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Creatine for Muscle: Why Every Woman Should Know About This Powerful Supplement

Creatine for Muscle: Why Every Woman Should Know About This Powerful Supplement

Kadia Bielecki
When most people think about creatine, they picture bodybuilders loading up before a heavy workout. But science tells a much bigger story. Creatine is one of the most extensively studied nutritional supplements in sports medicine, with hundreds of clinical trials demonstrating benefits for muscle performance, recovery, and long-term musculoskeletal health.¹ Rather than being just a "gym supplement," creatine plays a fundamental role in how our muscles produce energy. For women, this matters more than ever. Women naturally store less creatine than men, consume less dietary creatine on average, and experience several life stages; including menstruation, pregnancy, postpartum, and menopause; that influence muscle metabolism and energy demands.² These physiological differences mean women may derive unique benefits from creatine supplementation throughout their lives.² Whether your goal is building strength, improving athletic performance, maintaining muscle during menopause, or simply feeling stronger in everyday life, creatine deserves a place in the conversation. What Is Creatine? Creatine is a naturally occurring compound synthesized from the amino acids glycine, arginine, and methionine. Approximately 95% of the body's creatine is stored in skeletal muscle, where it helps regenerate adenosine triphosphate (ATP), the body's immediate source of cellular energy.¹ During short bursts of high-intensity activity; lifting weights, sprinting, climbing stairs, or carrying groceries; your muscles rapidly use ATP. Creatine helps replenish ATP stores, allowing muscles to maintain power output for longer periods before fatigue develops.¹ Although creatine is found naturally in foods such as red meat and fish, dietary intake alone often falls below the amounts used in research studies examining muscle health and performance.¹ Why Creatine May Be Especially Beneficial for Women Historically, most creatine research focused on male athletes. Fortunately, more recent studies have specifically examined women and found consistent benefits. Women generally have: Lower total creatine stores² Lower dietary creatine intake² Reduced intramuscular phosphocreatine concentrations² Hormonal fluctuations that influence muscle metabolism² Emerging evidence suggests that creatine supplementation may be particularly valuable during periods of hormonal transition, including perimenopause and menopause, when declining estrogen contributes to reductions in muscle mass and strength.² Importantly, creatine does not alter hormones or act as a steroid. It works by improving the muscle's ability to rapidly regenerate energy during exercise.¹ Creatine Helps Build Lean Muscle One of the strongest findings in the literature is that creatine enhances the effects of resistance training. Numerous randomized controlled trials and systematic reviews demonstrate that individuals taking creatine while participating in resistance training gain more lean body mass than those completing the same exercise program without creatine.¹˒³ Creatine improves the quality of training sessions by allowing individuals to perform slightly more repetitions, maintain higher training intensity, and recover more effectively between sets.¹ Over weeks and months, these small improvements accumulate into greater increases in muscle mass. Research involving women has shown significant improvements in lean muscle mass following resistance training combined with creatine supplementation compared with resistance training alone.² Creatine Improves Strength and Power Building muscle is important, but improving muscle function is equally valuable. Meta-analyses consistently show that creatine supplementation increases maximal strength, muscular power, and high-intensity exercise performance.¹˒³ For women, these improvements can translate into: Lifting heavier weights Performing more repetitions Greater explosive power Better functional strength for everyday activities These benefits extend beyond competitive athletes and are seen in recreational exercisers and older adults as well.¹ Better Recovery Means Better Progress Recovery is where adaptation happens. Exercise creates microscopic damage within muscle fibres, initiating repair processes that ultimately make muscles stronger. However, excessive fatigue or inadequate recovery can limit training quality. Evidence suggests creatine may help improve recovery by supporting energy restoration, reducing exercise-induced muscle damage, and attenuating inflammatory responses following intense exercise.¹˒⁴ While creatine is not a replacement for adequate nutrition, sleep, or protein intake, it may help women recover more efficiently between workouts and maintain consistent training. Supporting Muscle Through Menopause Beginning around menopause, women experience an accelerated decline in muscle mass, strength, and physical function due largely to decreasing estrogen levels.⁵ This age-related muscle loss, known as sarcopenia, contributes to reduced mobility, lower metabolic health, increased fall risk, and decreased independence later in life.⁵ Emerging evidence suggests creatine supplementation combined with resistance training can help preserve lean muscle, improve strength, and support functional performance in postmenopausal women.²˒⁵ Although more long-term research is underway, current findings suggest creatine may become an important nutritional strategy for healthy aging in women. Does Creatine Cause Weight Gain? This is one of the most common concerns. Creatine does not cause fat gain. Instead, it increases water stored inside muscle cells, known as intracellular water.¹ This contributes to muscle hydration and creates an environment that supports muscle growth and recovery. Some women notice a small increase in body weight during the first week of supplementation, typically between 0.5 and 2 kilograms, depending on whether a loading protocol is used.¹ This reflects increased muscle water content rather than increased body fat. For women taking a daily maintenance dose without a loading phase, these changes are often gradual and less noticeable. How Much Creatine Should Women Take? The International Society of Sports Nutrition recommends creatine monohydrate as the preferred form due to its extensive evidence base and established safety profile.¹ Two common approaches include: Loading protocol 20 g/day divided into four doses for 5 to 7 days Followed by 3 to 5 g/day for maintenance¹ Maintenance-only approach 3 to 5 g/day from the start¹ Both methods ultimately achieve similar muscle creatine saturation. The maintenance-only approach simply takes a few weeks longer. Taking creatine with meals that contain carbohydrate and protein may modestly improve uptake into muscle.¹ Is Creatine Safe? Creatine is among the most rigorously studied dietary supplements available. Large systematic reviews and decades of research consistently demonstrate that creatine monohydrate is safe for healthy individuals when consumed at recommended doses.¹ There is no convincing evidence that creatine damages healthy kidneys or causes dehydration, muscle cramps, or hair loss in healthy adults.¹ Individuals with existing kidney disease or other significant medical conditions should consult their healthcare provider before beginning supplementation. The Bottom Line Creatine is far more than a supplement for elite athletes. For women, creatine offers an evidence-based way to support lean muscle development, improve strength, enhance recovery, and promote healthy aging when paired with regular resistance exercise. Whether you're just beginning your fitness journey, training for performance, navigating menopause, or simply hoping to stay strong as you age, creatine monohydrate is one of the safest and most effective nutritional tools available. As always, supplementation works best alongside consistent strength training, adequate dietary protein, quality sleep, and a well-rounded nutrition plan. References  Kreider RB, Kalman DS, Antonio J, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2022;19(1):244-307. doi:10.1186/s12970-021-00412-w Smith-Ryan AE, Cabre HE, Eckerson JM, et al. Creatine supplementation in women throughout the lifespan: a review of the evidence. Nutrients. 2021;13(3):877. doi:10.3390/nu13030877 Chilibeck PD, Kaviani M, Candow DG, Zello GA. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. Open Access J Sports Med. 2017;8:213-226. doi:10.2147/OAJSM.S123529 Rawson ES, Venezia AC. Use of creatine in the elderly and evidence for effects on cognitive function in young and old. Amino Acids. 2011;40(5):1349-1362. doi:10.1007/s00726-011-0855-9 Candow DG, Forbes SC, Chilibeck PD, et al. Creatine supplementation and aging musculoskeletal health. Endocrine. 2021;71(3):635-648. doi:10.1007/s12020-021-02670-6
Jun 30, 2026
5 min read
The Silent Signs of Chronic Inflammation Every Woman Should Know

