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Many women silently suffer with Polycystic Ovary Syndrome (PCOS) because they feel the symptoms of hormonal imbalance aren’t real. Women assume that because these symptoms are common and their doctors don’t seem concerned about them, these symptoms must be normal. This is a sad and dangerous pattern in the approach to women’s health. Even worse, many women feel invalidated and dismissed by their mainstream medical doctors when discussing their symptoms: Women are often told their pain isn’t real, and their symptoms aren’t real. Many doctors label a woman’s symptoms as “hormonal” or “just a normal symptom of a monthly cycle”. It’s estimated that 10-21% of women of reproductive age have PCOS and that 50% of them aren’t properly diagnosed, taking around 2-3 years for healthcare professionals to make a diagnosis. [1] [2]

Recent studies of PCOS patients in 2023 revealed that 98% of those diagnosed felt they were not taken seriously by their doctors. Women also found more helpful PCOS resources and support from the internet: Not their doctors. [2] Not only does this mean that women are suffering in silence, but it also means their health is in danger: Hormone imbalances can contribute to a wide variety of conditions because hormones are connected to every system in the body.

PCOS and Hormone Imbalance

At its core, PCOS is hormonal imbalance: If the hormonal imbalance isn’t corrected, PCOS can increase a woman’s risk of infertility, diabetes, cancer, heart disease, and more. If women’s health concerns aren’t validated, fewer and fewer women will seek answers for their symptoms. The number of women with PCOS and PCOS-related health complications will keep growing if we don’t start taking women’s health much more seriously.

While many people think of cysts because of the name, PCOS isn’t just about the cysts: It’s about the hormones needed to make sure your body develops an egg that releases properly. If you have low hormones – or none at all – your body isn’t going to be able to do this process effectively.

  • Hormones are a way of communicating with the brain: As the egg develops, estradiol continues to rise until it alerts the brain that it’s time to ovulate.
  • If estradiol is low or high all the time, the brain doesn’t know what to do. As a result, you might not ovulate.
  • If you do ovulate, it might happen before the egg is fully developed: If an underdeveloped egg isn’t released it could cause cysts to develop, which can damage the ovaries. However, it’s important to note that despite the acronym, not all women with PCOS develop cysts.

Your Hormones are Always Changing!

After all, it’s part of your cycle. When your hormones aren’t balanced, you may experience symptoms that you might not recognize as being related to hormones. Those are the silent symptoms of PCOS that can leave you very sick. Every individual will have different symptoms manifest in the body. If you have any of the symptoms below, make sure to get your hormones fully tested: All of your hormones! After all, estrogen isn’t just one hormone but many hormones labeled as part of the estrogen family. Your hormone testing should be comprehensive enough to determine all hormone levels.

There are many misconceptions about hormones because doctors will only test for those that have an easy textbook “fix,” such as prescription drugs. If you have one or more of these signs, get your hormones tested as soon as you can. 

9 Symptoms of PCOS and Hormonal Imbalance

A woman's hands with a pencil and magnifying glass looking at a puzzle piece1 – Your Sex Drive is Higher than Your Guy’s

A healthy sex drive occurs mainly during certain weeks in your cycle: However, if you’re insatiable for sex and have a high sex drive all the time, your hormones could be imbalanced. Physiologically speaking, a woman’s hormones don’t naturally cause a high sex drive every single day of the month. Your hormones are supposed to cycle, which will naturally change your sex drive throughout the month.

2 – Feeling Fatigued Most of the Time

Sleep problems are common in women with PCOS. If you have trouble sleeping at night or trouble staying awake during the day, you might have PCOS. [1] Hormonal imbalance can cause an exhausting cycle for sleep health: After all, sleep deprivation can lead to even more hormone imbalances. The cycle repeats itself over and over again.

3 – You Find Hair Growing in Unexpected (and annoying) Places

Ovaries usually produce small amounts of androgens and testosterone, but some women with PCOS may experience high levels of these hormones. [3] These elevated levels of testosterone and androgens can lead to hair growth in places women don’t expect it – and don’t want it – such as the nipples, upper lip, chin, abdomen, and inner thighs.

4 – Your Period is Absent or Unpredictable

If your brain doesn’t know when to release the egg because of hormone imbalance, it won’t know when to shed the uterine lining either. [2][3] When your period is irregular and very unpredictable, it may disappear for a month or two and then drown you with two periods in the same month. Your cycle might skip a few months at a time but lasts for two weeks when it arrives. Regardless of the pattern, if your period hasn’t shown up in several months, it’s important to get those hormone levels tested to determine all contributing factors.

5 – When Your Period Shows Up, it’s Painful and Heavy

If you have infrequent periods, your uterine lining is still building tissue despite not being able to shed this tissue every month. When your period does arrive, that excess lining of the uterus can contribute to very heavy and painful periods.

