Living with Polycystic Ovary Syndrome

Dr. Mandy Ellison, PT

June 6, 2019

Polycystic Ovary Syndrome (PCOS) is an endocrine disorder (disorder of the hormone regulating system) that can affect females. Diagnosis of PCOS is based on the presence of at least two of the following:

  • Polycystic ovaries (cyst on the ovaries)
  • Increased levels of androgen – hormone known to promote male sexual characteristics (androsterone, testosterone)
  • Menstrual irregularities or more than 35 days between menstrual cycles

Living with Polycystic Ovary Syndrome

PCOS is commonly accompanied by the presence of:

  • Infertility
  • Acne
  • Hirsutism – excessive or unwanted hair grown
  • Alopecia – patchy hair loss
  • Hyperinsulinemia – increased levels of insulin (often associated with type II diabetes)
  • Increased weight
  • Depression, anxiety
  • PAIN
All fun things right? No, not exactly. At least those of you living with PCOS would agree that these can have a large impact on our quality of life. Individually and in combination, these symptoms can lead to other serious health issues including depression, anxiety and high stress.

Let's Talk More About Stress…

Increased stress can worsen the symptoms associated with PCOS and impact fertility levels. Individuals with PCOS already produce more cortisol (stress hormone) compared to individuals without PCOS. Increased levels of cortisol can lead to increased androgens, which as mentioned earlier, is one of the diagnostic criteria for PCOS. High levels of cortisol can also lead to an increase in insulin resistance. Insulin resistance, commonly seen in those with PCOS, is also associated with type II diabetes.

Obesity can exacerbate the effects of stress on PCOS. This is important to realize as individuals with PCOS are at higher risk for obesity.

It can become an endless cycle and it comes full circle. Stress increases symptoms and increased symptoms lead to stress. What's important to know is, there are things you can do to reduce stress, and as a result, reduce your symptoms.

For a more detailed explanation of how stress can impact PCOS, visit…

Pelvic Pain

If all the talk about hormones nearly lost you, come back, because this is important… most places you search for information on PCOS (on the web and elsewhere) won’t talk about pelvic pain as a possible symptom, but it can be! If you're experiencing pelvic pain, you are not alone and there are treatment options.

Pelvic pain can present as just that, pain in or around the pelvis or low abdomen, pain with intercourse, pain with pelvic exams and/or painful periods. Pain can be related to injury, tissue damage/dysfunction, structural changes, psychosocial issues, disease or syndromic related. No matter the cause, acute pain can lead to postural changes in an attempt to compensate or ease symptoms. These postural changes can contribute to musculoskeletal dysfunction and chronic pain. If you're experiencing any of these symptoms, consult with your primary care physician and/or physical therapist for proper evaluation and appropriate treatment.

For more on pelvic pain and PCOS, visit…

Now What?

Consider a team approach for treatment of PCOS. Your team can include any or all of the following: primary care physician, gynecologist, physical therapist, mental health specialist, dietician/nutritionist and/or functional medicine practitioner. A team approach is necessary given the variety of body systems involved (endocrine, reproductive, musculoskeletal, integumentary, nervous, digestive, etc.).

Your physician may prescribe oral contraceptives or other medications to help regulate hormones, pain, etc. They may refer you to the proper specialist based on individual needs. A functional medicine practitioner and nutritionist/dietician can provide advice on dietary changes to do the same, as well as to help reduce inflammation and boost immune function. Your physical therapist can help with pain, as well as provide additional information on healthy modifications to exercise, activity level and lifestyle changes. A mental health specialist can provide counsel for life stressors and help patients deal with depression and anxiety.

Early intervention of PCOS is important to reduce long-term cardiovascular, metabolic or reproductive complications. If you are experiencing the symptoms we've discussed, consult with your primary care doctor to get the help you need.

Diet and Lifestyle Changes

  • Diet – Consider whole food diets like paleo or Whole30. Reduce intake of processed foods, sugar and caffeine. The goal is to eliminate inflammatory foods and increase foods that promote healthy digestive and immune function.
  • Exercise – Regular exercise and activity. Daily MOVEMENT is key. Consider yoga for its calming and functional benefits.
  • Mindfulness, Meditation, Manifestation – Proven to help manage stress and its impact on symptoms. If you're new to meditation, I recommend Emily Fletcher’s book Stress Less, Accomplish More to help guide you.
  • Do Something Daily that Makes You Feel HAPPY and GOOD About Yourself!


Goodman, N. F., Cobin, R. H., Futterweit, W., Glueck, J. S., Legro, R. S., & Carmina, E. (2015). American Association Of Clinical Endocrinologists, American College Of Endocrinology, And Androgen Excess And Pcos Society Disease State Clinical Review: Guide To The Best Practices In The Evaluation And Treatment Of Polycystic Ovary Syndrome - Part 1. Endocrine Practice,21(11), 1291-1300. doi:10.4158/ep15748.dsc (2019). Polycystic Ovary Syndrome in Adolescents. Available at:
[Accessed 2 May 2019].



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