PCOS Awareness Month: Understanding Your Hormones, Skin and Symptoms From the Root Up

If you have PCOS, chances are you have spent years being told different, sometimes contradictory things about your own body. Lose weight and things will improve. Your bloods are ‘’normal’’, so there is nothing to investigate further. PCOS is complex and just something you will have to manage. Meanwhile, you’re left to cope with periods that are unpredictable, fatigue that’s unrelenting, acne that’s all-consuming, and the frustration of trying to manage it all on your own - while having to keep up with the demands of a busy, full life.

This September, PCOS Awareness Month lands with a difference. In May 2026, a landmark global consensus published in The Lancet officially renamed polycystic ovary syndrome to polyendocrine metabolic ovarian syndrome, or PMOS. The name change doesn't matter as much as why it changed and what that means for how PCOS should be understood, tested for, and supported, particularly the parts of the condition that rarely get heard in a ten-minute appointment.

PCOS Awareness Month 2026: Why This Year Looks Different

The old name focused attention on ovarian cysts, which are not actually the defining feature of the condition and are not present in every case. The new name puts the emphasis where it belongs: on the endocrine and metabolic dysfunction that sits underneath the symptoms most women actually experience. That reframing has been over a decade in the making, built on input from more than 14,000 patients and health professionals worldwide, and it did not happen quickly or lightly.

For any woman out there who has or had a PCOS diagnosis dismissed because a scan did not show cysts, this shift is validating. It confirms that PCOS/PMOS is a whole-body hormonal and metabolic condition. You will likely still see PCOS used as the more recognised label for the condition for some years to come. But understanding the shift towards PMOS helps give language to something many women have felt without being able to name it and why root-cause, whole-body approaches to PCOS have always made more sense than symptom-by-symptom management.

What Is PCOS and What's Actually Happening in Your Body

At its core, PCOS is a combination of hormonal imbalance, insulin resistance, and low-grade inflammation, the combination of which can look different for every woman. Elevated androgens (the hormones often thought of as "male" hormones, though everyone produces them) can disrupt ovulation and drive symptoms like acne and unwanted hair growth. Insulin resistance, which affects a large proportion of women with PCOS, including many who are not overweight, makes it harder for cells to manage blood glucose levels properly, driving androgen production even higher and playing a role in mood swings and energy crashes many women struggle with.

Chronic, low-level inflammation often sits alongside it - part of why breakouts take longer to clear and energy never quite bounces back.

Cortisol deserves a mention here too. Chronic stress, whether from work, caregiving, or simply running on empty for too long, keeps cortisol elevated, and elevated cortisol worsens insulin resistance. That, in turn, drives belly weight and feeds back into the androgen picture and the rest, which is exactly why treating PCOS as a single symptom to be managed rarely gets anyone very far.

The reality of a PCOS/PMOS diagnosis is that different women can have it and be dealing with entirely different root drivers, one insulin-led, another more inflammation-led, another shaped by chronic stress and cortisol dysregulation. Understanding which pattern is at play can lead to more effective management of symptoms and explain why the same protocol handed to two different women with PCOS can produce two very different results.

How Is PCOS Diagnosed

PCOS is typically diagnosed when a woman meets at least two of three signs based on the Rotterdam criteria: irregular ovulation, signs of excess androgens (such as acne, hirsutism, or high testosterone on blood test results), or polycystic ovaries on ultrasound. In practice, the name skewed the focus toward polycystic ovaries, so a "normal" scan sometimes ruled the diagnosis out even when the other two criteria were clearly present. It's a significant part of why an estimated 70% of women with the condition remain undiagnosed, which is part of why the name change matters. 

It also means different women with the exact same diagnosis can look, feel, and experience PCOS in a completely different way due to a very different combination of symptoms and underlying drivers.

The Hormone-Skin Connection: Acne, Hair Loss and Excess Hair Growth

Skin and hair symptoms are some of the most visible, and often most distressing, parts of PCOS. Persistent jawline acne, thinning hair at the crown or part line, and excess facial or body hair growth (hirsutism) are not separate problems. They are all downstream effects of elevated androgens and the insulin resistance driving them.

