What happens in the body during polycystic ovary syndrome (PCOS)
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Time to read 4 min
What is PCOS – and why is it worth taking a closer look?
When a woman's cycle suddenly becomes irregular, her skin becomes more problematic than before, or her weight is difficult to control despite a conscious diet, many women initially feel helpless. Often, these changes are dismissed as a "phase," a consequence of stress, or an individual problem. But there is often more to it. One possible cause: polycystic ovary syndrome, or PCOS for short.
PCOS is one of the most common hormonal disorders in women of reproductive age – and also one of the most misunderstood. Many people associate PCOS solely with the ovaries or with the term "cysts." In fact, however, PCOS is not just an ovarian disorder, but a complex hormonal and metabolic disorder that can affect the entire body.
Hormones, metabolism, menstrual cycle, skin, weight, energy levels, and even mental health are closely interconnected. If one part of this system becomes unbalanced, it can affect many areas of life. This article addresses precisely this point: It aims to explain what happens in the body with PCOS , why so many different symptoms can occur, and which systems are particularly affected. Knowledge creates understanding – and understanding is often the first step towards greater control.
Table of contents
Hormonal imbalance: The core issue
At the heart of PCOS lies a complex interplay of several hormonal and metabolic processes.
- Doctors frequently observe elevated androgen levels in women with PCOS – that is, an increased production of so-called "male" hormones such as testosterone. These hormones are also completely normal in the female body, but are often present in higher concentrations in women with PCOS.
- A disturbed function of the ovaries – this can lead to follicles in the ovaries not maturing regularly and not triggering ovulation.
- At the same time, insulin resistance plays a key role: The body produces insulin, but the body's cells react less strongly to this hormone – which in turn can stimulate androgen production .
Metabolism & Insulin: The “hidden” influence
Many sufferers are surprised: Even if they are not overweight, metabolism plays a major role. Put simply, insulin resistance means that your body cells respond less well to insulin, sugar (glucose) is absorbed less efficiently, and the pancreas produces more insulin to counteract this. In PCOS, this increased insulin production raises androgen levels in the ovaries – which in turn can exacerbate menstrual and hormonal problems.
Furthermore, insulin resistance creates risks for other metabolic diseases, such as type 2 diabetes and cardiovascular disease. Important: Even slim women with PCOS can have insulin problems – being overweight is a risk factor, but not a requirement.
Which areas of the body are affected?
1st cycle, ovaries & fertility
Due to hormonal imbalances, follicles often don't mature fully, and regular ovulation may be absent. Many affected women have irregular periods or fewer than nine per year. These irregularities can make conception more difficult and affect fertility – meaning that PCOS affects not only the menstrual cycle but also womanhood and family planning.
2. Skin, hair, body hair
Elevated androgens can have visible effects: for example, increased hair growth on the face or body ("hirsutism"), acne, oily skin, and hair loss on the scalp. Dark, velvety patches of skin on the neck, armpits, or groin (known as acanthosis nigricans) can also occur as a sign of insulin resistance.
3. Weight, body composition, appetite
Because insulin and hormone levels are affected, this can lead to weight gain – especially in the abdominal area – and losing weight often becomes more difficult.
A vicious cycle :
Weight ↔ Insulin resistance ↔ Androgens ↔ Cycle ↔ Body image.
4. Metabolism , cardiovascular system, long-term health
PCOS increases the risk of metabolic diseases: type 2 diabetes, high blood pressure, unfavorable cholesterol levels, sleep apnea. The liver (e.g., non-alcoholic fatty liver), cardiovascular system, and long-term health risks are also affected.
5. Psyche , energy , quality of life
Although often less visible, mood swings, fatigue, stress sensitivity, and lower self-esteem are common – much of this is related to the hormonal environment and the stressful way in which symptoms are managed. Important: PCOS is not just "a menstrual cycle problem," but affects the body, metabolism, and daily life.
A holistic view
Irregularities (androgens, insulin, ovarian signaling), metabolic factors (insulin resistance, weight, metabolism), and concrete effects in many areas of life: menstrual cycle, skin, weight, metabolism, and mental health. Action options exist: The earlier symptoms are recognized and understood, the sooner lifestyle changes, medication, supplements, or medical support can be effective.
Frequently Asked Questions
Why does insulin play such a big role in PCOS?
Insulin influences hormone production in the ovaries. Insulin resistance can increase androgen levels and exacerbate menstrual cycle problems.
What symptoms are typical for PCOS?
Common symptoms include irregular cycles, acne, increased body hair, hair loss, weight gain, food cravings or exhaustion – the severity varies from person to person.
How is PCOS diagnosed?
The diagnosis is usually made through a combination of cycle observation, hormone levels, ultrasound of the ovaries and, if necessary, metabolic tests.
Can diet and lifestyle really make a difference?
Yes. Nutrition, exercise, sleep and stress management directly influence the hormonal and metabolic cycles and are a key component of therapy.
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List of sources
- “Polycystic ovary syndrome (PCOS) – Symptoms & causes”, Mayo Clinic. Mayo Clinic
“Diabetes & PCOS – risk factors”, Centers for Disease Control and Prevention (CDC). cdc.gov
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“Insulin Resistance in Polycystic Ovary Syndrome”, (PMC Publ. 2022) – scientific review article. PMC+1
“Polycystic ovary syndrome (PCOS),” Cleveland Clinic. Cleveland Clinic
“Polycystic ovary syndrome – Causes”, NHS (UK). nhs.uk
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“PCOS Diet,” Johns Hopkins Medicine. hopkinsmedicine.org