Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a common condition that affects women during their reproductive years. If you’ve been dealing with irregular periods, acne, or changes in weight, you may be trying to understand what’s causing these symptoms.

At our clinic in San Antonio, we evaluate and manage PCOS as both a hormonal and metabolic condition. Despite its name, PCOS is not defined by true ovarian cysts. The changes seen on ultrasound are actually multiple immature follicles that contain eggs.

Polycystic ovary syndrome (PCOS) is a hormonal condition that affects how the ovaries work. If you’re asking what PCOS is, it helps to think of it as a condition that affects both your hormones and how your body uses insulin.

With PCOS, hormone levels can get out of balance. The body may make higher levels of androgens, often called “male hormones,” even though women naturally have them in small amounts. This imbalance can disrupt ovulation and lead to symptoms like irregular periods, acne, and unwanted hair growth.

PCOS is also linked to insulin resistance. When your body doesn’t respond to insulin the way it should, insulin levels can rise. This can make hormone imbalances worse and affect how your body handles blood sugar.

Despite the name, not everyone with PCOS has cysts on their ovaries. The structures seen on ultrasound are small follicles, not true cysts, and they aren’t required for diagnosis.

PCOS develops from a mix of genetic and hormonal factors. While there isn’t one single cause, two key drivers are insulin resistance and higher androgen levels.

When your body becomes resistant to insulin, it produces more of it to keep blood sugar stable. These higher insulin levels can signal the ovaries to make more androgens. This may disrupt ovulation and affect how eggs develop and are released.

Hormone signals between the brain and ovaries can also change. That can further affect ovulation and contribute to irregular cycles.

PCOS often runs in families. If a close relative has PCOS, your risk may be higher.

PCOS symptoms can vary, but they often relate to hormone imbalance and insulin resistance.

You may notice:

• Irregular or missed periods
• Acne that doesn’t improve with typical treatments
• Increased facial or body hair (hirsutism)
• Thinning hair on the scalp
• Weight changes or trouble losing weight
• Darkened skin in areas like the neck or underarms
• Difficulty getting pregnant

Symptoms can range from mild to more noticeable, depending on hormone levels and insulin response.

PCOS is diagnosed using a combination of symptoms, medical history, and testing. There isn’t a single test that confirms it.

Your provider may look for:

• Irregular or absent ovulation
• Signs of higher androgen levels
• Ovarian changes on ultrasound

Blood tests are often used to check hormone levels and blood sugar, especially since PCOS is closely linked to insulin resistance. These may include:

• Fasting glucose
• HbA1c
• Glucose tolerance testing

PCOS doesn’t just affect your periods. It can also affect your long-term health.

Because it’s linked to insulin resistance, PCOS can increase your risk of:

• Type 2 diabetes
• High cholesterol
• High blood pressure
• Cardiovascular concerns

This is why treatment often focuses on both hormone balance and metabolic health.

PCOS treatment is based on your symptoms and goals. Lifestyle support is often the foundation. This may include:

• Regular physical activity
• Balanced nutrition
• Consistent sleep habits

Medications may be used when needed, such as:

• Birth control pills to regulate cycles
• Metformin to improve insulin response
• Anti-androgen medications for symptoms like hair growth
• Ovulation support if pregnancy is a goal

Treatment plans are often adjusted over time based on how your body responds.

PCOS can affect your hormones, metabolism, and long-term health, but the right treatment plan can help you take control of your symptoms and feel more like yourself again.

If you’re dealing with irregular periods, acne, unwanted hair growth, or weight changes, it’s time to get answers. Our team in San Antonio provides personalized PCOS care focused on hormone balance, insulin health, and long-term wellness.

Schedule an appointment today to get a clear diagnosis and a treatment plan built around your goals.

1. Can PCOS go away on its own?

PCOS doesn’t usually go away on its own. It’s a long-term condition, but symptoms can improve with treatment and lifestyle changes.

2. How do I know if I have PCOS?

PCOS can’t be diagnosed based on symptoms alone. A provider will review your cycle, symptoms, and lab results, and may use imaging if needed.

3. What age does PCOS usually start?

PCOS often starts in the teen years or early adulthood. Some people don’t notice symptoms until later, especially if their cycles are only mildly irregular.

4. Does PCOS cause weight gain?

PCOS can make weight changes more likely, especially around the abdomen. Hormones and insulin may both play a role, but not everyone with PCOS gains weight.

5. Should I see a doctor for PCOS symptoms?

Yes. If you have ongoing symptoms like irregular periods, acne, unwanted hair growth, or trouble with weight changes, it’s a good idea to get evaluated. Early care can help you understand what’s going on and plan next steps.