The skin's oil glands and hair follicles are highly sensitive to androgen activity, which is why these symptoms often flare together, and why they can be some of the first visible signs that something hormonal is going on, sometimes appearing before cycle irregularities are even noticed. For many women, it is the skin or hair changes, not the missed periods, that first prompt a trip to the GP, and it can be disheartening to be handed a topical acne cream or the pill without any further investigation.

Addressing the root hormonal picture, rather than only treating the skin or hair symptom in isolation, makes more sense than short-term management. That means looking at how androgens are being produced and metabolised, not just how much is circulating, since two women can have similar androgen levels on a standard blood test and very different symptoms depending on how those hormones are broken down and processed. It also means looking upstream, at insulin - since higher insulin levels are often what pushes androgen production up in the first place.

Fertility, Fatigue And Weight Gain

For many women with PCOS where fertility is their primary concern, the same insulin-androgen pattern is frequently part of the why. Higher insulin levels can push the ovaries to produce more androgens, and elevated androgens can interfere with the signals that trigger ovulation each cycle.

Fatigue - the kind that doesn't lift no matter how much sleep or rest you get can be one of the hardest PCOS symptoms to shift, partly because it's so easy to explain away by ‘stress’, a busy week, a "bad night’s sleep" - anything but the hormones underneath it. And partly because insulin resistance makes it harder for your cells to use the glucose you have available, or in storage, for energy. 

Insulin resistance is also what makes weight loss genuinely harder. It can make conversations around it feel vulnerable, because you may well have already tried all the things, including the calories-in-calories-out advice that fails so many women with PCOS, especially if calories aren't what's driving the weight gain to begin with - when insulin resistance is in the picture.

Same driver, many faces - so how do you work upstream of the problem?

Nutrition and Lifestyle Support

Working upstream means working on blood sugar stability and insulin resistance - and holistically, that starts with nutrition, stress, movement, and sleep support. But it’s not always as easy as it sounds. While the Mediterranean diet is the "PCOS diet" most recommended, even the best diets on paper can fail due to overwhelm. What tends to work best is introducing habits to support blood sugar regulation and stability, one at a time.

Food-wise, that can look like working in more protein, fibre, healthy fats, and carbohydrates with a lower glycaemic load into meals; switching to regular, predictable eating patterns rather than leaving long gaps between food; or even approaching what you eat off the plate in a particular order. 

Movement matters too. More is not always better. Strength training often supports insulin sensitivity and metabolic health more effectively than high-intensity exercise alone. This is especially true when cortisol is already elevated, since very intense training can sometimes add to that stress load rather than relieve it. 

Sleep, alcohol, and stress management are not add-ons here; they are core levers, since they directly affect blood sugar stability, insulin, and androgen levels. A night out, too little sleep, or a skipped meal will not undo months of progress, but the cumulative pattern over weeks and months matters enormously.

The goal is not to find ways of making what already feels hard to live with, even harder. I believe in building sustainable habits that support ALL your hormones, which is exactly what I set out to achieve with the Essential Hormone Habits programme. With 10-minute daily habits, you can start building the small, science-backed changes that move you away from some of the drivers of PCOS - even with a busy life.

Where to Start: Whole-Body Support

If you recognise yourself in any of this, the most useful next step is understanding your own hormonal and metabolic picture rather than continuing to guess, and there are many ways to achieve this. Monitoring tools like continuous glucose monitors (included in the 30 Day Metabolic + Energy Reset programme) and at-home hormone testing, such as the Mira hormone monitor, can show you at a glance how your blood sugar, habits and hormones are behaving and influencing one another day to day. 

A DUTCH hormone panel can be used as a standalone test or complement to CGM and at-home hormone monitoring to reveal patterns standard lab work often misses, including how your body is metabolising androgens and where cortisol and nutrients fit into your PCOS picture

Targeted support can be built around any and all of your results to address the underlying drivers of your symptoms. The Happier Hormones programme is built for exactly this kind of root-cause, whole-body approach.

This PCOS Awareness Month, the most powerful thing you can do is stop managing symptoms in isolation and start figuring out what your body needs. 

Book a free discovery call to talk through what that could look like for you.