The Silent Signs of Chronic Inflammation Every Woman Should Know

Kadia Bielecki
Feeling tired, bloated, foggy, or “off” in your body but being told everything looks normal? You’re not imagining it. Chronic inflammation can be subtle. Unlike acute inflammation; the redness, swelling, or pain that happens after an injury; chronic low-grade inflammation can simmer quietly in the background for months or years. It has been linked to metabolic health concerns, cardiovascular disease, autoimmune conditions, chronic pain, reproductive health conditions, and changes in mood and energy.¹ For women, inflammation can be especially complex because it often overlaps with hormones, the menstrual cycle, gut health, stress, blood sugar regulation, and conditions like PCOS and endometriosis.²˒³ Here are seven silent signs of chronic inflammation every woman should know, and what you can do to start supporting your body. What Is Chronic Inflammation? Inflammation is part of your immune system’s natural defence process. When you get injured or fight an infection, inflammation helps your body heal. But when inflammation becomes chronic, the immune system stays activated even when there is no immediate threat. Over time, this can affect tissues, hormones, metabolism, and overall wellbeing.¹ Chronic inflammation is not a diagnosis on its own, but it may be a signal that something deeper is going on. Can You Test for Chronic Inflammation? There is no single test that diagnoses chronic inflammation. Depending on your symptoms and medical history, your healthcare provider may consider tests such as: hs-CRP (high-sensitivity C-reactive protein) ESR (erythrocyte sedimentation rate) Complete blood count (CBC) Metabolic markers such as glucose and insulin Autoimmune screening when appropriate Laboratory testing is only one piece of the picture and should always be interpreted alongside symptoms, medical history, and a comprehensive assessment. 1. You Feel Tired No Matter How Much You Sleep Persistent fatigue is one of the most common signs associated with chronic inflammation. Inflammatory molecules called cytokines can affect the brain and nervous system, contributing to low energy, reduced motivation, and that heavy “I can’t fully recharge” feeling.⁴ This is different from normal tiredness after a busy week. Inflammation-related fatigue often feels deeper and may not improve completely with rest. What You Can Do Start with the basics: Aim for 7–9 hours of quality sleep and maintain a consistent sleep-wake schedule whenever possible Eat enough protein throughout the day Avoid skipping meals Move your body gently and consistently Speak with a healthcare provider to rule out low iron, thyroid dysfunction, vitamin B12 deficiency, autoimmune conditions, and other medical causes 2. You Struggle With Brain Fog Brain fog can show up as forgetfulness, difficulty focusing, word-finding trouble, or feeling mentally “cloudy.” Research suggests that inflammation can influence brain signalling, mood, and cognitive function.⁴ Chronic low-grade inflammation has also been associated with metabolic dysfunction, which may further affect energy availability and mental clarity.¹˒⁵ What You Can Do Support brain and metabolic health by focusing on: Stable blood sugar Regular meals Omega-3-rich foods like salmon, sardines, chia seeds, and walnuts Hydration Daily movement Stress reduction 3. Your Digestion Feels Off Bloating, constipation, loose stools, abdominal discomfort, and food sensitivities can all have many causes, but inflammation and gut health are closely connected. The gut barrier, microbiome, and immune system constantly communicate with one another. When this balance is disrupted, it may contribute to immune activation and low-grade inflammation.⁶ What You Can Do Support your gut by adding: Fibre-rich foods Colourful fruits and vegetables Fermented foods, if tolerated Adequate hydration Slowly increasing legumes, whole grains, nuts, and seeds If digestive symptoms are persistent, painful, or worsening, it’s important to seek medical support. 4. Your Periods Are Painful, Heavy, or Disruptive Period pain is common, but severe pain is not something you should have to normalize. Chronic inflammation is believed to play a role in conditions such as endometriosis, a disorder where tissue similar to the uterine lining grows outside the uterus and can cause pelvic pain, painful periods, pain with sex, digestive symptoms, and fertility challenges.³ Inflammatory pathways may also influence menstrual symptoms, pelvic pain, and reproductive health more broadly.²˒³ What You Can Do Track symptoms such as: Severe cramps Heavy bleeding Pain with bowel movements Pain with sex Pelvic pain outside your period Fatigue around your cycle If your period disrupts your life, it’s worth speaking with a healthcare provider. Painful periods deserve investigation, not dismissal. 5. You Have Skin Flare-Ups The skin is often a reflection of what’s happening internally. Acne, eczema, psoriasis, rosacea, and other inflammatory skin conditions may be influenced by immune activity, hormones, gut health, and metabolic function.⁷ For women, skin changes can also fluctuate with the menstrual cycle, stress, sleep, and blood sugar changes. What You Can Do Support skin from the inside out by focusing on: Blood sugar balance Enough dietary fibre Anti-inflammatory fats Sleep consistency Stress management Gentle, non-irritating skincare If skin symptoms are persistent or painful, a dermatologist can help identify the underlying condition and treatment options. 6. You Feel Puffy, Achy, or Stiff Generalized aches, stiffness, puffiness, or feeling “inflamed” can be associated with immune activation, fluid shifts, stress, poor sleep, hormonal changes, or underlying inflammatory conditions. Chronic inflammation has been linked to pain sensitivity and tissue-level changes that can influence how the body feels day to day.¹˒⁴ What You Can Do Gentle movement can be powerful. Regular physical activity has been shown to have anti-inflammatory effects and can support insulin sensitivity, circulation, mood, and metabolic health.⁸ Start with: Walking Yoga Pilates Resistance training Mobility work Low-impact cardio The goal is consistency, not intensity. 7. Your Blood Sugar Feels Unstable Do you feel shaky between meals, crave sugar, crash after eating, or feel hungry soon after a meal? Blood sugar dysregulation and inflammation often influence one another. Chronic inflammation can interfere with insulin signalling, while insulin resistance can contribute to further inflammatory stress in the body.⁵ This connection is especially relevant for women with PCOS, where insulin resistance and inflammatory pathways may both contribute to symptoms.² What You Can Do Build meals around: Protein Fibre-rich carbohydrates Healthy fats Colourful plants Examples include: Eggs with avocado and whole grain toast Greek yogurt with berries and chia seeds Salmon with quinoa and roasted vegetables Lentil soup with olive oil and leafy greens Tofu stir-fry with brown rice and vegetables How to Support Healthy Inflammation Levels Naturally Chronic inflammation is complex, but daily habits can make a meaningful difference. Eat More Anti-Inflammatory Foods Dietary patterns rich in vegetables, fruits, legumes, whole grains, nuts, seeds, olive oil, and omega-3 fatty acids are associated with lower inflammatory markers and improved metabolic health.⁹ Focus on adding: Leafy greens Berries Beans and lentils Fatty fish Extra virgin olive oil Nuts and seeds Herbs and spices Prioritize Sleep Poor sleep can increase inflammatory signalling and affect glucose metabolism, appetite regulation, mood, and immune function.¹⁰ Try to keep a consistent sleep schedule, reduce late-night screen time, and create a wind-down routine that helps your nervous system shift into rest mode. Move Your Body Regularly Exercise has well-established anti-inflammatory effects, especially when done consistently over time.⁸ You don’t need extreme workouts. Walking, strength training, cycling, swimming, yoga, and Pilates can all support healthier inflammatory balance. Manage Stress Chronic psychological stress can increase inflammatory activity and affect immune regulation.¹¹ Stress support can look like: Deep breathing Journaling Therapy Meditation Time outside Gentle movement Setting boundaries Social connection Support Hormone and Metabolic Health Because inflammation, hormones, and metabolism are deeply connected, it’s helpful to take a whole-body approach. That means looking at: Blood sugar Sleep Stress Gut health Menstrual symptoms Nutrient status Movement Recovery Your symptoms are not isolated. They are signals worth listening to. When to Speak With a Healthcare Provider You should seek medical support if you experience: Severe or worsening fatigue Unexplained weight changes Persistent digestive symptoms Severe period pain Heavy bleeding Chronic pelvic pain Joint swelling Frequent infections Rashes that don’t improve Symptoms that interfere with daily life Chronic inflammation can be connected to many different conditions, including autoimmune disease, endometriosis, PCOS, metabolic syndrome, thyroid disorders, and chronic infections. Getting the right assessment matters. The Bottom Line Chronic inflammation doesn’t always announce itself loudly. Sometimes, it shows up as fatigue, brain fog, bloating, painful periods, skin flare-ups, aches, cravings, or simply feeling disconnected from your body. The goal isn’t to fear inflammation. Inflammation is part of how your body protects and heals you. The goal is to recognize when your body may be asking for more support. By focusing on blood sugar balance, nutrient-dense foods, sleep, stress management, movement, and medical support when needed, you can begin to create a stronger foundation for long-term health. Your symptoms are information. And you deserve care that takes them seriously. References Furman D, Campisi J, Verdin E, et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019;25(12):1822-1832. doi:10.1038/s41591-019-0675-0 Rudnicka E, Suchta K, Grymowicz M, et al. Chronic low grade inflammation in pathogenesis of PCOS. Int J Mol Sci. 2021;22(7):3789. doi:10.3390/ijms22073789 Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020;382(13):1244-1256. doi:10.1056/NEJMra1810764 Dantzer R, O’Connor JC, Freund GG, Johnson RW, Kelley KW. From inflammation to sickness and depression: when the immune system subjugates the brain. Nat Rev Neurosci. 2008;9(1):46-56. doi:10.1038/nrn2297 Hotamisligil GS. Inflammation and metabolic disorders. Nature. 2006;444(7121):860-867. doi:10.1038/nature05485 Bischoff SC, Barbara G, Buurman W, et al. Intestinal permeability: a new target for disease prevention and therapy. BMC Gastroenterol. 2014;14:189. doi:10.1186/s12876-014-0189-7 Chen L, Deng H, Cui H, et al. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 2018;9(6):7204-7218. doi:10.18632/oncotarget.23208 Gleeson M, Bishop NC, Stensel DJ, Lindley MR, Mastana SS, Nimmo MA. The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nat Rev Immunol. 2011;11(9):607-615. doi:10.1038/nri3041 Casas R, Sacanella E, Estruch R. The immune protective effect of the Mediterranean diet against chronic low-grade inflammatory diseases. Endocr Metab Immune Disord Drug Targets. 2014;14(4):245-254. doi:10.2174/1871530314666140922153350 Irwin MR. Sleep and inflammation: partners in sickness and in health. Nat Rev Immunol. 2019;19(11):702-715. doi:10.1038/s41577-019-0190-z Slavich GM. Life stress and health: a review of conceptual issues and recent findings. Teach Psychol. 2016;43(4):346-355. doi:10.1177/0098628316662768
Jun 26, 2026
7 min read
The 6 Most Common Signs of Insulin Resistance in Women (And What You Can Do About It)

The 6 Most Common Signs of Insulin Resistance in Women (And What You Can Do About It)

