6 Things No One Tells You About PCOS

It’s Not Just About Your Periods

Yes, irregular and absent periods are a classic hallmark feature of PCOS but its only one part of the condition. PCOS is a syndrome. This means it easily overlaps and intersects with other areas of the body. While PCOS does cause reproductive problems and can affect ovulation, it’s also associated with metabolic issues.

Women with PCOS are at an increased risk for developing type 2 diabetes, fatty liver disease, and cardiovascular disease. Insulin resistance is present in as many as 70% of women with PCOS regardless of weight and is a main contributing factor to these metabolic issues.  

Adult woman having a visit at female doctor's office
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You May Be At Risk For A Vitamin B12 Deficiency

Metformin and oral contraceptive pills are two of the most common medications used to treat PCOS. What many don’t realize is that both of these medications can interfere with the absorption of vitamin B12. A deficiency of vitamin B12 is serious as it can result in permanent neurological and nerve damage. Common symptoms in those with a vitamin B12 deficiency include mood changes, fatigue, and numbness or tingling in their arms, fingers, legs, and feet.

If you take either of these medications, you should supplement vitamin B12. In addition, ask your healthcare provider to check your vitamin B12 level which can be done with a blood test, to see if your levels are normal. 

Your Milk Supply Can Be Affected

It’s not conclusive, but it has been suggested that women with PCOS could have more difficulty producing an adequate milk supply to breastfeed their children. Part of the reasons why this is could be related to the hormone imbalance of higher androgen and insulin levels, which may interfere with milk production. Another theory is that the hormone imbalance during puberty can interfere with proper development of breast tissue.

If you are trying to become pregnant or are currently pregnant, be sure to let the nurses and lactation consultants at the hospital know you have PCOS. They will be able to provide you with effective strategies to boost your milk supply and help you to successfully breastfeed your baby. If you are currently nursing and having a difficult time, contact the La Leche League to find a lactation consultant in your area who can help you. 

You May Suffer From Mood Disorders

As if women with PCOS don’t have enough to deal with, they are also at a higher risk for mood disorders. Anxiety, depression, and bipolar depression have been shown to be more common in women with PCOS. Mood disorders may be more prevalent in PCOS women due to hormonal imbalances. On the other hand, PCOS is an extremely frustrating condition. Dealing with the metabolic, reproductive, and dermatological symptoms (weight gain, hair growth, hair loss) can have a significant impact on mood.

If you are struggling with anxiety, depression, or body image, consult with a mental health professional to help you. In addition, "The PCOS Workbook: Your Guide to Complete Physical and Emotional Health," may be a helpful resource to reduce anxiety, depression, and problematic eating in women with PCOS, and could be a helpful resource.

You Can Get Pregnant

Yes, PCOS is the main cause of ovulatory infertility. But that doesn’t mean you can’t have a baby. There have been new advancements in reproductive medicine over the past decade aimed to help women with PCOS conceive. One of these advancements is the use of letrozole, which has been shown to be more effective than Clomid for ovulation induction in PCOS women and the dietary supplement inositol, which can aid in improving egg quality and restore menstrual cycles.

Diet and Lifestyle Are the Primary Treatment Approaches

One thing that is for sure is that diet and lifestyle are the primary treatment approaches for PCOS. A healthy eating plan, regular exercise, supplements, sufficient sleep, and stress management all work together to improve your fertility and optimize your health. Not sure where to start or need help? Consult with a registered dietitian nutritionist who specializes in PCOS. 

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  5. Grassi A, Mattei S. The PCOS Workbook: Your Guide to Complete Physical and Emotional Health. Haverford, PA: Luca Publishing; 2009.

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By Angela Grassi, MS, RDN, LDN
 Angela Grassi, MS, RDN, LDN, is the founder of the PCOS Nutrition Center.