Common symptoms
- •Irregular, missed or very long cycles
- •Acne, oily skin, scalp hair thinning
- •Excess facial or body hair
- •Difficulty losing weight
- •Sugar cravings, energy crashes
- •Trouble conceiving
What drives it
- •Insulin resistance (most common driver)
- •Adrenal androgen excess
- •Post-pill PCOS (transient)
- •Inflammation
Testing approach
Useful testing goes beyond a single androgen panel. We look at LH:FSH ratio, total and free testosterone, SHBG, DHEA-S, fasting insulin, HbA1c and AMH — together they identify which type of PCOS is driving symptoms.
What to do next
- ✓Identify the PCOS subtype (insulin-driven, adrenal, post-pill, inflammatory)
- ✓Address insulin first — protein, strength training, sleep, sometimes inositol or metformin
- ✓Re-test after 3–6 months to confirm the protocol is working
Frequently asked
Yes — 'polycystic ovaries' is just one of three diagnostic criteria. Many women with PCOS have completely normal-looking ovaries.
The pill masks symptoms but doesn't address the underlying insulin or androgen drivers. Many women find symptoms return — sometimes worse — when they come off.
Insulin-driven PCOS responds dramatically to nutrition, training and sleep. Cycles often regularise within a few months — though the genetic susceptibility doesn't disappear.
There's no single test. We look at LH:FSH ratio, total and free testosterone, SHBG, DHEA-S, fasting insulin, HbA1c and AMH — together they identify which PCOS subtype is driving symptoms.
Yes — about 20% of women with PCOS are lean. The driver is usually adrenal androgens or post-pill rather than insulin, and the treatment is different.
PCOS is the most common cause of anovulatory infertility, but it's also one of the most treatable. Most women with PCOS conceive once ovulation is restored.
Myo- and d-chiro-inositol (40:1) improve insulin sensitivity and restore ovulation in many women with insulin-driven PCOS within 3–6 months. It's cheap, evidence-backed and a sensible first step alongside lifestyle work.
References
- ESHRE/ASRM — International evidence-based PCOS guideline (2023)— Diagnosis, assessment and management of PCOS
- Jean Hailes for Women's Health — PCOS— PCOS consumer information and lifestyle management
- RANZCOG — PCOS clinical practice— PCOS management in Australian and New Zealand practice
- Endocrine Society — PCOS guidelines— Metabolic and reproductive features of PCOS
References are provided for educational context only. Her Form is not affiliated with these organisations. Always interpret results with a qualified healthcare professional.