6 – Your Pants Are Fitting a Little Tight (especially around the waist)

Have you noticed some weight gain, especially around your belly? Imbalanced hormones can lead to insulin resistance. Insulin is the hormone that tells your body what to do with the sugar in your blood: 50-70% of women with PCOS have insulin resistance. [3]

Insulin resistance can contribute to weight gain. However, the weight gain experienced by women with hormone imbalance is not just because of insulin resistance. In fact, a recent study of PCOS patients revealed very high levels of visceral adiposity – also known as belly fat stored deep within the abdominal cavity -regardless of a patient’s BMI. [4] . If you’re struggling to lose weight, the culprit could be hormone imbalance.

7 – Painful Acne Around Your Jawline

You weren’t expecting a cyst to show up on your face, but there it is: A warning that there may be an underlying hormonal problem like PCOS. High levels of androgens and testosterone for women can contribute to acne and other skin concerns. When women are a week or so from the start of their period, PCOS patients might notice more acne lesions around their jawline, chin, or neck: This hormonal acne is typically very large and painful. [5] Hormonal acne is deep into the layers of skin, which causes these lesions to heal slowly.

8 – Ovarian Cysts and/or Infertility

Approximately 70-80% of women with PCOS experience infertility: The prevalence of PCOS-related infertility can be attributed to a lack of ovulation, higher levels of insulin in the blood, and androgen dominance. [6]  The years spent waiting for a doctor to seriously consider a woman’s concerns and make an accurate PCOS diagnosis can also be a contributing factor of infertility. The more time that passes, the risk of damage to the ovaries increases due to a build-up of ovarian tissue and cysts.

9 – Anxiety, Depression or Just Feeling Off

If you haven’t been sleeping well and your periods are heavy, you have a valid reason to feel down and anxious. Although it’s unclear how they’re connected, mood disorders such as anxiety, depression, and others are closely tied to hormonal imbalances like PCOS.

One potential reason for this link between depression, anxiety, and PCOS is the chronic stress felt by patients trying to get pregnant. However, common infertility treatments prescribed by mainstream medical doctors don’t ease a woman’s stress very effectively. Often, these treatments can drastically alter hormone levels. [7] Don’t underestimate the power of your hormones: They dictate so much of who we are and how we react to stress.

What Can Contribute to PCOS and Hormonal Imbalance?

  • Mental Stress: Emotional trauma and chronic stress are the biggest factors of hormonal imbalance. Emotional stress is not an insignificant factor in determining overall health. In fact, the impact of stress the body can be as powerful as the physical ailments in triggering hormonal imbalances.
  • Endocrine Disruptors: These chemicals can negatively affect your endocrine system and hormone balance. [8] These disruptors mimic natural hormones and are commonly found in shampoo, pans, laundry soap and other products.
  • Birth Control Pills: This overly-prescribed medication deserves its own spot on this list. Hormonal birth control works by disrupting your hormones, which can lead to many other long-term problems. There are other ways to balance your hormones without birth control: Your body wants to achieve balance but birth control pills can slow this process down long past the time you stop taking it.
  • Inflammation: It’s hard for your hormones to transition properly with chronic inflammation. Inflammation can be caused by inflammatory foods and allergies. Be sure to get your food allergies tested and avoid consuming these common inflammatory foods.

Are You Experiencing Any of These Silent Symptoms of PCOS?

The first step is to understand how your cycle is transitioning throughout the month. The only way to do this is through comprehensive hormone testing with a proficient doctor. Some women with PCOS have high testosterone levels, but that’s not always the case for every patient: Some have more severe symptoms than others. However, anyone with PCOS can also have an increased risk for infertility, diabetes, cancer, and other chronic health conditions.

There is no magic pill that will help everyone the same way

At The Wellness Way, we dig deeper to solve the health challenges others can’t. We don’t just address symptoms: We run tests to find out what’s going on behind the scenes.  Testing is the only way to take control of your hormonal health: You need to ensure you’re properly tested. You don’t have to suffer with the silent symptoms of PCOS, waiting for a doctor to take your concerns seriously. Take control of your health and your hormones: You’ve suffered in silence long enough.

Originally Published March 27, 2019
Updated and Republished February 2, 2024

Educational Resources to Stay Informed About PCOS and Hormone Imbalance

Videos and Webinars Related to PCOS and Hormone Imbalance:

PCOS, Belly Fat, and Sugar Consumption | A Different Perspective | January 27, 2024
“Why Can’t I Lose Weight?”: Insulin, Cortisol, & Menopause | A Different Perspective | November 25, 2023
PCOS and I Disagree: Having a Successful Relationship | A Different Perspective | August 5, 2023

Articles to Support Those with PCOS and Hormone Imbalance

PCOS: Embracing Natural Solutions for Hormonal Harmony | The Wellness Way
Endometriosis: Balance Hormones and Heal Naturally | The Wellness Way
Estrogen Dominance: Is This Imbalance Behind Your Hormone Problems? | The Wellness Way\

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Disclaimer: This content is for educational purposes only. It’s not intended as a substitute for the advice provided by your Wellness Way clinic or personal physician, especially if currently taking prescription or over-the-counter medications. Pregnant women, in particular, should seek the advice of a physician before trying any herb or supplement listed on this website. Always speak with your individual clinic before adding any medication, herb, or nutritional supplement to your health protocol. Information and statements regarding dietary supplements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease.

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