Polycystic ovary syndrome (PCOS) is often regarded as one of the most common hormonal and metabolic conditions affecting women of reproductive age [1].
While PCOS shares some similarities with autoimmune diseases, it is classified differently and is not considered an autoimmune condition. Diagnosis relies on precise clinical criteria (like lab tests and ultrasounds), and management varies from patient to patient.
However, healthy lifestyle changes, hormone-blocking medications, and strategic long-term care plans are all effective tools to manage PCOS–despite the symptoms that are unique to your diagnosis–so we’ll also dive into some of the most common treatment options.
Ultimately, this guide aims to shed light on what PCOS is, how it is diagnosed, its common symptoms, available treatment options, and practical strategies for living with this extremely common but often misunderstood disease.
What Is PCOS?
PCOS is a disorder involving hormone production and imbalance, as well as changes to your metabolism that can impact various aspects of your short and long-term health. The three main signs of PCOS are: irregular ovulation, increased levels of androgens (which may include testosterone but are often referred to as male hormones in most patient guides), and the presence of cystic ovaries. [2]
The condition affects every woman differently, but some common signs may include:
- Irregular or absent menstrual periods
- Excessive hair growth (hirsutism) [3]
- The thinning of hair on the scalp
- Insulin resistance and weight gain
- Mood fluctuations
- Sleep disturbances
- Acne
The long-term health considerations associated with untreated PCOS may include an elevated risk of developing:
- Type 2 diabetes
- Cardiovascular disease
- Endometrial hyperplasia (a thickening of the lining of the uterus)
- Cancer
Remember: PCOS manifests differently in puberty, and symptoms may change as you progress through different stages in your life.
Is PCOS an Autoimmune Disease?
Short answer: No. PCOS is not an autoimmune disease, however it does share some similar thyroid-related symptoms with immune system disorders like Hashimoto’s Thyroiditis. That’s why your doctor will likely check thyroid function when making a diagnosis – to be certain.
Autoimmune diseases are like “glitches” in the immune system that cause your body’s defense mechanisms to overreact and attack your own organs or certain tissues as though they were foreign invaders.
PCOS primarily originates from hormone imbalances and disruptions to your metabolism that involve insulin resistance and elevated androgen (male hormone) levels.
Why PCOS Is Not Classified as Autoimmune
PCOS does not cause the body to produce an autoimmune response: when your white blood cells mistake specific tissues or organs as a foreign invader, and your body attacks itself. Instead, PCOS is considered a reproductive and metabolic disorder that affects different systems in the body altogether, rather than your immune system.
However, some women with PCOS may exhibit higher rates of autoimmunity related to their thyroid gland, but this symptom alone does not qualify PCOS to be considered a true autoimmune disorder by researchers and healthcare professionals.
Symptoms of PCOS
The symptoms of PCOS can vary widely, but they generally fall into four main categories[4]:
- Menstrual and Ovulatory Issues: Irregular periods, anovulation (lack of ovulation), and potential infertility.
- Androgen-Related Symptoms: Excessive facial and body hair, acne, and thinning hair on the scalp.
- Metabolic Changes: A tendency toward weight gain, insulin resistance, and a higher risk of developing diabetes.
- Emotional and Other Symptoms: Mood swings and the potential risk of sleep apnea.
Diagnosing PCOS: The Rotterdam Criteria
Your doctor or healthcare specialist will refer to what’s called “The Rotterdam Criteria” when making their initial PCOS diagnosis. If you present at least two of the following symptoms, you may meet the criteria for a PCOS diagnosis.
It is impossible to diagnose yourself with PCOS using the Rotterdam Criteria [5] as lab tests and ultrasound tests are required. Remember, only your doctor can diagnose you with PCOS.
Patients must present with at least two of the following signs:
- Irregular ovulation.
- Clinical or laboratory evidence of elevated androgens.
- Polycystic ovaries were observed via ultrasound.
During the diagnostic process, physicians will conduct a series of tests to assess hormone levels (like testosterone and DHEA-S), metabolic markers (including fasting glucose and lipid profiles), and check your thyroid function.
Types of PCOS: Understanding the Phenotypes
PCOS can also be categorized based on unique phenotypes, leading to tailored treatments. The common phenotypes include [6]:
- Phenotype A: Ovulatory dysfunction + hyperandrogenism + polycystic ovaries.
- Phenotype B: Ovulatory dysfunction + hyperandrogenism.
- Phenotype C: Hyperandrogenism + polycystic ovaries.
- Phenotype D: Ovulatory dysfunction + polycystic ovaries.
Patients may also use terms like adrenal PCOS or post-pill PCOS [7] to describe their experiences. While these are not official diagnoses, they provide useful shorthand in conversation.
