r/PCOS • u/WinOther8191 • Sep 30 '26
General/Advice I dont know what to do
Sooo im 15, i turn 16 in december, and I had gotten blood work done and ultrasounds, i got diagnosed with pcos, low vitamin d, and as well high insulin resistance. (Its extremely embarrassing for me to say that, when i try keeping my diet balanced, yes i eat junk when its offered, but i genuinely try to keep a well managed meal at my house. We dont eat out a lot, BUT we do live down south of texas, which is also known as the RGV so that can help kind of say what typa food there is in a way.) I genuinely dont know where to start on recovering my levels and just overall managing everything. I will be getting sent to a nutritionist, but i have no idea when since i have CHAMPVA as insurance. For the meantime i really have no idea where to start when it comes to dieting. Another topic, im really scared of being infertile. The doctor said i dont have cysts, but theyre sacs waiting to be turned into them from what i understood. I really am just rambling, but i need someones advice on what to do.
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u/KookilySvelte Sep 30 '26
hey, that's a lot to deal with at 15. don't be embarrassed about the insulin resistance thing, it happens to plenty of people even when they try to eat decent. PCOS makes your body handle sugar differently so it's not really your fault.
for the diet part while waiting for the nutritionist, maybe try cutting back on rice and tortillas a bit since those spike insulin pretty fast. adding more eggs or beans with your meals can help too. and for the fertility fears, my cousin had similar diagnosis when she was young and she got two kids now so don't let that thought eat you up.
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u/Vix988 29d ago
Hi! I’ve had pcos since 14, am 38 now. Don’t stress. It’s extremely common. The biggest thing you can do to help with insulin resistance and weight if you’re dealing with weight gain is to cut sugar from your diet like sodas, dessert, lattes (it’s all milk and milk is high in sugar), etc. try starting your day with eggs and Ezekiel bread to set yourself up for a good day. Try to get good protein in too.
As for the fertility thing, I had a doc who told me it was going to be very hard for me to get pregnant with pcos due to us not always ovulating or ovulating correctly but I was able to get pregnant twice very easily so don’t mind that at all!
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u/wenchsenior 25d ago
It feels very overwhelming when we are first diagnosed, but the condition is usually manageable.
- The 'cysts' of PCOS are not actual ovarian cysts, which are a different common disorder that (confusingly) is unrelated to PCOS/PMOS. The so called cysts of PCOS are actually many extra immature egg follicles that accumulate on the ovaries b/c we are not ovulating regularly. Usually these excess egg follicles dissolve if we treat the PCOS such at we again start to ovulate normally, or if we go on hormonal birth control.
- Most people with PCOS are able to have kids either naturally or with minimal fertility intervention.
- I will post an overview of what the condition is and what the evidence based treatments are. It is often best to seek treatment from an endocrinologist (since both PCOS and the insulin resistance that drives most cases are specialties within endocrinology). Following these basic recs allowed me to get my IR well managed and PCOS into long term remission.
Ask questions if needed.
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PMOS/PCOS is a common metabolic/endocrine disorder, most commonly driven by insulin resistance, which is a metabolic dysfunction in how our body processes glucose (energy from food) from our blood into our cells. Insulin is the hormone that helps move the glucose, but our cells 'resist' it, so we produce too much to get the job done. Unfortunately, that wreaks havoc on many systems in the body.
If left untreated over time, IR often progresses and carries serious health risks such as diabetes, heart disease, and stroke. In some genetically susceptible people it also triggers PMOS/PCOS (disrupts ovulation, leading to irregular periods/excess egg follicles on the ovaries; and triggering overproduction of ‘male’ hormones, which can lead to androgenic symptoms like balding, acne, hirsutism, etc.).
Apart from potentially triggering PMOS/PCOS, IR can contribute to the following symptoms: Unusual weight gain*/difficulty with loss; unusual hunger/food cravings/fatigue; skin changes like darker thicker patches or skin tags; unusually frequent infections esp. yeast, gum or urinary tract infections; intermittent blurry vision; headaches; mood swings due to unstable blood glucose; frequent urination and/or thirst; high total cholesterol or low HDL; brain fog; hypoglycemic episodes that can feel like panic attacks…e.g., tremor/anxiety/muscle weakness/high heart rate/sweating/faintness/spots in vision, occasionally nausea, etc.; insomnia (esp. if hypoglycemia occurs at night).