Kadia Bielecki
Have you ever felt like you're doing everything "right"—eating well, exercising regularly, getting enough sleep—yet you're still struggling with low energy, intense cravings, stubborn weight changes, or irregular periods? If so, insulin resistance could be part of the picture. Insulin resistance is one of the most common metabolic concerns affecting women today. It's closely linked to conditions like PCOS/PMOS, prediabetes, metabolic syndrome, and type 2 diabetes, but it often develops before any diagnosis is made.¹ The challenge? Many of the symptoms are subtle and easy to dismiss as stress, aging, or simply being busy. Understanding the early signs of insulin resistance can help you take action sooner and support your long-term health. What Is Insulin Resistance? Insulin is a hormone produced by the pancreas that helps move glucose (sugar) from the bloodstream into cells, where it can be used for energy.⁵ When insulin resistance develops, cells become less responsive to insulin's signal. To compensate, the pancreas produces more insulin to maintain normal blood glucose levels.⁵ Over time, this compensatory increase in insulin production (hyperinsulinemia) may contribute to changes in appetite regulation, energy metabolism, inflammation, cardiovascular risk, and reproductive hormone function.¹˒²˒⁵ Insulin resistance is considered a key feature of polycystic metabolic ovary syndrome (PMOS/PCOS) and can occur across a range of body sizes. Current evidence suggests that many individuals with PMOS/PCOS experience insulin resistance, even in the absence of overweight or obesity.¹˒² Because insulin resistance can develop gradually and may be present before blood glucose levels become abnormal, assessment often extends beyond standard diabetes screening. Healthcare practitioners may evaluate markers such as hemoglobin A1C (HbA1c), fasting glucose, fasting insulin, and calculated indices such as the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) to gain a more complete picture of metabolic health and insulin function.¹˒² While no single test definitively diagnoses insulin resistance, evaluating multiple markers together can help identify early metabolic changes and guide individualized treatment strategies.¹˒² 1. You're Constantly Craving Sugar or Carbohydrates Do you feel like you're always thinking about your next snack? Frequent cravings—especially for sweets, baked goods, chips, or refined carbohydrates—may be a sign that your body is struggling to regulate blood sugar efficiently.³ When blood sugar rises and falls rapidly, it can trigger hunger signals that make you reach for quick sources of energy. Elevated insulin levels may further contribute to this cycle by influencing appetite regulation and food cravings.³ What You Can Do Focus on building balanced meals that include: 20-30 g of protein (e.g., eggs, Greek yogurt, chicken, fish, tofu, edamame) Fibre-rich carbohydrates (e.g., berries, lentils, oats, quinoa, sweet potatoes) Healthy fats (e.g., avocado, nuts, seeds, olive oil) This combination helps slow digestion, support satiety, and promote more stable blood sugar levels throughout the day.¹ A simple example might be Greek yogurt with berries and walnuts for breakfast, or a grain bowl with chicken, quinoa, roasted vegetables, and olive oil for lunch. 2. You Feel Tired After Eating Feeling sleepy after a large meal is normal occasionally. Feeling exhausted after most meals is not. Many women with insulin resistance experience significant fatigue, brain fog, or energy crashes after eating, particularly after meals high in refined carbohydrates.² This occurs because the body is working harder to manage glucose and insulin fluctuations. Over time, these swings can leave you feeling drained rather than energized.² What You Can Do Similarly to the food cravings mentioned above, strategies can include trying: Starting your day with a protein-rich breakfast such as eggs with vegetables or Greek yogurt with nuts and seeds Limiting meals that rely heavily on refined carbohydrates alone, such as pastries, sugary cereals, or white toast Going for a 10-15 minute walk after meals Even brief walks after eating have been shown to improve post-meal glucose control and support insulin sensitivity.⁴ 3. You're Gaining Weight Around Your Midsection While weight gain can occur for many reasons, increased abdominal fat is commonly associated with insulin resistance.⁵ Excess insulin promotes energy storage and can make it more difficult for the body to access stored fat for fuel. Elevated insulin levels are also associated with increased visceral fat, the type of fat stored around internal organs that contributes to metabolic risk.⁵ Importantly, insulin resistance can occur in women of all body sizes. Not everyone with insulin resistance lives in a larger body, and body weight alone is not a reliable indicator of metabolic health.¹ What You Can Do Instead of focusing solely on weight loss, prioritize: Strength training Blood sugar balance Sleep quality Stress management Consistent movement Research shows improvements in insulin sensitivity can occur even without significant changes in body weight.¹ 4. You Struggle With Brain Fog or Difficulty Concentrating If you often feel mentally sluggish, forgetful, or unable to focus, blood sugar fluctuations may be contributing. The brain relies heavily on glucose for energy. When glucose regulation becomes less stable, cognitive symptoms such as difficulty concentrating, fatigue, and reduced mental clarity may become more noticeable.⁶ What You Can Do Support steady energy by: Eating balanced meals regularly Staying hydrated Managing stress Prioritizing sleep Small lifestyle changes can have a significant impact on both metabolic health and cognitive function. 5. You Have Irregular Periods Insulin doesn't only affect blood sugar—it also influences reproductive hormones. Elevated insulin levels can stimulate ovarian androgen production, contributing to hormonal imbalances that affect ovulation and menstrual cycle regularity.¹ For many women, irregular periods may be one of the earliest signs that metabolic and hormonal health are interconnected. What You Can Do If you're experiencing: Irregular cycles Missed periods Difficulty conceiving New symptoms of acne or excess hair growth it's important to speak with a healthcare provider for a comprehensive assessment. 6. You're Developing Skin Tags or Darkened Skin Patches Certain skin changes are strongly associated with insulin resistance. Acanthosis nigricans—a condition characterized by darker, velvety patches of skin commonly found around the neck, underarms, or groin—is often linked to elevated insulin levels.² Skin tags may also occur more frequently in individuals with insulin resistance.⁷ What You Can Do These symptoms warrant a conversation with your healthcare provider, particularly if they occur alongside other signs of blood sugar dysregulation. Early intervention can help prevent progression toward prediabetes or type 2 diabetes.² How to Improve Insulin Sensitivity Naturally The good news is that insulin resistance is highly responsive to lifestyle interventions.¹ Current evidence supports several key strategies: Prioritize Resistance Training Strength training is one of the most effective tools for improving insulin sensitivity because muscle tissue acts as a major site for glucose uptake.⁸ Move More Throughout the Day Regular movement—including walking—helps muscles use glucose more efficiently and improves metabolic health.⁴ Focus on Fibre Fibre slows glucose absorption and supports healthy blood sugar regulation.¹ Aim to include: Vegetables Fruit Legumes Whole grains Nuts and seeds Support Sleep Poor sleep is associated with reduced insulin sensitivity and impaired glucose metabolism.⁹ Aim for 7-9 hours of quality sleep each night. Manage Stress Chronic stress can contribute to elevated cortisol levels, which may negatively affect insulin sensitivity and metabolic health.¹ Practices such as mindfulness, yoga, breathwork, and time outdoors can help support stress resilience. The Bottom Line Insulin resistance doesn't happen overnight, and neither does improving it. The first step is recognizing the signs. If you've been experiencing persistent cravings, fatigue, brain fog, irregular periods, increased abdominal weight gain, skin changes, or constant hunger, it may be worth exploring your metabolic health with a qualified healthcare provider. Remember: insulin resistance is not a personal failure. It's a complex physiological process influenced by genetics, hormones, lifestyle factors, and overall health. The goal isn't perfection. It's creating sustainable habits that support your body, your hormones, and your long-term wellbeing. References Teede HJ, Tay CT, Laven JJE, et al. Recommendations From the 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023;108(10):2447-2469. Sung N, Amir J, Alwahab UA, Falcone T. Polycystic ovary syndrome: An update on diagnosis and management. Cleve Clin J Med. 2026;93(3):176-183. Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA. 2002;287(18):2414-2423. DiPietro L, Gribok A, Stevens MS, Hamm LF, Rumpler W. Three 15-minute bouts of moderate postmeal walking significantly improve 24-hour glycemic control in older people at risk for impaired glucose tolerance. Diabetes Care. 2013;36(10):3262-3268. Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006;444(7121):840-846. Arnold SE, Arvanitakis Z, Macauley-Rambach SL, et al. Brain insulin resistance in type 2 diabetes and Alzheimer disease: concepts and conundrums. Nat Rev Neurol. 2018;14(3):168-181. Sinha S, Schwartz RA. Juvenile acanthosis nigricans. J Am Acad Dermatol. 2007;57(3):502-508. Bird SR, Hawley JA. Update on the effects of physical activity on insulin sensitivity in humans. BMJ Open Sport Exerc Med. 2017;2:e000143. Reutrakul S, Van Cauter E. Sleep influences on obesity, insulin resistance, and risk of type 2 diabetes. Metabolism. 2018;84:56-66.
Jun 24, 2026
7 min read
PCOS/PMOS And Me: Learning To Listen To My Body

