PCOS: More Than Just a Hormone Issue - How Blood Sugar, Root Causes & Foundations Play a Role

So, What is PCOS?

Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age, but it’s also one of the most misunderstood.

While the name “PCOS” suggests it’s all about ovarian cysts, it’s so much deeper than that. You don’t even need to have cysts to be diagnosed.

PCOS is a syndrome, meaning it’s a collection of symptoms and imbalances, not a one-size-fits-all diagnosis. It primarily affects how your ovaries function, often disrupting ovulation, causing irregular or missing periods, and leading to a higher output of androgens (male hormones like testosterone).

There are different “types” or drivers of PCOS, including:

• Insulin-resistant PCOS (by far the most common)

• Post-pill PCOS (symptoms triggered after stopping hormonal birth control)

• Inflammatory PCOS

• Adrenal PCOS (linked to stress and cortisol output)

How is PCOS diagnosed?

Doctors generally use the Rotterdam criteria, and a woman must meet two out of the following three:

1. Irregular or absent ovulation (often seen as irregular cycles)

2. Elevated androgens (either via bloodwork or symptoms like acne, facial hair, or hair thinning)

3. Polycystic ovaries on ultrasound (more than 12 follicles per ovary or enlarged ovaries)

   
   

👉 Important to note: You do not need cysts to have PCOS and not all ovarian cysts mean you have PCOS.

Common PCOS Symptoms:

• Irregular or absent periods

• Fertility struggles

• Acne (especially jawline/chin)

• Hair thinning or hair loss

• Unwanted facial/body hair

• Mood swings or anxiety

• Cravings and blood sugar crashes

• Weight gain or difficulty losing weight

• Fatigue and low energy

• Bloating or digestive issues

How does blood sugar come into play?

Insulin resistance is at the core of many PCOS cases. When your body struggles to use insulin efficiently, your pancreas pumps out more to keep blood sugar levels in check. Chronically high insulin levels drive the ovaries to produce more androgens, which contribute to many of the hallmark PCOS symptoms like acne, missed periods, and hair issues. Even lean women with PCOS can be insulin resistant.

Early signs of blood sugar imbalance that show up before lab markers do:

• Energy crashes after meals

• Constant hunger or cravings

• Feeling shaky or irritable when you haven’t eaten

• Waking up at night around 2-3 am

• Mood swings tied to meals or stress

  
  

What are the root causes?

PCOS doesn’t just "happen"; there’s often a combination of deeper imbalances at play:

• Chronic blood sugar dysregulation

• Inflammation from diet, stress, gut issues, or environmental toxins

• Post-birth control hormonal rebound

• Nutrient deficiencies (like magnesium, zinc, B vitamins)

• Stress and dysregulated cortisol patterns

• Gut imbalances (which can increase inflammation and impair estrogen detox)

Balancing the Foundations First

Before diving into protocols, supplements, or expensive treatments, you have to support the body’s foundational systems. I’ve seen women get massive symptom relief just by doing this:

Balance Blood Sugar

• Eat protein, fat, and fibre at every meal (especially breakfast)

• Avoid skipping meals or going long hours without food

• Pair carbs with fibre and protein

• Try apple cider vinegar before high-carb meals

• Walk after meals to lower post-meal blood sugar

  
  

Support Digestion + Gut Health

• Manage bloating, constipation, or reflux

• Increase fermented foods and fibre (SLOWLY)

• Eliminate inflammatory triggers (gluten, dairy, seed oils — based on the individual)

• Use digestive bitters or enzymes if needed

  
  

Reduce Inflammation

• Prioritize sleep

• Get daily movement, even walking counts

• Eliminate unnecessary toxins (fragrance, plastics, processed food)

  
  

Nourish with Key Nutrients

• Magnesium (especially glycinate)

• Zinc, Omega-3s, B vitamins

• Real, whole food > calorie counting

  
  

Regulate Stress + Nervous System

• Morning sunlight exposure

• Breathwork or prayer

• Movement - strength training and walking, preferably

  
  

The Bottom Line: PCOS Is Manageable

You’re not broken, and you don’t need to stay stuck in the cycle of symptom suppression. When you understand why your body is out of balance, you can begin to support it with intention. Addressing the root cause, not just the surface symptoms, is where true healing happens.

Ready to start healing your PCOS from the root?

I work with women who are tired of being dismissed and ready to feel at home in their bodies again. My programs focus on personalized support, foundational nutrition, and root-cause healing.

💌 Click here to apply for 1:1 coaching — let’s uncover what’s going on in your body and create a clear path forward.

-Jessica McLean, NTP