If you’ve ever felt like your body has a mind of its own like surprise breakouts, irregular periods, sudden mood shifts — you’re not imagining it. For many people with PCOS, the real culprit is a complex mix of hormones that aren’t playing nice together.
But here’s the good news: once you understand what these hormones do and how they interact, managing PCOS starts to feel a lot less mysterious.
In this article, we’re going to break it down in plain language:
🧠What are hormones anyway?
⚖ How do they get out of balance in PCOS?
💡 What symptoms are linked to which hormones?
📊 And most importantly — what can help?
Think of this as a friendly explainer from a doctor who gets it ; no med-school dictionary required. You’ll also find visuals, analogies, and an FAQ section based on real questions people like you are already asking online.
So let’s unravel the hormone mystery ,starting with the basics.
🧬 What Are Hormones — and Why Do They Matter in PCOS?
Hormones are like tiny messengers that travel through your bloodstream, telling different parts of your body what to do and when. They control everything from your mood, hunger, and energy levels to your skin, hair, and menstrual cycle.
In a healthy system, these hormones work together like an orchestra — each playing its part in harmony. But with PCOS, it’s like the drummer (testosterone) is banging too loud, the violinist (estrogen) is offbeat, and the conductor (your brain) is confused.
Let’s meet the main hormonal players in PCOS and what each one does:
💡 Analogy to Help It Click:
Imagine your hormones are a group of friends planning a group trip:
- FSH is trying to pick a date (egg maturing),
- LH is in charge of booking the flight (ovulation),
- Estrogen is coordinating the outfits (cycle prep),
- Progesterone is making sure everyone gets home safely (cycle balance),
- But Testosterone keeps crashing the group chat,
- And Insulin keeps feeding the drama behind the scenes.
With PCOS, communication breaks down, the trip never takes off (no ovulation), and everything feels chaotic.
Now let’s connect these imbalances to real-life symptoms:
- High insulin — Acne, facial/body hair (hirsutism), weight gain
- High testosterone — Irregular periods, infertility, oily skin
- Low FSH — Anovulation (no egg release)
- High LH (relative to FSH) — Polycystic-looking ovaries
- Low progesterone — Missed periods, mood swings
Let’s take a quick look on how these hormones involved work in a normal menstrual cycle;
🔄 How Hormones Work in a Normal Menstrual Cycle
🧠 First: What Should Happen in a Normal Cycle
I like to think of the menstrual cycle like a monthly team project:
- Follicular Phase (Day 1–14) — Your brain sends FSH(follicular stimulating hormone) to help a few eggs grow. One becomes dominant.
*Key Hormones Involved* — FSH ↑, Estrogen ↑
2. Ovulation (Around Day 14) — LH surges (luteinizing hormone)→ the dominant egg is released (ovulation).
*Key Hormones Involved* — LH ↑↑ (big surge), Estrogen peaks
3. Luteal Phase (Day 15–28) — After ovulation, the body produces progesterone to prepare for pregnancy.
- *Key Hormones Involved* — Progesterone ↑, Estrogen remains steady
4. If No Pregnancy — Hormone levels drop → period starts, cycle resets.
- Key Hormones Involved* — All hormone levels ↓
🔄 This rise and fall of FSH → Estrogen → LH → Progesterone keeps the cycle flowing and ovulation happening like clockwork.
⚠️ What Happens in PCOS
In PCOS, it’s like the group chat gets chaotic. The cycle doesn’t go as planned:
- Follicular Phase — FSH is too low → eggs don’t mature properly. Multiple small follicles start, but none dominate.
*Hormonal disruption* — FSH ↓, AMH ↑
2. Ovulation — No LH surge → no egg is released. Ovulation often doesn’t happen.
*Hormonal disruption* — LH stays high, no sharp peak
3. Luteal Phase — No ovulation → progesterone stays low.
*Hormonal disruption* — Progesterone ↓
4. Result — Irregular or missed periods, thickened uterine lining, and hormone confusion.
- *Hormonal disruption* — Estrogen stays high, androgens (like testosterone) rise.
🧬 Hormones Commonly Tested for PCOS
Here are the key players and what doctors are looking for:
🧠 Okay, but what does this all mean for you?
Here’s the part people don’t talk about enough: PCOS isn’t a one-size-fits-all condition.
Let’s look at some real-life patterns that confuse people and explain why they happen:
1. “I have irregular periods but no acne or facial hair.”
🔍 Possible lab findings:
- Normal or low testosterone
- Elevated LH:FSH ratio
💬 What this means:
You can have PCOS without high testosterone. Your irregular periods may be due to ovulation not happening regularly (anovulation), but without a significant rise in androgens. That’s why you don’t see acne or facial hair but those symptoms are mostly tied to high testosterone.
2. “I have acne and facial hair, but my periods are regular.”
🔍 Possible lab findings:
- Elevated testosterone
- Normal LH:FSH ratio
- Normal cycles
💬 What this means:
You may have hyperandrogenism (high male hormones like testosterone) without the classic cycle disturbances. You might have elevated androgens from another cause, like congenital adrenal hyperplasia or idiopathic hirsutism not always PCOS. This still falls under PCOS diagnosis if paired with polycystic ovaries or elevated androgens in bloodwork. However, other conditions like adrenal hyperandrogenism should also be ruled out.
3. “My testosterone is low. Does that mean I don’t have PCOS?”
💡 Not necessarily.