PCOS/PMOS And Me: Learning To Listen To My Body

Kadia Bielecki
When I first heard the words, "You have PCOS," it felt like a mix of relief, confusion, and fear. Relief because I finally had an answer to years of irregular cycles, unexplained weight changes, and frustrating acne. Confusion because I had no idea what the diagnosis actually meant or where to go from there. And fear because the online space is filled with overwhelming and often inaccurate information. Looking back, I wish someone had told me that this diagnosis wasn't just about my ovaries or a condition to "fix." Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic condition that affects reproductive health, hormones, metabolism, and overall wellbeing.¹ You may have seen discussions online about changing the name polycystic ovary syndrome (PCOS). Many researchers and healthcare professionals believe the current name does not fully reflect the metabolic, hormonal, and reproductive aspects of the condition.¹ While alternative names have been proposed, PCOS remains the internationally recognized diagnostic term.¹ Regardless of what it's called, it's important to remember that the condition involves far more than the ovaries alone. Here's what I've learned through trial, error, and self-discovery. https://www.youtube.com/shorts/wOdxClzl9K0 Your Symptoms Are Valid, Even If They Don't Fit the Textbook One of the most challenging things about PCOS is that it doesn't look the same for everyone. Some women experience acne, irregular periods, and weight changes, while others struggle with hair loss, excess facial or body hair (hirsutism), infertility, or metabolic concerns.¹PCOS is a highly heterogeneous condition, meaning symptoms can vary significantly from person to person.¹It's easy to feel like your experience isn't "bad enough" or "typical enough" to count. But your symptoms, and your feelings, are valid.Learning to honour my own experience instead of comparing it to others was one of the first steps toward taking control of my health. It's Not About Perfection, It's About Balance When I was first diagnosed, I thought managing PCOS meant completely overhauling my life overnight: cutting out carbs, exercising every day, and somehow eliminating stress while balancing work, family, and everything else life throws at us. The truth is, there is no one-size-fits-all solution. Current evidence suggests that sustainable lifestyle changes—including regular physical activity, balanced nutrition, stress management, and adequate sleep—can support both metabolic and reproductive health in women with PCOS.¹ Maybe that means swapping sugary snacks for protein-rich options, prioritizing sleep, taking a daily walk, or incorporating strength training into your routine. Consistency matters far more than perfection. Advocate for Yourself at the Doctor's Office PCOS can be frustrating to navigate, particularly because diagnosis and treatment experiences vary widely. If I could go back, I'd remind myself that I have every right to ask questions, request clarification, seek additional testing when appropriate, and pursue a second opinion if something doesn't feel right. The 2023 International Evidence-Based Guideline for PCOS emphasizes the importance of patient-centred care, shared decision-making, and individualized treatment plans.¹ The right healthcare team—one that listens, educates, and supports your goals—can make a tremendous difference. Blood Sugar Is a Bigger Deal Than You Think I never realized how closely PCOS and blood sugar are connected until I started learning more about insulin resistance. Insulin resistance is a common feature of PCOS and may contribute to hormonal imbalances, irregular menstrual cycles, fertility challenges, and metabolic symptoms.¹˒² That doesn't mean you need to eliminate carbohydrates. In fact, current evidence supports consuming fibre-rich, minimally processed carbohydrates as part of a balanced eating pattern.¹ Simple strategies such as pairing carbohydrates with protein or healthy fats, choosing whole grains, and eating regular meals may help support more stable blood sugar levels and sustained energy throughout the day.¹˒³ For me, these small changes made a meaningful difference in how I felt. Your Mental Health Deserves Care Too PCOS isn't just a physical condition. Research consistently shows that women with PCOS experience higher rates of anxiety, depression, body image concerns, and reduced quality of life compared with women without the condition.¹˒⁴ The emotional impact of managing symptoms, navigating healthcare, and dealing with uncertainty can be significant. Therapy, journaling, mindfulness practices, and connecting with other women living with PCOS were all important parts of my journey. Remember: asking for help is a sign of strength, not weakness. You Are So Much More Than Your Diagnosis PCOS may be a part of your life, but it does not define who you are. Looking back, I wish I had been kinder to myself. I wish I had celebrated the small wins, trusted the process, and recognized that progress doesn't have to be perfect to be meaningful. If you've recently been diagnosed with PCOS, take a deep breath. You don't need to have all the answers today. Start with learning, stay curious, and remember that support exists. There is an entire community of healthcare professionals, researchers, advocates, and women walking this path alongside you. And most importantly, your diagnosis is only one part of your story. What I Wish I'd Done Sooner If I could go back to the day I was diagnosed, there are a few things I would have focused on earlier. Prioritize Protein at Every Meal For years, I focused on eating less rather than eating enough of the foods that kept me full and energized. Prioritizing protein helped me feel more satisfied between meals, reduced cravings, and made it easier to build balanced meals.¹˒³ Start Strength Training Sooner I used to think exercise had to mean long cardio sessions. What I didn't realize is that resistance training can help improve insulin sensitivity, support metabolic health, and preserve lean muscle mass.¹ Whether it's lifting weights, using resistance bands, or following a bodyweight workout at home, strength training became one of the most impactful changes I made. Learn About Fertility Before I Needed To One of the biggest misconceptions I had was that a PCOS diagnosis automatically meant infertility. While PCOS can affect ovulation and fertility, many women with PCOS conceive naturally or with appropriate medical support.¹ I wish I had learned sooner that fertility is not an all-or-nothing outcome and that there are effective treatment options available if challenges arise. Focus on Progress, Not Restriction I spent too much time searching for the "perfect" diet and not enough time building habits I could actually sustain. Looking back, the biggest improvements came from simple, consistent actions: eating balanced meals, moving my body regularly, prioritizing sleep, and managing stress.¹˒³ The habits that support PCOS are often the same habits that support overall health, and they don't have to be perfect to make a difference. References Cooney LG, Lee I, Sammel MD, Dokras A. High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2017;32(5):1075-1091. doi:10.1093/humrep/dex044 Teede HJ, Tay CT, Laven JJE, et al. Recommendations From the 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertil Steril. 2023;120(5):951-984. doi:10.1016/j.fertnstert.2023.07.025 Lim SS, Kakoly NS, Tan JWJ, et al. Metabolic syndrome in polycystic ovary syndrome: a systematic review, meta-analysis and meta-regression. Obes Rev. 2019;20(2):339-352. doi:10.1111/obr.12762 Barrea L, Muscogiuri G, Frias-Toral E, et al. Nutrition and PCOS: A systematic review of dietary patterns and nutritional interventions. Nutrients. 2021;13(8):2762. doi:10.3390/nu13082762
Jun 22, 2026
5 min read
Balancing Blood Sugar With PCOS: The Secret To Taking Back Control Of Your Hormones

Balancing Blood Sugar With PCOS: The Secret To Taking Back Control Of Your Hormones