Embracing Treatment Options for PCOS
How you manage PCOS will always be personalized to your phenotype, preexisting conditions, and other variables your doctor might test for, but common treatments often revolve around setting individual goals such as cycle regulation, fertility, metabolic health, and symptom relief.
Potential treatment options may include a combination of therapies specialized to targeting each of these goals. Here are some common treatment patterns designed to treat each cluster of symptoms:
- Cycle Regulation: Combined hormonal contraception, progestin IUDs, or cyclic progestins.
- Fertility: Letrozole (the first-line option), clomiphene, or assisted reproductive technologies if needed. [8]
- Metabolic Health: Metformin or, in some cases, weight-loss medications. [9]
- Androgen-Related Symptoms: Spironolactone combined with contraception, as well as topical or oral acne treatments.
PCOS Diet and Healthy Lifestyle Choices
Maintaining a positive outlook is crucial in managing PCOS, and key to that is optimizing gut-brain health. One of the best ways to manage PCOS is to adopt a balanced diet rich in fiber, lean protein, and healthy fats can make a considerable difference.
Here are some PCOS diet strategies your doctor or nutritionist might recommend:
- Minimize refined carbohydrates and pair them with proteins or healthy fats.
- Engage in regular physical activity that includes both aerobic and resistance exercises – like swimming, biking, or yoga.
- Prioritize quality sleep and find effective stress management techniques.
- Avoid ultra-processed foods, fried foods, alcohol, red meat, saturated fats, refined flour, white rice, and sugary drinks.
Targeted Functional Medicine Interventions for PCOS at Harper Clinic Utah
There is no cure for PCOS, so establishing a supportive relationship with your healthcare provider is key to effectively managing PCOS. Regular follow-ups can catch potential complications before they arise, so your key to success is to be proactive!
Remember, you are not alone on this journey. If you are suffering from PCOS symptoms, Harper Clinic provides integrative functional medicine treatment to address hormonal imbalances and targeted interventions to improve your quality of life. Contact our team today!
Sources
[1] Cleveland Clinic. (n.d.). Polycystic ovary syndrome (PCOS). Cleveland Clinic. Retrieved September 18, 2025, from https://my.clevelandclinic.org/health/diseases/8316-polycystic-ovary-syndrome-pcos
[2] Hopkins Medicine. (n.d.). Polycystic ovary syndrome (PCOS). Johns Hopkins Medicine. Retrieved September 18, 2025, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos
[3] Cleveland Clinic. (n.d.). Hirsutism. Cleveland Clinic. Retrieved September 18, 2025, from https://my.clevelandclinic.org/health/diseases/14523-hirsutism
[4] Cedars-Sinai. (n.d.). Polycystic ovary syndrome. Cedars-Sinai Blog. Retrieved September 18, 2025, from https://www.cedars-sinai.org/blog/polycystic-ovary-syndrome.html
[5] American College of Obstetricians and Gynecologists. (n.d.). Polycystic ovary syndrome (PCOS). ACOG. Retrieved September 18, 2025, from https://www.acog.org/en/womens-health/faqs/polycystic-ovary-syndrome-pcos
[6] Verywell Health. (2024, May 10). Types of PCOS. Verywell Health. Retrieved September 18, 2025, from https://www.verywellhealth.com/types-of-pcos-8790371
[7] Medical News Today. (2020, September 22). Post-pill PCOS: What to know. Medical News Today. Retrieved September 18, 2025, from https://www.medicalnewstoday.com/articles/post-pill-pcos
[8] Teede, H., Gibson-Helm, M., Norman, R. J., & Boyle, J. (2010). Polycystic ovary syndrome: Perceptions and attitudes of women and primary health care physicians on features of PCOS and renaming the syndrome. BMC Medicine, 8(1), 1–9. https://pmc.ncbi.nlm.nih.gov/articles/PMC5399492/#sec31:~:text=Hormonal%20contraceptives%20are%20the%20first%2Dline%20management%20for%20menstrual%20abnormalities%20and%20hirsutism/acne%20in%20PCOS
[9] GoodRx. (2023, May 2). PCOS medications. GoodRx. Retrieved September 18, 2025, from https://www.goodrx.com/conditions/pcos/pcos-medications
[10] NYU Langone Health. (n.d.). Medication for polycystic ovary syndrome. NYU Langone Health. Retrieved September 18, 2025, from https://nyulangone.org/conditions/polycystic-ovary-syndrome/treatments/medication-for-polycystic-ovary-syndrome
[11] EatingWell. (2023, April 21). PCOS meal plan. EatingWell. Retrieved September 18, 2025, from https://www.eatingwell.com/article/7920027/pcos-meal-plan/#toc-pcos-diet-guidelines