Low testosterone doesn’t rule out PCOS. In fact, many people with PCOS don’t show textbook lab results. You may still have:
- Insulin resistance
- Ovulatory dysfunction
- Polycystic ovaries on ultrasound
…even if your testosterone is on the lower end.
🧩 Why This Happens: PCOS Is a Spectrum
Think of PCOS like a big umbrella. Under that umbrella are different types or “phenotypes” of PCOS:
Type A (Classic PCOS) — High androgens, irregular periods, polycystic ovaries
Type B — High androgens, irregular periods, but no cysts
Type C — (Ovulatory PCOS)High androgens, regular periods, cysts present
Type D — (Lean PCOS)Normal weight, irregular periods, cysts — hormones may be normal
⏱️ When Should You Get Tested?
- If you’re not on birth control:
Test between Day 2–5 of your period for baseline hormone levels.
If you don’t get periods, testing can be done randomly, but with caution when interpreting results. - If you’re on hormonal contraception:
Birth control affects hormone levels — you may need to stop it (under supervision) before accurate testing.
🔍 Tips for Understanding Your Hormonal Pattern
Every woman with PCOS has a slightly different “hormonal fingerprint.” Here’s how to start decoding yours:
💡 Tip 1: Track Your Symptoms Alongside Your Labs
Make a chart with:
- Your symptoms (acne, hair growth, missed periods, etc.)
- Your lab values
Over time, you’ll see what hormone shifts align with what symptoms.
💡 Tip 2: Don’t Rely on One Test Alone
One snapshot doesn’t tell the full story. Hormone levels fluctuate — especially in PCOS. Repeat tests or track over months for a clearer picture.
💡 Tip 3: Understand the Types of PCOS
(Summarized from earlier)
Knowing your type helps guide treatment
💡 Tip 4: Work With a Doctor Who Understands PCOS
A supportive doctor will:
- Interpret results in context (not just based on lab ranges)
- Consider symptoms, cycle history, ultrasound, and test results together.
Here are some other questions that people ask;
Q: Can I fix my hormones naturally?
A: Some people see big improvements with lifestyle changes like diet, exercise, stress management, and supplements. But others may need medications or a combination of approaches — especially if fertility is a goal.
Q: Is it safe to ignore mild hormone imbalances if I’m not trying to get pregnant?
A: Even if you’re not planning pregnancy now, unmanaged PCOS can lead to issues like irregular periods, thickened uterine lining (endometrial hyperplasia), insulin resistance, or future fertility problems. Regular monitoring helps.
#Let’s dive into ways we can fix these hormonal imbalances#
🌿 What Can Help Balance Hormones in PCOS?
We’ve talked about how hormones like insulin, LH, FSH, estrogen, progesterone, and testosterone get out of sync in PCOS. But how do we begin to nudge them in the right direction using simple, everyday habits?
Let’s explore non-pharmaceutical ways to support your hormonal rhythm.
🍽️ 1. Eating to Support Hormone Balance
Food is not a cure, but it’s a powerful hormone helper.
- Low-Glycemic Meals: Helps reduce insulin spikes and cravings
👉 e.g., oats, lentils, sweet potatoes, berries, leafy greens - Anti-inflammatory Foods: Tame the low-grade inflammation seen in PCOS
👉 e.g., turmeric, salmon, olive oil, avocado, nuts - Healthy Fats: Needed for hormone production
👉 Include flaxseed, avocado, olive oil, and eggs - Avoid skipping meals: Helps stabilize cortisol and insulin
📝 Tip: Start with a balanced plate — protein + fiber + healthy fat + slow carbs.
🧘🏽 2. Movement, Not Just Exercise
Exercise does more than burn calories. It lowers insulin, cortisol, and androgens.
- Strength Training: Improves insulin response and boosts metabolism
- Walking: Especially post-meal walks can reduce blood sugar spikes
- Gentle Movement: Yoga, Pilates, or stretching lowers cortisol levels
You don’t need to exhaust yourself. Aim for consistency over intensity.
🌙 3. Sleep and Circadian Rhythm
Did you know sleep disturbances are common in PCOS?
Poor sleep can worsen:
- Insulin resistance
- Appetite regulation
- Cortisol and testosterone imbalance
🛏️ Tips for Better Sleep:
- Limit screens 1 hour before bed
- Keep your room dark and cool
- Wake and sleep around the same time daily
🧠 4. Managing Stress = Managing Hormones
Cortisol (your stress hormone) can throw off progesterone and insulin.
Simple stress-busters:
- Deep belly breathing or meditation
- Getting outdoors daily
📊 5. Track Your Cycle (Even if It’s Irregular)
Understanding your own hormonal rhythm helps you recognize patterns and progress.
Use apps(like clue and flow app) or a simple journal to track:
- Period dates
- Cervical mucus changes
- Energy levels
- Skin, appetite, sleep quality
This helps you identify signs of ovulation, especially when trying supportive treatments.
💊 6. Targeted Supplements (Optional but Helpful)
Always check with your healthcare provider before starting anything new.
- Ovofolic(inositol): Helps improve insulin sensitivity and ovulation
- Magnesium: Supports blood sugar and sleep
- Vitamin D: Often low in PCOS, supports hormone health
- Omega-3s: Anti-inflammatory and supports hormone communication
💬 “Still have questions and need clarity on your hormones? Share your concerns or questions in the comments — I’d love to connect.”
Follow me for more women’s health content @ Boyindetem Besong