Kadia Bielecki
Navigating life with PCOS can feel overwhelming, especially when it comes to figuring out what to eat. With so much conflicting advice out there, it's easy to fall into extremes, cutting carbs entirely or jumping on the latest diet trend. But what if the answer lies in balance, not restriction? Understanding how nutrition and blood sugar levels impact PCOS is a powerful tool for managing symptoms[1]. By making thoughtful, sustainable changes to your diet, you can support hormone balance, metabolic health, and overall wellbeing[1]. The Connection Between Blood Sugar and PCOS Blood sugar regulation is closely linked to PCOS for many women. Insulin resistance is a common feature of the condition and contributes to both metabolic and reproductive symptoms[1]. When the body becomes less responsive to insulin, higher levels of insulin may be needed to regulate blood sugar. Elevated insulin levels can stimulate the ovaries to produce more androgens (such as testosterone), which may contribute to irregular menstrual cycles, acne, excess hair growth, difficulty managing weight, and fertility challenges[1]. By focusing on balancing blood sugar, you're addressing one of the key underlying drivers of PCOS rather than simply managing symptoms as they arise[1]. https://www.youtube.com/shorts/j_6Wph0Dj44 Nutritional Strategies for Blood Sugar Balance Prioritize Protein in Every Meal Protein is a powerhouse when it comes to supporting blood sugar balance. Including high-quality protein at meals can help improve satiety, reduce hunger between meals, and support more stable blood sugar levels throughout the day[1,2]. Great options include: Eggs, chicken, turkey, or fish Greek yogurt or cottage cheese Plant-based proteins such as tofu, edamame, tempeh, beans, and lentils Starting your day with a protein-rich breakfast may be particularly helpful for appetite regulation and energy levels[1]. Choose the Right Carbs Carbohydrates are not the enemy. In fact, current evidence supports including carbohydrates as part of a balanced diet for PCOS[1] Rather than eliminating carbs altogether, focus on high-fiber, minimally processed carbohydrate sources that support blood sugar stability and overall metabolic health[1,2]. Examples include: Quinoa, brown rice, barley, or farro Sweet potatoes Beans and legumes Whole fruits such as berries, apples, and pears Oats Pairing carbohydrates with protein and healthy fats can further help reduce rapid blood sugar fluctuations after meals[2]. Incorporate Healthy Fats Healthy fats play an important role in overall health and can help increase feelings of fullness after meals. Unsaturated fats from foods such as olive oil, nuts, seeds, and avocado are associated with improved cardiovascular and metabolic health[1]. Try adding: Avocado Extra virgin olive oil Almonds, walnuts, pistachios Chia seeds, hemp seeds, and flaxseeds Don't Skip Meals Skipping meals may seem like a strategy for weight management, but it can sometimes lead to increased hunger, energy crashes, and overeating later in the day[1]. Consistent eating patterns may help support appetite regulation, energy levels, and blood sugar management[1]. Rather than following a strict schedule, aim for regular meals that fit your lifestyle and hunger cues. Snack Smart Snacks can be a helpful tool for preventing excessive hunger and supporting stable energy between meals. When choosing snacks, aim for a combination of protein, healthy fats, and fiber. Examples include: Apple slices with almond butter A handful of nuts with berries Greek yogurt with chia seeds Vegetables with hummus Cottage cheese with cucumber or cherry tomatoes Foods That Support Blood Sugar Balance Certain foods may offer additional benefits for blood sugar regulation and overall metabolic health. Leafy Greens Leafy greens are rich in fiber, magnesium, vitamins, and antioxidant compounds that support overall health[2]. Examples include: Spinach Kale Swiss chard Arugula Berries Berries are naturally rich in fiber and antioxidants and can be included as part of a balanced eating pattern to support blood sugar management[2]. Examples include: Blueberries Strawberries Raspberries Blackberries Ceylon Cinnamon Some studies suggest cinnamon may support healthy blood sugar regulation, particularly in women with PCOS, although the evidence is still evolving.[1] Try adding cinnamon to: Oatmeal Greek yogurt Smoothies Herbal tea Legumes Beans, lentils, and chickpeas provide both fiber and plant-based protein, making them excellent foods for supporting satiety and blood sugar regulation[2]. Soy Foods Soy foods such as tofu, edamame, and tempeh provide high-quality plant protein and may support overall metabolic health. Current evidence suggests that moderate soy consumption is safe for individuals with PCOS and can be included as part of a balanced eating pattern[3]. The Role of Meal Timing How you eat can be just as important as what you eat. For many women with PCOS, eating consistently throughout the day may help support stable energy levels, appetite regulation, and blood sugar management[1]. While there is no single meal schedule that works for everyone, some women find it helpful to eat meals and snacks at relatively consistent times. For example: Breakfast around 8–9 AM Snack around 11 AM Lunch around 1–2 PM Afternoon snack around 4 PM Dinner around 6–7 PM The goal isn't perfection or rigid scheduling. Instead, aim for a routine that feels sustainable and works with your lifestyle. Lifestyle Additions to Boost Results Move After Meals Taking a short walk after eating can help improve post-meal glucose control and support insulin sensitivity[4]. Even a 10–15 minute walk after meals may provide benefits. Think of it as your body's way of putting glucose to good use. Prioritize Regular Exercise Regular physical activity is one of the most effective lifestyle strategies for managing PCOS. Both aerobic exercise and resistance training have been shown to improve insulin sensitivity, metabolic health, and overall wellbeing, regardless of whether weight loss occurs[1]. Find movement you enjoy, whether that's: Walking Strength training Pilates Yoga Swimming Cycling Stay Hydrated Adequate hydration supports overall health, metabolism, and energy levels. Drinking enough water throughout the day may also help with appetite awareness and digestion[2]. If plain water feels boring, try: Sparkling water Herbal teas Water infused with lemon, cucumber, or berries Manage Stress Chronic stress can influence cortisol levels and may negatively affect metabolic health and wellbeing[1]. Incorporating stress-management practices such as mindfulness, meditation, yoga, deep breathing exercises, journaling, or spending time outdoors may help support both mental and physical health[1]. Finding Your Balance The goal with PCOS isn't to follow a rigid diet or eliminate entire food groups. Instead, focus on building a sustainable way of eating that nourishes your body, supports blood sugar balance, and promotes overall wellbeing[1]. Start small. Add more protein to breakfast, swap refined carbohydrates for higher-fiber options, take a walk after dinner, or experiment with new anti-inflammatory recipes. While some women with PCOS may pursue weight management goals, improvements in blood sugar control, hormone balance, energy levels, and overall health can occur regardless of changes on the scale[1]. Focusing on sustainable habits rather than restrictive dieting is often more beneficial in the long term[1]. Remember, managing PCOS is a journey, not a race. With time, consistency, and self-compassion, these nutrition and lifestyle strategies can help you feel more empowered and in control of your symptoms and your health. References Mass General Brigham. Nutrition for PCOS: How Diet Can Help Manage Symptoms. Accessed June 16, 2026. Teede HJ, Tay CT, Laven JJE, et al. Recommendations from the 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertil Steril. 2023;120(5):951-984. doi:10.1016/j.fertnstert.2023.07.025 Johns Hopkins Medicine. PCOS Diet: How Nutrition Can Help Manage Symptoms. Updated 2026. Accessed June 16, 2026. Sung N, Amir J, Alwahab UA, Falcone T. Polycystic ovary syndrome: An update on diagnosis and management. Cleve Clin J Med. 2026;93(3):176-183. doi:10.3949/ccjm.93a.25090
Jun 19, 2026
5 min read
Creatine for Brain Health: Benefits, Uses, and What the Research Says

