Were we wrong about PCOS?

DEEP DIVE

Were we wrong - should we treat PCOS as a Metabolic Disorder…instead of a hormonal one?

As of 2023 the International Evidence-Based Guideline for the Assessment and Management of PCOS emphasizes:

• Lifestyle modification is the first-line treatment for managing PCOS.

• This includes nutrition, physical activity, sleep, and emotional well-being before moving on to medical or surgical options.

• Medications like metformin or hormonal contraceptives may help, but they work best when paired with foundational lifestyle changes.

This is supported by the following research by Parker et al. that gives strong evolutionary and biological reasoning for why lifestyle is at the core of PCOS management. [Read the full article here]

TLDR

1. Insulin Resistance Is Central

• The article highlights insulin resistance (IR) as a key driver of PCOS symptoms: irregular cycles, excess androgens, and weight gain.

• IR is directly worsened by poor diet, excess refined carbs, low activity, and disrupted circadian rhythms.
  ✅ Lifestyle strategies—like balanced nutrition, strength training, and weight management—directly target IR.

2. Gut Health & Inflammation

• The authors emphasize gut dysbiosis (imbalanced microbiome) and chronic inflammation as major contributors.

• Diet high in fiber, prebiotics, and anti-inflammatory foods can restore microbiome balance and reduce systemic inflammation.
  ✅ This supports why guidelines recommend nutrition and physical activity first.

3. Endocrine Disrupting Chemicals (EDCs)

• Modern chemical exposures can worsen hormone imbalances, especially if exposure happens prenatally.

• Reducing plastics, filtering water, and using low-toxin products are lifestyle choices that cut down EDC impact.
  ✅ Again, something only lifestyle—not medication—can address.

4. Circadian Rhythm & Sleep

• Modern habits (late nights, artificial light, irregular meal times) disrupt circadian rhythms, worsening PCOS symptoms.

• The article shows how aligning with natural rhythms (consistent sleep, regular meal timing, exercise) can improve metabolic and hormonal function.
  ✅ Guidelines call this out as part of lifestyle intervention.

5. Evolutionary Model = Lifestyle is the Lever

• The central argument of the paper is that PCOS is an evolutionary mismatch: genetic traits once beneficial are now maladaptive in modern environments.

• This mismatch can’t be “fixed” with pills alone—but can be improved by adjusting diet, sleep, physical activity, and environment to better match what our biology is adapted for.

The revised guidelines and this article point to the same truth:
👉 Lifestyle is not a side note—it’s the foundation.

• Medications can help symptoms, but if insulin resistance, poor gut health, disrupted sleep, and inflammatory diets remain unaddressed, PCOS will keep “fighting back.”

• Small, consistent lifestyle interventions—balanced meals, more movement, sleep hygiene, lowering toxin exposure—are the first and most powerful steps.

^{Why PCOS Queens? I want to save you the energy and time in researching and instead give you the shortcut to managing PCOS. I want to help you avoid feeling self-conscious and thinking you have to accept how things are. I want to help you overcome the worst of your symptoms, feel empowered and discover your inner strength. I want to hand you the keys to take back control of your life.}

*Disclaimer: Every women is unique, and this information is provided for educational purposes only. I share summarized research data and personal experience, but this should not be considered medical advice. Always consult your healthcare provider for guidance on your specific health needs.