Dear Me: What I Wish I Knew When I Was Diagnosed With PCOS/PMOS

Your Body Isn’t Working Against You

It may feel like your body has let you down. You might wonder what you did wrong or why this happened.

The truth is, you didn’t cause this.

PCOS/PMOS is one of the most common endocrine disorders affecting women of reproductive age. It develops because of a complex combination of genetics, hormone signalling, insulin regulation, and environmental influences. Researchers know that PCOS/PMOS is not caused by a lack of willpower or poor lifestyle choices.¹⁻³

Instead of trying to “fight” your body, start getting curious about it.

Keep track of your symptoms, ask questions during appointments, and remember that understanding your body is the first step toward supporting it.

There Is No One Right Way to Manage PCOS/PMOS

You’re about to hear every piece of advice imaginable.

“Go keto.”

“Cut carbs.”

“Exercise more.”

“Take this supplement.”

The reality is that PCOS/PMOS looks different for everyone. Some women primarily experience irregular periods, while others struggle with acne, excess hair growth, insulin resistance, fertility challenges, or weight changes.²˒³

Rather than trying every trend you see online, focus on building a routine that you can actually maintain.

The foundations of PCOS/PMOS management are often less about finding the “perfect” diet or supplement and more about supporting your body consistently through lifestyle habits. The 2023 International Evidence-Based Guideline for PCOS/PMOS recommends prioritizing nutrition, regular physical activity, adequate sleep, stress management, and maintaining a healthy relationship with food and your body.¹ Aim for a pattern of eating that includes plenty of vegetables, fruit, whole grains, healthy fats, and lean protein rather than focusing on restrictive diets.

Start with one or two sustainable habits, whether that’s adding more protein to breakfast, taking a walk after dinner, strength training a few times each week, or creating a consistent bedtime routine. Small, consistent changes are often more powerful than dramatic ones.

Build a Healthcare Team You Trust

One of the biggest lessons you’ll learn is that you don’t have to figure everything out alone.

Research shows women with PCOS/PMOS are more likely to experience anxiety, depression, body image concerns, and reduced quality of life than women without PCOS/PMOS.⁴⁻⁵

Find healthcare providers who listen to your concerns.

Consider working with a registered dietitian if nutrition feels overwhelming, or a mental health professional if you’re struggling emotionally.

And don’t underestimate the value of connecting with other women who understand what you’re going through.

Your healthcare team may also help you determine whether additional supports could benefit you. Depending on your symptoms and goals, this might include working with a physiotherapist to address pelvic pain, a dermatologist for acne or hair concerns, or discussing whether certain supplements, such as inositol, vitamin D, omega-3 fatty acids, or other evidence-supported options, are appropriate for you.¹ The best plan is one that’s individualized to your needs.

Learn About Blood Sugar Early

Even if your doctor doesn’t mention insulin resistance today, it’s something worth learning about.

Approximately 50% to 75% of women with PCOS/PMOS have some degree of insulin resistance, regardless of body weight.²

The good news is that you don’t have to change everything overnight.

Start by:

• Pairing carbohydrates with protein or healthy fats.
• Eating fibre-rich foods at most meals.
• Moving your body regularly, including resistance training a few times per week when possible.
• Eating consistently instead of skipping meals.
• Prioritizing quality sleep, since poor sleep can make blood sugar regulation more challenging.
• Finding healthy ways to manage stress, as chronic stress can also affect hormones and metabolic health.

These simple habits work together to support healthy blood sugar regulation and may help improve energy, cravings, ovulation, and overall metabolic health over time.¹˒²˒⁶

Remember that lifestyle changes don’t have to be all-or-nothing. Every nourishing meal, every walk, every workout, every good night’s sleep, and every small act of self-care is another way of supporting your body.

It’s Okay to Grieve the Expectations You Had

You might worry about your fertility.

You might feel frustrated by symptoms that seem invisible to everyone else.

You might mourn the effortless relationship with your body you thought you’d have.

Those feelings are completely valid.

But this diagnosis doesn’t mean your future has been written.

Many women with PCOS/PMOS successfully manage their symptoms, improve their health, and go on to have healthy pregnancies if they choose to.²

Give yourself permission to feel disappointed today, but don’t let today’s emotions convince you that tomorrow won’t look different.

Measure Progress Differently

One thing I wish I knew sooner is that healing isn’t always obvious.

Success isn’t only measured by the number on the scale or whether your cycle is perfectly regular.

Sometimes progress looks like:

• Having more energy during the day.
• Feeling fewer cravings.
• Sleeping better.
• Feeling more confident in your choices.
• Finding a routine that feels sustainable.

Those wins matter, too.

Don’t Put Your Life on Hold

PCOS/PMOS deserves your attention, but it doesn’t deserve to become your entire personality.

Go celebrate birthdays.

Travel.

Enjoy dinner with friends.

Eat dessert sometimes.

Chase your goals.

Take care of your health because you love yourself, not because you’re trying to earn the right to enjoy your life.

One Day You’ll Look Back Differently

Looking back, I don’t remember the fear nearly as much as I remember everything it taught me.

I learned how to advocate for myself.

I learned to pay attention to what my body was telling me.

I learned that health isn’t about being perfect, it’s about finding habits that help me feel my best.

So take a deep breath.

You don’t need to have everything figured out today.

Start with one question.
One healthy habit.
One appointment.
One step.

Before you know it, those small steps will become a life that feels manageable again.

PCOS/PMOS is one chapter of your story.

It is not the whole book.

With love,

Your Future Self

References

1. Teede HJ, Misso ML, Costello MF, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertil Steril. 2023;120(5):984-999.
2. Azziz R, Carmina E, Chen Z, et al. Polycystic ovary syndrome. Nat Rev Dis Primers. 2016;2:16057.
3. Lizneva D, Suturina L, Walker W, Brakta S, Gavrilova-Jordan L, Azziz R. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril. 2016;106(1):6-15.
4. 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.
5. Dokras A, Stener-Victorin E, Yildiz BO, et al. Androgen Excess-Polycystic Ovary Syndrome Society: Position statement on depression, anxiety, quality of life, and eating disorders in polycystic ovary syndrome. Fertil Steril. 2018;109(5):888-899.
6. Moran LJ, Ko H, Misso M, Marsh K, Noakes M, Talbot M, et al. Dietary composition in the treatment of polycystic ovary syndrome: A systematic review to inform evidence-based guidelines. J Acad Nutr Diet. 2013;113(4):520-545.
7. Neff KD. Self-compassion: Theory, method, research, and intervention. Annu Rev Psychol. 2023;74:193-218.