Creatine for Brain Health: Benefits, Uses, and What the Research Says

Kadia Bielecki
Creatine Is Not Just for Muscle Creatine is often known as a fitness supplement, but it also plays an important role in brain energy metabolism.¹ The brain has high energy needs, and creatine helps support the recycling of adenosine triphosphate, or ATP, which cells use for energy.² Because the brain relies on consistent energy availability, researchers are studying creatine for memory, attention, mental fatigue, mood, aging, and sleep deprivation.¹,² The current evidence is promising, but not definitive.¹ For most healthy adults, creatine should be viewed as a supportive nutrient, not a cure or stand-alone treatment for cognitive or mental health concerns.¹,³ What Is Creatine? Creatine is a naturally occurring compound made from amino acids and stored mainly in muscle, with smaller amounts found in the brain.² Creatine can also be obtained through foods such as meat and fish, and through supplemental creatine monohydrate.²,⁴ Inside cells, creatine helps replenish ATP by participating in the creatine kinase and phosphocreatine energy system.² This energy-buffering system is especially relevant in tissues with high or fluctuating energy demands, including skeletal muscle and the brain.² How Might Creatine Support Brain Health? Creatine may support brain health by helping maintain cellular energy availability during periods of increased cognitive or metabolic demand.¹,² Research suggests that creatine supplementation can increase brain creatine stores, although changes in brain creatine may depend on dose, duration, baseline status, age, sex, diet, and study methods.² Creatine appears most likely to help cognition when the brain is under stress, such as during sleep deprivation, aging, or low creatine availability.¹,²,⁵ A naturopathic lens would frame creatine as part of a broader brain-health foundation that also includes sleep, protein intake, blood sugar balance, exercise, stress regulation, and nutrient sufficiency.¹,² Creatine and Memory A 2024 systematic review and meta-analysis of randomized controlled trials found that creatine supplementation had a significant positive effect on memory function in adults.¹ The same review found that creatine did not improve every cognitive outcome, which suggests that its benefits may be domain-specific rather than global.¹ However, benefits were not observed across all cognitive domains, suggesting that creatine's effects may be more targeted rather than broadly enhancing cognition.¹ In older adults, a 2025 systematic review found that most included studies reported a positive relationship between creatine and cognition, particularly in memory and attention.That said, the overall body of evidence is still developing, and larger, high-quality studies are needed to better understand the extent of these benefits.⁶ Creatine may be a helpful tool for supporting memory and cognitive health, but it should be viewed as one component of a broader brain health strategy rather than a standalone solution.¹,⁶ Creatine, Attention, and Processing Speed Emerging research suggests that creatine may also support aspects of attention and processing speed. A 2024 systematic review and meta-analysis found that creatine supplementation improved attention time and processing speed time in adults, indicating that participants were able to complete certain cognitive tasks more efficiently.¹ These findings are particularly interesting because attention and processing speed play important roles in everyday cognitive performance, influencing how quickly we absorb information, respond to stimuli, and complete mentally demanding tasks.¹ Additional evidence comes from a large randomized, double-blind, placebo-controlled crossover trial in which participants supplemented with 5 g of creatine daily for 6 weeks. Researchers observed small but measurable improvements in cognitive performance, further supporting creatine's potential role in brain function.⁴ While improvements were not observed across every cognitive measure, the overall findings suggest that creatine may help support cognitive efficiency, particularly in situations where mental energy demands are higher.¹,⁴ Taken together, current evidence indicates that creatine may offer meaningful support for attention, processing speed, and overall cognitive performance as part of a comprehensive brain health strategy.¹,⁴ Creatine and Sleep Deprivation Creatine may be particularly relevant when the brain is under acute energy stress.⁵ A 2024 Scientific Reports study found that a high single dose of creatine during sleep deprivation improved cognitive performance and processing speed while also changing brain high-energy phosphate markers.⁵ The dose used in that study was 0.35 g per kg of body weight, which is much higher than the typical daily creatine dose used by many consumers.⁵ Because high-dose protocols may increase the likelihood of gastrointestinal discomfort and are not necessary for everyone, people should not assume that sleep-deprivation study doses are appropriate for routine daily use.⁵,⁷ Creatine and Mood Creatine is also being studied in nutritional psychiatry because brain energy metabolism may be relevant to mood regulation.³,⁸ A 2025 systematic review and meta-analysis found that creatine may offer a small-to-moderate benefit for depressive symptoms, but the evidence was very uncertain and the average effect may not be clinically important.³ From a holistic perspective, creatine may be one nutritional tool to discuss with a qualified clinician when mood, fatigue, exercise recovery, and brain energy are all part of the picture.³,⁸ Why Creatine May Be Especially Interesting for Women Creatine research in women is still less developed than creatine research in men.⁹ A women’s health review reported that creatine metabolism may be influenced by life-stage factors such as menstruation, pregnancy, postpartum, and menopause.⁹ The same review noted that creatine supplementation may have potential relevance across the female lifespan, including for strength, body composition, mood, and cognitive health.⁹ For Wellex readers, this is important because brain health is often connected to energy, sleep, hormones, stress resilience, muscle health, and healthy aging.²,⁹ Can You Get Creatine From Food? Yes, creatine is found primarily in animal foods such as red meat and fish.² People who eat little or no animal protein may have lower dietary creatine intake than omnivores.²,⁴ However, a 2023 randomized controlled trial found that vegetarians did not benefit more from creatine than omnivores in that specific study, which suggests that diet may matter but does not fully predict response.⁴ This is another reason creatine should be approached individually rather than as a one-size-fits-all supplement.⁴ What Type of Creatine Is Best Studied? Creatine monohydrate is the most studied form of creatine.² Most clinical research on creatine uses creatine monohydrate, making it the most evidence-supported option for people considering supplementation.²,⁷ Other forms of creatine are often marketed as superior, but there is not strong evidence that they are consistently more effective for brain or body outcomes than creatine monohydrate.²,⁷ How Much Creatine Is Used for Brain Health? There is no universally established dose for brain health.¹,² Many general creatine studies use 3 to 5 g per day, while some cognitive or sleep-deprivation studies use higher short-term doses.⁴,⁵,⁷ A practical, conservative approach for healthy adults is often 3 to 5 g of creatine monohydrate daily, although dosing should be individualized based on health status, goals, body size, diet, and clinician guidance.²,⁷ People with kidney disease, people taking kidney-affecting medications, and people who are pregnant or breastfeeding should speak with a qualified healthcare provider before starting creatine.⁷,⁹ Is Creatine Safe? Creatine is one of the most studied dietary supplements, and creatine monohydrate has a strong safety record in healthy adults.²,⁷ A 2025 systematic review and meta-analysis found that creatine supplementation was associated with a modest increase in serum creatinine, but did not significantly change glomerular filtration rate, suggesting preserved kidney function in the included studies.⁷ Because serum creatinine can rise due to creatine metabolism, lab interpretation should consider supplement use.⁷ Some people may experience gastrointestinal discomfort or temporary water retention, particularly with higher doses or loading protocols.⁴,⁷ Who Might Consider Creatine for Brain Health? Creatine may be worth discussing with a healthcare provider if someone is interested in supporting memory, mental fatigue, exercise recovery, healthy aging, or cognitive performance during periods of high demand.¹,²,⁵,⁶ It may also be relevant for people who consume little meat or fish, although response can vary and is not guaranteed.²,⁴ Creatine is not a substitute for sleep, adequate calories, protein, hydration, iron status, thyroid assessment, mental health care, or medical evaluation of persistent symptoms.¹,³ Frequently Asked Questions Is creatine good for brain health? Creatine may support brain health by helping maintain cellular energy availability, and research suggests potential benefits for memory, attention time, processing speed time, and cognition under stress.¹,²,⁵ Does creatine improve memory? A 2024 systematic review and meta-analysis found a significant positive effect of creatine supplementation on memory function in adults.¹ Does creatine help with brain fog? Brain fog is not a formal diagnosis and can have many causes, including poor sleep, stress, low iron, thyroid dysfunction, blood sugar fluctuations, medication effects, and mental health conditions.¹,³ Creatine may support aspects of cognition in some contexts, but persistent brain fog should be assessed by a healthcare provider.¹,³ Is creatine helpful for women? Creatine may be relevant for women across different life stages, but female-specific research is still developing.⁹ Is creatine safe to take every day? Creatine monohydrate is generally well studied and appears safe for healthy adults when used appropriately, but people with kidney disease or specific medical conditions should seek medical guidance first.²,⁷ What is the best creatine for brain health? Creatine monohydrate is the best-studied form and is the most evidence-supported option.² The Bottom Line Creatine is more than a gym supplement.¹ It plays a meaningful role in cellular energy metabolism, including in the brain.² Current research suggests creatine may support memory, attention time, processing speed time, and cognitive performance during periods of metabolic stress such as sleep deprivation.¹,⁵ The evidence is promising but still evolving, and benefits are likely to be modest, context-dependent, and individualized.¹,⁴,⁶ From a naturopathic perspective, creatine fits best as part of a broader brain-health foundation that includes sleep, protein, movement, stress regulation, nutrient sufficiency, hydration, and personalized care.¹,² References Xu C, Bi S, Zhang W, Luo L. The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis. Front Nutr. 2024;11:1424972. doi:10.3389/fnut.2024.1424972 Candow DG, Forbes SC, Ostojic SM, et al. “Heads up” for creatine supplementation and its potential applications for brain health and function. Sports Med. 2023;53(1):49-65. doi:10.1007/s40279-023-01870-9 Eckert I, Lima J, Dariva AA. Creatine supplementation for treating symptoms of depression: a systematic review and meta-analysis. Br J Nutr. 2025;134(11):947-959. doi:10.1017/S0007114525105588 Sandkühler JF, Kersting X, Faust A, et al. The effects of creatine supplementation on cognitive performance: a randomised controlled study. BMC Med. 2023;21:440. doi:10.1186/s12916-023-03146-5 Gordji-Nejad A, Matusch A, Kleedörfer S, et al. Single dose creatine improves cognitive performance and induces changes in cerebral high energy phosphates during sleep deprivation. Sci Rep. 2024;14:4937. doi:10.1038/s41598-024-54249-9 Marshall S, Kitzan A, Wright J, Bocicariu L, Nagamatsu LS. Creatine and cognition in aging: a systematic review of evidence in older adults. Nutr Rev. 2026;84(2):333-344. doi:10.1093/nutrit/nuaf135 Kabiri Naeini E, Eskandari M, Mortazavi M, Gholaminejad A, Karevan N. Effect of creatine supplementation on kidney function: a systematic review and meta-analysis. BMC Nephrol. 2025;26:622. doi:10.1186/s12882-025-04558-6 Hossain M, Khan S, et al. The role of brain creatine in behavioral health conditions. Front Psychiatry. 2025;16:1667639. doi:10.3389/fpsyt.2025.1667639 Smith-Ryan AE, Cabre HE, Eckerson JM, Candow DG. Creatine supplementation in women’s health: a lifespan perspective. Nutrients. 2021;13(3):877. doi:10.3390/nu13030877
Jun 17, 2026
8 min read
Mineral Deficiencies in Women: Signs, Causes, and How to Support Optimal Health