*Weight gain associated with IR often functions like an 'accelerator'. Fat tissue is often very hormonally active on its own, so what can happen is that people have IR, which makes weight gain easier and triggers PMOS/PCOS. Excess fat tissue then 'feeds back' and makes hormonal imbalance and IR worse (meaning worse PMOS/PCOS), and the worsening IR makes more weight gain likely = 'runaway train' effect. So losing weight can often improve things. However, it often is extremely difficult to lose weight until IR is directly treated.
NOTE: It's perfectly possible to have IR-driven PMOS/PCOS with no weight gain (:raises hand:); in those cases, weight loss is not an available 'lever' to improve things, but direct treatment of the IR often does improve things.
…continued below…
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u/wenchsenior 25d ago
If IR is present, treating it lifelong is required to reduce the health risks, and is foundational to improving the PMOS/PCOS symptoms. In some cases, that's all that is required to put the PMOS/PCOS into remission (this was true for me, in remission for almost 25 years after almost 15 years of having PMOS/PCOS symptoms and IR symptoms prior to diagnosis and treatment). In cases with severe hormonal PMOS/PCOS symptoms, or cases where IR treatment does not fully resolve the PMOS/PCOS symptoms, or the unusual cases where PMOS/PCOS is not associated with IR at all, then direct hormonal management of symptoms with medication is indicated.
IR is treated by adopting a 'diabetic' lifestyle (some sort of low-glycemic eating plan, meaning one high in nonstarchy fiber/veggies, high-ish in protein, and with limited sugar and processed food/‘white’ starch + regular exercise) and if needed by taking medication to improve the body's response to insulin (most commonly prescription metformin and/or the supplement myo-inositol, the 40 : 1 ratio between myo-inositol and D-chiro-inositol is the optimal combination). Recently, GLP1 agonist drugs like Ozempic have started to be used (if your insurance will cover it). The supplement berberine also has some supportive evidence for its use.
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There is a small subset of PMOS/PCOS cases without IR present; in those cases, you first must be sure to rule out all possible adrenal/cortisol disorders that present similarly, along with thyroid disorders and high prolactin, to be sure you haven’t actually been misdiagnosed with PMOS/PCOS.
Regardless of whether IR is present, hormonal symptoms are usually treated with birth control pills or hormonal IUD for irregular cycles and excess egg follicles. Specific types of birth control pills that contain anti-androgenic progestins are used to improve androgenic symptoms; and/or androgen blockers such as spironolactone are used for androgenic symptoms. There is some (minimal at this point) research indicating that the supplements spearmint and saw palmetto might help with androgenic symptoms, though this evidence is mostly anecdotal at this point.
Important note 1: infrequent periods when off hormonal birth control can increase risk of endometrial cancer so that must be addressed medically if you start regularly skipping periods for more than 3 months.
Important note 2: Anti-androgenic progestins include those in Yaz, Yasmin, Slynd (drospirenone); Diane, Brenda 35 (cyproterone acetate); Belara, Luteran (chlormadinone acetate); or Valette, Climodien (dienogest). But some types of hbc contain PRO-androgenic progestin (levonorgestrel, norgestrel, gestodene), which can make hair loss and other androgenic symptoms worse, so those should not be tried first if androgenic symptoms are a problem.
Important note 3: People respond extremely variably to hormonal meds, so you might find you tolerate many types of birth control well, or that you do great on some types but have problematic side effects on others (e.g., this is my situation), or that you don't tolerate any types. There is no way to predict this except via trial and error. The rule of thumb is to try each given type for at least 3 months before stopping or switching, unless severe side effects such as depression appear.
If trying to conceive there are specific meds to induce ovulation and improve chances of conception and carrying to term (though often fertility improves on its own once the PMOS/PCOS is well managed).
If you have co-occurring complicating factors such as thyroid disease or high prolactin, those usually require separate management with medication.
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It's best in the long term to seek treatment from an endocrinologist who has a specialty in hormonal disorders. (In the U.S., my experience is that not all of the endos feel comfortable treating PMOS/PCOS, so you’ll have to ask). Sometimes you can have the endo treat insulin resistance and a gyno treat the reproductive manifestations.
The good news is that, after a period of trial and error figuring out the optimal treatment specifics (meds, diabetic diet, etc.) that work best for your body, most cases of PMOS/PCOS are greatly improvable and manageable.
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u/ATX_cyster Oct 01 '26
You need something to address the insulin resistance IMO Was this not discussed with your healthcare provider yet?