Know your family history. And if your LDL meets one of those thresholds, loop your provider back in. It isn’t diagnostic, it just means it’s worth a closer look. The earlier you start the conversation, the longer your runway to change the trajectory.

Want the full walk-through in my own words? Watch the full video here, and if it lands, subscribe to my YouTube channel for more like it.

Is this you?

Shift Society is my community for women navigating PMOS (formerly PCOS) and metabolic health. Members get my Lab Clarity Mini-Series & Checklist to help you make sense of your bloodwork, plus the member resources from my videos. Real science, real talk. If that’s you, come join us and try it with the 7-day free trial.

Start your 7-day free trial

Ready to look at your own picture?

If you’re in BC, a Clarity Call is a free, up to 15 minute fit conversation, not a medical visit. We figure out whether working together makes sense, and I point you in the right direction either way.

Book a free Clarity Call

Virtual across BC · No pressure, ever

This article is educational, not medical advice or a diagnosis. If something here resonates, bring it to your healthcare team, who can look at it through the lens of your individual health.

If you’re looking at your own panel and wondering which numbers matter, I broke that down here: PCOS and Cholesterol: Which Numbers to Know (and Why They Matter).

Main references
  1. Teede HJ, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023. PubMed
  2. Brunham LR, et al. Canadian Cardiovascular Society Position Statement on Familial Hypercholesterolemia: Update 2018. Can J Cardiol. 2018. PubMed
  3. Teede HJ, et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. The Lancet. 2026. PubMed

By

Can You Reverse PMOS · PCOS? Why “Cure” Is the Wrong Word

By Dr. Mélanie DesChâtelets, ND · Naturopathic Doctor and Menopause Society Certified Practitioner · Burnaby and virtual care across BC

Have you heard someone say you can reverse PCOS, or maybe even cure it? I want to talk about why that messaging is misleading, and honestly, why I think it’s a little dangerous. PMOS (formerly PCOS) is what the clinical guidelines call an enduring diagnosis. If you’ve been properly diagnosed, it’s a diagnosis you have for life. So “cure” and “reverse” set you up to expect something that isn’t how this condition works. And the cost of that expectation is real.

I’m not saying this to take anything away from you. I’m saying it because the truth gives you better footing than a promise that doesn’t hold.

▶ Liked this video? Subscribe on YouTube.

Want this kind of straight talk in your inbox? One short email a week on PMOS / PCOS and metabolic health. No spam, unsubscribe anytime.

In this article

Can you cure PCOS?

No. PMOS · PCOS is an enduring diagnosis, and that’s not my opinion, it’s the consensus in the clinical guidelines. The 2023 international PCOS guideline treats it as a condition you carry for life once you’ve been accurately diagnosed.

Part of why matters here. PMOS isn’t a simple diagnosis. With a lot of conditions, one lab flags and you have the diagnosis. PMOS · PCOS has inclusion criteria (which change depending on your age at diagnosis) and exclusion criteria. More moving parts means more room for error, so completing the diagnostic process properly is the thing that matters. If you’re not sure yours was done thoroughly, that’s a good conversation to bring to your own healthcare team.

Can you reverse PCOS naturally?

You can change how your symptoms show up, sometimes dramatically. You can’t reverse the diagnosis itself. Those are two different things, and the difference is the whole point.

Here’s the good news. Lifestyle, and sometimes supplements or medication, can have a pretty potent impact on how symptoms present. Someone who’s very symptomatic at diagnosis can do real work and no longer have those symptoms. That’s worth celebrating. It just doesn’t undo the diagnosis underneath.

I’ll be honest. I got this wrong early in my career. I thought if you no longer met the diagnostic criteria, you no longer had it. Like high cholesterol: you do the bloodwork, you change some things, your cholesterol normalizes, and the diagnosis drops off. That’s a real thing for cholesterol. It is not how PMOS · PCOS works.

If my symptoms are gone, do I still have PCOS?

Yes. Feeling good and looking good on the surface doesn’t mean the underlying condition left.

The reasons come down to a few things:

  • The cause is multifactorial. Genetics is one driver, and you can’t just turn that off.
  • Even when you feel better, people with PMOS · PCOS carry higher health risks that still need monitoring compared to people without it.
  • That higher risk holds even when two people are matched for body size. Same size, same everything, the one difference is the PMOS diagnosis, and the risk is still higher.

I want to be clear this isn’t me trying to scare you. Higher risk of something doesn’t mean you’ll get it. It just means it belongs on your radar so you can keep an eye on it with your care team. The problem comes when we pretend the diagnosis is gone and stop checking. That’s how things get missed.

Why does PCOS need ongoing monitoring?

Because the real harm of “cure” language is that people stop watching for the things worth catching early.

“Cure” gives the illusion that a certain set of actions will manage everyone’s symptoms the same way. So someone takes positive action, it improves their symptoms to a point, and then there are leftover symptoms that still need managing in other ways. With “cure” framing, that feels like failure. It isn’t. It’s a reflection of how complex this is and how much genetics is underneath it.

If you believe you’ve reversed it, the quiet risk is that you drop the monitoring. Then a risk that could have been caught early gets missed. That’s the danger I keep coming back to. Not the word itself, but what the word makes people stop doing.

Do I need repeat ultrasounds to track PCOS?

No. We don’t monitor PMOS · PCOS with more and more ultrasounds.

That doesn’t mean you’ll never have another ultrasound. It means the reason for one should be something other than “tracking my PCOS.” So how do you know you’re heading in the right direction? Your symptoms tell you more than the ultrasound does. If your cycles improve, we’d actually expect the ovary picture to improve too, because the communication between your brain and your ovaries is healthier. The way your ovaries look on a scan (morphology is just the fancy word for it) follows the cycles, not the other way around.

What should I focus on instead of a cure?

Focus on sustainable systems over willpower. Not a finish line you sprint to and then you’re done.

Think of it like a dimmer switch, not a light switch. This isn’t a light we turn off. It’s a dimmer. There are real things you can do to make the symptoms less bright. For some people that goes as far as cycles normalizing, less acne, fewer androgenic symptoms, less hair loss on the head and less hair growth on the face. The lights can get a lot dimmer. They don’t switch off.

So don’t treat this as a mountain to conquer once. It’s for life, and that doesn’t mean there’s nothing you can do to feel better than you do today. It means we shift the goal away from perfectionism and toward something personalized to you. Accuracy matters here, because the cost of inaccuracy isn’t abstract: it’s not getting the care you need, not being monitored, and risks going unspotted.

Want the full walk-through in my own words? Watch the full video here, and if it lands, subscribe to my YouTube channel for more like it.

Is this you?

Shift Society is my community for women navigating PMOS (formerly PCOS) and metabolic health. Members get my Lab Clarity Mini-Series & Checklist to help you make sense of your bloodwork, plus the member resources from my videos. Real science, real talk. If that’s you, come join us and try it with the 7-day free trial.

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This article is educational, not medical advice or a diagnosis. If something here resonates, bring it to your healthcare team, who can look at it through the lens of your individual health.

“For life” lands hard when nobody explains what it means. I unpacked that here: Is PCOS Permanent? What “Having It for Life” Actually Means.

Main references
  1. Teede HJ, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023. PubMed