Mineral Deficiencies in Women: Signs, Causes, and How to Support Optimal Health

Kadia Bielecki
Mineral Deficiencies in Women Are More Common Than You Think Fatigue that won't go away. Frequent headaches. Muscle cramps. Hair shedding. Feeling cold all the time. While these symptoms can have many causes, mineral deficiencies are often an overlooked piece of the puzzle. Minerals are essential nutrients that support energy metabolism, thyroid function, immune health, nervous system function, bone health, and hormone production.¹ Research suggests that inadequate intake of key minerals remains common worldwide, with women disproportionately affected by deficiencies in iron, iodine, calcium, magnesium, zinc, selenium, and other micronutrients due to menstruation, pregnancy, dietary patterns, and increased physiological demands.² From a naturopathic perspective, symptoms can sometimes reflect underlying nutritional imbalances. Mineral status is one foundational area worth evaluating when persistent symptoms arise. What Are Mineral Deficiencies? A mineral deficiency occurs when the body does not receive, absorb, or utilize enough of a specific mineral to meet physiological needs.¹ Minerals participate in hundreds of enzymatic and biochemical processes throughout the body, influencing energy production, cellular signaling, immune function, hormone synthesis, oxygen transport, and bone metabolism.¹ Even mild deficiencies may contribute to symptoms before a deficiency progresses to a diagnosable condition.¹ Why Are Women More Vulnerable to Mineral Deficiencies? Women's nutrient needs shift throughout different life stages. Menstruation Menstrual blood loss increases iron requirements and is one of the leading contributors to iron deficiency among women of reproductive age.³ Pregnancy and Breastfeeding Pregnancy significantly increases the body's requirements for iron, iodine, zinc, calcium, and other micronutrients needed to support maternal health and fetal development.⁴ Restrictive Diets Vegetarian, vegan, low-calorie, and highly restrictive eating patterns may increase the risk of inadequate intake of certain minerals if not appropriately planned.² Digestive Challenges Digestive conditions that impair absorption, including celiac disease, inflammatory bowel disease, and chronic gastrointestinal disorders, may contribute to nutrient deficiencies.¹ Soil Depletion and Food Quality Modern agricultural practices may influence the mineral content of some foods. Selenium content, for example, varies considerably depending on soil concentrations, which can affect dietary intake across different geographic regions.⁸ The Most Common Mineral Deficiencies in Women 1. Iron Deficiency Iron deficiency is among the most common nutrient deficiencies globally and disproportionately affects women during their reproductive years.²,³ Common Symptoms of Iron Deficiency Common symptoms may include:³ Fatigue Weakness Reduced exercise tolerance Shortness of breath Dizziness Hair loss Difficulty concentrating Food Sources of Iron Red meat Poultry Shellfish Lentils Beans Pumpkin seeds Consuming vitamin C-rich foods alongside plant-based iron sources can improve non-heme iron absorption.⁵ 2. Magnesium Deficiency Magnesium is a cofactor in more than 300 enzymatic reactions and plays important roles in energy metabolism, muscle contraction, nervous system function, and blood glucose regulation.⁶ Although severe magnesium deficiency is relatively uncommon, inadequate magnesium intake remains widespread in many populations.⁶ Possible Symptoms of Low Magnesium Magnesium insufficiency has been associated with:⁶ Muscle cramps Muscle twitches Fatigue Sleep disturbances Headaches Reduced stress resilience Food Sources of Magnesium Pumpkin seeds Almonds Cashews Black beans Avocado Leafy greens 3. Iodine Deficiency Iodine is required for the production of thyroid hormones, which regulate metabolism, growth, and neurological function.¹ Women are at greater risk of iodine insufficiency during pregnancy and reproductive years due to increased physiological demands.²,⁴ Possible Symptoms of Iodine Deficiency Symptoms associated with inadequate iodine status may include:¹ Fatigue Feeling cold Dry skin Hair thinning Brain fog Changes in thyroid function Both iodine deficiency and excessive iodine intake may negatively affect thyroid health, highlighting the importance of individualized assessment.¹ 4. Zinc Deficiency Zinc contributes to immune function, wound healing, reproductive health, DNA synthesis, and cellular growth.¹ Potential Signs of Zinc Deficiency Low zinc status may contribute to:¹ Frequent illness Slow wound healing Hair shedding Changes in taste or smell Reduced appetite Food Sources of Zinc Oysters Beef Poultry Pumpkin seeds Chickpeas Hemp seeds Phytates naturally found in legumes and grains may reduce zinc absorption, which can increase zinc requirements in some plant-based diets.¹ 5. Calcium Deficiency Calcium is essential for bone health, muscle contraction, nerve signaling, and cardiovascular function.⁷ Inadequate calcium intake remains a significant global public health concern.² Possible Signs of Low Calcium Intake Muscle cramps Brittle nails Reduced bone mineral density over time Increased osteoporosis risk Food Sources of Calcium Dairy products Sardines Tofu Tahini Kale Bok choy Calcium's Important Nutrient Partners Calcium does not work in isolation. Vitamin D helps increase calcium absorption from the digestive tract and supports bone mineralization.⁷ Magnesium plays a critical role in vitamin D activation and calcium regulation within the body.⁶˒⁷ Vitamin K2 helps direct calcium into bones and teeth while supporting healthy calcium distribution throughout the body.⁹ Optimal bone health depends on adequate intake and balance of all of these nutrients rather than calcium alone.⁷˒⁹ 6. Selenium Deficiency Selenium is a trace mineral that plays important roles in antioxidant defense, immune function, reproductive health, and thyroid hormone metabolism.⁸ Selenium is required for enzymes that help convert thyroxine (T4) into the more biologically active thyroid hormone triiodothyronine (T3), making it an important nutrient for thyroid health.⁸ Selenium intake can vary considerably depending on soil concentrations, and low-selenium regions may be associated with lower dietary intake.⁸ Possible Signs of Low Selenium Status Low selenium status may contribute to:⁸ Fatigue Impaired thyroid function Increased oxidative stress Weakened immune function Hair thinning Food Sources of Selenium Brazil nuts Seafood Tuna Sardines Eggs Turkey Sunflower seeds Brazil nuts are among the richest dietary sources of selenium, although selenium content can vary substantially depending on where they are grown.⁸ Can You Be Deficient Even If You Eat a Healthy Diet? Yes. Diet is only one factor influencing mineral status. Additional factors include:¹ Malabsorption Digestive disorders Certain medications Increased physiological demands Heavy menstrual bleeding Chronic inflammation This is why individualized assessment is often more informative than focusing on dietary intake alone. How to Support Healthy Mineral Levels Naturally Prioritize Nutrient-Dense Foods A varied diet rich in vegetables, legumes, seafood, quality proteins, nuts, seeds, and whole foods helps support adequate mineral intake.¹ Support Digestive Health Healthy digestion plays an important role in nutrient absorption and utilization.¹ Avoid Unnecessary Restriction Long-term restrictive dietary patterns may increase the risk of nutrient gaps if not carefully planned.² Consider Testing When Appropriate Laboratory testing can help identify certain nutrient deficiencies and guide personalized interventions.¹ Use Supplements Strategically Supplements may be beneficial in specific situations, but they should complement rather than replace a nutrient-dense dietary foundation.¹ References Raiten DJ, Ashour FAS, Ross AC, et al. The science of micronutrients in clinical practice. Clin Nutr. 2023;42(10):1761-1774. doi:10.1016/j.clnu.2023.06.021 Passarelli S, Free CM, Shepon A, et al. Global estimation of dietary micronutrient inadequacies: a modelling analysis. Lancet Glob Health. 2024;12(10):e1590-e1599. doi:10.1016/S2214-109X(24)00276-6 Haas JD, Egli I, Beard JL, et al. Identification and management of iron deficiency in women of reproductive age. Int J Gynecol Obstet. 2023;163(S1):12-22. Camaschella C, Pagani A, Nai A, Silvestri L. Iron deficiency and micronutrient needs across the female life cycle. JAMA. 2025. Lynch SR, Cook JD. Interaction of vitamin C and iron absorption: mechanisms and implications. Am J Clin Nutr. 2023 update review. Schuette SA, Rosanoff A, DiNicolantonio JJ, et al. Magnesium: health effects, deficiency burden, and future public health directions. Nutrients. 2025;17(22):3626. Weaver CM, Gordon CM, Janz KF, et al. Peak bone mass development and lifestyle factors: a systematic review and position statement. Osteoporos Int. 2016;27(4):1281-1386. doi:10.1007/s00198-015-3440-3 Kieliszek M. Selenium—fascinating microelement, properties and sources in food. Molecules. 2019;24(7):1298. Akbari S, Rasouli-Ghahroudi AA. Vitamin K and bone metabolism: a review of the latest evidence in preclinical studies. Biomed Res Int. 2018.
Jun 15, 2026
6 min read
The Different Types of PCOS/PMOS: Why Your Symptoms May Not Look Like Someone Else’s

The Different Types of PCOS/PMOS: Why Your Symptoms May Not Look Like Someone Else’s

Kadia Bielecki
Polycystic ovary syndrome, or PCOS/PMOS, is often talked about as one condition. But anyone who works with women’s hormones knows that PCOS/PMOS rarely looks the same from person to person. One woman may have irregular cycles, acne, and high androgens. Another may have insulin resistance and weight gain. Someone else may have elevated AMH, polycystic-appearing ovaries, and difficulty ovulating, but very little metabolic dysfunction. This is one of the reasons PCOS/PMOS can feel confusing, frustrating, and under-personalized. The diagnosis is real, but the presentation is highly individual. Newer research is helping us understand PCOS/PMOS less as a single “type” of hormone imbalance and more as a spectrum with distinct patterns. A large 2025 study published in Nature Medicine identified four reproducible PCOS/PMOS subtypes using clinical and hormone data from more than 11,000 women, with validation across multiple international cohorts.¹ This does not replace a clinical diagnosis, but it does give patients and practitioners a more nuanced way to think about symptoms, risks, and care. First, What Is PCOS/PMOS? PCOS/PMOS is a common endocrine and metabolic condition that can affect menstrual cycles, ovulation, androgen levels, fertility, skin, hair growth, insulin sensitivity, and long-term cardiometabolic health.² Most clinicians diagnose PCOS/PMOS using the Rotterdam criteria, which require at least two of the following after other causes are excluded: Irregular ovulation or irregular menstrual cycles Clinical or biochemical signs of hyperandrogenism, such as acne, hirsutism, or elevated testosterone Polycystic ovarian morphology on ultrasound or, in some cases, elevated anti-Müllerian hormone, also known as AMH²,³ But these criteria do not tell the whole story. Two people can both meet diagnostic criteria for PCOS/PMOS and have completely different root drivers, symptoms, fertility patterns, and metabolic risks. This is also one reason some experts and organizations have begun using the term PMOS (Polyfollicular Metabolic Ovarian Syndrome) alongside or instead of PCOS. The traditional name, polycystic ovary syndrome, can be misleading because the ovaries do not actually contain cysts, and not everyone with the condition has polycystic-appearing ovaries. The newer terminology aims to better reflect the metabolic, hormonal, and reproductive features of the condition rather than focusing on a single ovarian finding. Regardless of the name used, the underlying message remains the same: PCOS/PMOS is a highly diverse condition that can present differently from person to person. That is where subtyping may be helpful. Why PCOS/PMOS Subtypes Matter Understanding PCOS/PMOS subtypes can help shift the conversation from “Do you have PCOS/PMOS?” to “What pattern of PCOS/PMOS are we seeing, and what does your body need most?” This distinction matters because PCOS/PMOS can involve different combinations of: Androgen excess Insulin resistance Ovulatory dysfunction Higher AMH or ovarian follicle activity Changes in body composition Inflammation and cardiometabolic risk Fertility and pregnancy-related risks Earlier research identified reproductive and metabolic subtypes of PCOS/PMOS, suggesting that PCOS/PMOS patterns may reflect different underlying biology rather than one uniform condition.⁴ The newer 2025 study expanded this work and identified four data-driven subtypes: hyperandrogenic PCOS/PMOS, obesity-associated PCOS/PMOS, high-SHBG PCOS/PMOS, and high-LH/AMH PCOS/PMOS.¹ These categories are not meant to put anyone in a box. Instead, they can help guide more personalized screening, lifestyle support, fertility planning, and long-term prevention. Type 1: Hyperandrogenic PCOS/PMOS Hyperandrogenic PCOS/PMOS is characterized by higher androgen levels, especially testosterone and DHEA-S.¹ Androgens are sometimes called “male-type” hormones, but all women naturally produce them. The issue in PCOS/PMOS is not the presence of androgens, but excess androgen activity or sensitivity. This subtype may be associated with: Acne Excess facial or body hair growth Scalp hair thinning Irregular cycles Higher testosterone or DHEA-S Possible lipid changes Increased risk of metabolic dysfunction over time¹ In the 2025 study, the hyperandrogenic subtype had the highest incidence of dyslipidemia during follow-up and was also associated with a higher risk of second trimester pregnancy loss in IVF data.¹ This does not mean that every woman with high-androgen PCOS/PMOS will experience these outcomes, but it does suggest that androgen-dominant PCOS/PMOS deserves careful cardiometabolic and reproductive monitoring. For this subtype, care often focuses on reducing androgen burden, supporting ovulation, improving insulin sensitivity when relevant, and monitoring cholesterol, blood pressure, and glucose markers. Helpful clinical areas to assess may include: Total and free testosterone DHEA-S SHBG Fasting insulin and glucose Hemoglobin A1c Lipid panel Cycle regularity and ovulation patterns Type 2: Metabolic PCOS/PMOS The obesity-associated PCOS/PMOS subtype is characterized by higher BMI, fasting glucose, and fasting insulin.¹ This pattern tends to overlap strongly with insulin resistance, although insulin resistance can occur in PCOS/PMOS at any body size. This subtype may be associated with: Weight gain or difficulty losing weight Insulin resistance Higher fasting insulin Higher fasting glucose Increased risk of type 2 diabetes Higher blood pressure Higher triglycerides or cholesterol changes Fatigue or blood sugar instability¹,⁵ In the 2025 study, this subtype had the most severe metabolic complications, including the highest prevalence of type 2 diabetes, dyslipidemia, and hypertension at baseline. During follow-up, it also had the highest incidence of type 2 diabetes.¹ This is one reason it is so important not to treat PCOS/PMOS as only a fertility or menstrual cycle issue. PCOS/PMOS is also a long-term metabolic health condition for many women. Large reviews have found that PCOS/PMOS is associated with increased cardiometabolic risk, including higher risk of impaired glucose regulation and type 2 diabetes.⁵ Support for this subtype often focuses on insulin sensitivity, metabolic flexibility, strength training, adequate protein, fiber intake, sleep, stress physiology, and medications when appropriate. In some cases, metformin or other metabolic therapies may be considered as part of a personalized plan.² It is also important to avoid framing this subtype as a willpower issue. Weight and insulin resistance are not simply behavioral problems. They are influenced by hormones, genetics, muscle metabolism, inflammation, sleep, stress, medications, and environment. Type 3: High-SHBG PCOS/PMOS SHBG stands for sex hormone-binding globulin. It is a protein made by the liver that binds hormones like testosterone and estrogen in the bloodstream. When SHBG is higher, there is generally less free, biologically active testosterone available. In the 2025 study, the high-SHBG subtype had the highest SHBG levels and the lowest BMI among the four groups. It was also associated with lower testosterone and LH levels, more favorable reproductive outcomes, and the lowest incidence of diabetes and hypertension during follow-up.¹ This subtype may be associated with: Irregular cycles Ovulatory dysfunction Polycystic ovarian morphology or elevated ovarian follicle markers Less obvious androgen excess Lower metabolic risk compared with other subtypes¹ This pattern may be confusing for patients because they may not “look like” the stereotypical PCOS/PMOS presentation. They may not have significant acne, facial hair growth, weight gain, or insulin resistance, yet they may still struggle with irregular cycles or ovulation. This is a good reminder that PCOS/PMOS is not always visible from the outside. A person does not need to have every classic symptom to deserve proper evaluation and care. For this subtype, the focus may be more reproductive and ovulatory than metabolic, though metabolic screening is still recommended for all people with PCOS/PMOS.² Type 4: High-LH/AMH PCOS/PMOS The high-LH/AMH subtype is characterized by elevated luteinizing hormone, or LH, and elevated anti-Müllerian hormone, or AMH.¹ LH is a brain-derived reproductive hormone involved in ovulation. AMH is produced by ovarian follicles and is often elevated in PCOS/PMOS because there may be a higher number of small developing follicles. This subtype may be associated with: Irregular or absent ovulation Longer or unpredictable cycles Elevated AMH Elevated LH Polycystic ovarian morphology Higher risk of ovarian hyperstimulation during IVF¹ In the 2025 study, this group had the lowest PCOS/PMOS remission rate during follow-up and the greatest risk of ovarian hyperstimulation syndrome during IVF treatment.¹ This may be especially relevant for women pursuing fertility treatment, since elevated AMH and high follicle activity can affect ovarian stimulation response. This subtype often reflects a more reproductive or ovarian-driven PCOS/PMOS pattern. Management may focus on supporting ovulation, carefully monitoring fertility treatment if needed, and avoiding overly aggressive ovarian stimulation. What About “Lean PCOS/PMOS”? Many people use the term “lean PCOS/PMOS” to describe PCOS/PMOS in individuals with a lower body weight or BMI. While this can be a useful descriptive term, it is not a complete subtype on its own. Body size alone does not determine the underlying hormonal or metabolic pattern. A person with lean PCOS/PMOS may still experience insulin resistance, androgen excess, ovulatory dysfunction, or other features commonly associated with the condition. Someone with lean PCOS may fall into a high-SHBG pattern, a high-LH/AMH pattern, or a hyperandrogenic pattern. They may also still have insulin resistance, even if their BMI is considered normal. This is why lab testing and symptom patterns matter more than appearance alone. What This Means for Personalized PCOS/PMOS Care The most important takeaway is that PCOS/PMOS care should not be one-size-fits-all. A person with high-androgen PCOS/PMOS may need more support with androgen symptoms, lipid monitoring, and ovulation. A person with metabolic PCOS/PMOS may need more intensive insulin and cardiometabolic support. A person with high-LH/AMH PCOS/PMOS may need fertility planning. A person with high-SHBG PCOS/PMOS may need ovulatory support even if they do not have obvious metabolic symptoms. A more personalized PCOS/PMOS workup may include: Menstrual cycle history Ovulation tracking when relevant Total and free testosterone DHEA-S SHBG LH and FSH AMH Fasting glucose Fasting insulin Hemoglobin A1c Lipid panel Blood pressure Thyroid and prolactin testing when clinically appropriate Screening for sleep, stress, mood, and disordered eating risk² The 2023 International Evidence-Based Guideline for PCOS/PMOS also emphasizes lifelong health, including metabolic screening, emotional wellbeing, fertility support, and individualized lifestyle care.² Lifestyle Still Matters, But It Should Be Matched to the Person Lifestyle support is foundational in PCOS/PMOS, but the goal is not to give every woman the same diet or exercise plan. For many women, the most helpful approach includes: Building balanced meals with protein, fiber, and healthy fats Supporting muscle through resistance training Improving sleep consistency Reducing long gaps without nourishment if blood sugar symptoms are present Managing stress physiology Supporting gut health and regular bowel movements Reducing ultra-processed foods without creating unnecessary restriction Addressing nutrient deficiencies when present There is no single “PCOS/PMOS diet” that works for everyone. The best plan is the one that supports insulin sensitivity, hormone balance, nervous system regulation, and long-term consistency without shame or over-restriction. A Few Important Misconceptions PCOS/PMOS is not always caused by weight. Weight can worsen insulin resistance and hormone symptoms for some people, but PCOS/PMOS is not simply a weight-related condition. Lean women can have PCOS/PMOS, and women in larger bodies deserve care that goes beyond weight-loss advice. Regular periods do not always rule out PCOS/PMOS. Some women with PCOS/PMOS have cycles that appear somewhat regular but still have androgen excess, polycystic ovarian morphology, or inconsistent ovulation. High AMH does not always mean better fertility. AMH can reflect a higher number of ovarian follicles, but in PCOS/PMOS it may also reflect disrupted follicle development and irregular ovulation. PCOS/PMOS care should not stop after pregnancy. PCOS/PMOS can affect long-term metabolic and cardiovascular health. Ongoing screening for glucose, lipids, blood pressure, and liver-related risk may be important, especially in more metabolic subtypes.²,⁵ Final Thoughts PCOS/PMOS is not one single pattern. It is a complex endocrine and metabolic condition with different presentations, different drivers, and different long-term considerations. Understanding PCOS/PMOS subtypes can help women feel less confused by their symptoms and more empowered in their care. It can also help clinicians move beyond generic advice and toward more personalized strategies. Whether your PCOS/PMOS pattern is more androgen-driven, metabolic, ovulatory, or ovarian-driven, the goal is the same: to understand your body clearly, support your hormones compassionately, and create a plan that protects your long-term health. Personalized PCOS/PMOS care is not about labeling you. It is about listening more closely to what your body is already telling us. References Gao X, Zhao S, Du Y, et al. Data-driven subtypes of polycystic ovary syndrome and their association with clinical outcomes. Nature Medicine. 2025;31(12):4214-4224. https://doi.org/10.1038/s41591-025-03984-1 Teede HJ, Tay CT, Laven J, et al. Recommendations from the 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Human Reproduction. 2023;38(9):1655-1679. https://doi.org/10.1093/humrep/dead156 Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Human Reproduction. 2004;19(1):41-47. https://doi.org/10.1093/humrep/deh098 Dapas M, Lin FTJ, Nadkarni GN, et al. Distinct subtypes of polycystic ovary syndrome with novel genetic associations: An unsupervised, phenotypic clustering analysis. PLOS Medicine. 2020;17(6):e1003132. https://doi.org/10.1371/journal.pmed.1003132 Wekker V, van Dammen L, Koning A, et al. Long-term cardiometabolic disease risk in women with PCOS: A systematic review and meta-analysis. Human Reproduction Update. 2020;26(6):942-960. https://doi.org/10.1093/humupd/dmaa029 Legro RS, Brzyski RG, Diamond MP, et al. Letrozole versus clomiphene for infertility in the polycystic ovary syndrome. New England Journal of Medicine. 2014;371(2):119-129. https://doi.org/10.1056/NEJMoa1313517
Jun 11, 2026
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