PCOS in Young Women

Understanding the Problem & Finding Solutions

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Dr. Aaron Hartman

May 7, 2025

PCOS

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    When I began my medical career, Polycystic Ovarian Syndrome (PCOS) rarely appeared in my patient files. Medical school taught us it was uncommon. Today, the landscape has changed dramatically, with PCOS rates climbing significantly among teenagers and young women.

    This condition now affects up to 13% of women of reproductive age[1], with the highest rates among 15–19-year-olds[2]. Research shows PCOS cases in late adolescents have increased by 67% over just a 12-year period.[3]. In my practice, I’m seeing this reflected in the growing number of young women seeking help for PCOS symptoms.

    What’s driving this increase, and more importantly, what can be done about it?

    I’ve identified several underlying factors and effective solutions that help young women regain hormonal balance.

    Beyond Ovarian Cysts: Understanding PCOS

    A close-up of a smartphone displaying a menstrual cycle tracking app with a calendar view, held by a person who is also holding a blister pack of pills.

    PCOS is frequently misunderstood as simply a reproductive issue. In reality, it’s fundamentally a metabolic disorder that affects a woman’s entire health system.

    Young women with PCOS typically experience some combination of:

    • Irregular or absent periods
    • Elevated levels of androgens (male hormones)
    • Small fluid-filled sacs on the ovaries
    • Unwanted hair growth, particularly on the face, chest, and back
    • Fertility challenges
    • Weight-management difficulties

    These visible symptoms reflect deeper imbalances in metabolism and hormone regulation.

    Root Causes Behind the PCOS Increase

    Having practiced medicine for over two decades, I’ve witnessed the transformation of PCOS from uncommon to increasingly prevalent. Three main factors appear to be driving this trend:

    Environmental Toxicity

    Our daily environments contain more hormone-disrupting chemicals than ever before. Government health surveys (NHANES data) confirm increasing levels of endocrine-disrupting compounds in our bodies. These chemicals from plastics, pesticides, and personal-care products interfere with normal hormone function and can contribute to PCOS development.

    Insulin Resistance

    A hand holding a digital blood glucose meter displaying a reading of 120 mg/dL, with a test strip collecting a blood sample from a fingertip.PCOS and insulin resistance are closely linked. As diabetes rates have increased, so have PCOS cases. In my practice, I regularly see insulin resistance in patients with PCOS, creating a metabolic environment that promotes hormone imbalance. Insulin resistance affects an estimated 60–80% of Americans, creating a perfect metabolic environment for hormonal disorders like PCOS to develop.

    When cells become resistant to insulin, the pancreas produces more insulin to compensate. This excess insulin signals the ovaries to produce more testosterone, contributing to many PCOS symptoms. Understanding this connection is crucial for effective treatment. This is why understanding the fundamentals of insulin and insulin resistance is crucial for PCOS management.

    Autoimmune Factors

    Growing research suggests PCOS may involve autoimmune components, where the body’s immune system mistakenly attacks its own tissues. As overall rates of autoimmunity increase in our population, I’m seeing corresponding rises in conditions like PCOS. This helps explain why conventional treatments often provide incomplete relief—they don’t address the underlying immune dysfunction. Understanding the myths about autoimmune disease can help patients better navigate their PCOS journey.

    Limitations of Conventional PCOS Treatment

    Hands holding several blister packs of oral contraceptive pills, each with white and brown tablets, on a light surface.

    Standard medical approaches to PCOS typically focus on:

    • Birth control pills: While these regulate periods and reduce male hormones, they don’t address root causes and can sometimes worsen insulin resistance.
    • Metformin: This diabetes medication helps with insulin sensitivity but works best when combined with dietary and lifestyle changes.

    These treatments can help manage symptoms but often fall short of addressing the underlying metabolic, inflammatory, and environmental factors driving the condition.

    A Comprehensive Approach to PCOS

    In my practice, I’ve found that addressing multiple factors simultaneously offers the best results for young women with PCOS:

    Targeting Insulin Resistance

    Since insulin problems underlie most PCOS cases, addressing this imbalance is essential:

    • Dietary changes: Reducing processed foods and refined sugars while focusing on whole, nutrient-dense foods often produces significant improvements.
    • Meal timing: Some patients benefit from time-restricted eating patterns that give the body periods of rest from insulin production.
    • Supportive supplements: Natural compounds like berberine can help improve insulin sensitivity with the added benefit of supporting gut health.

    For more detailed information on improving insulin sensitivity, check out our guide on nutrients that improve insulin sensitivity and our article on metabolic health.

    Reducing Inflammation

    Chronic inflammation interferes with proper hormone function. Effective approaches include:

    • Identifying food sensitivities: Common triggers like gluten and dairy can drive inflammation in susceptible individuals.
    • Addressing immune regulation: Treatments that help modulate immune function can reduce the autoimmune component of PCOS.
    • Healing gut imbalances: The gut microbiome directly influences both inflammation and hormone metabolism.

    Since PCOS is considered an autoimmune-spectrum disorder, reducing systemic inflammation is crucial for effective treatment.

    Supporting Detoxification

    A mason jar filled with cucumber, lemon slices, and herbs in water, with fresh cucumber and lemon slices on a table around it.

    Environmental toxins play a significant role in PCOS development. Helpful strategies include:

    • Enhancing natural detox pathways: Supporting liver function with specific nutrients and herbs can improve hormone processing.
    • Reducing toxin exposure: Choosing cleaner personal-care products, filtered water, and organic foods when possible.
    • Periodic detoxification support: Seasonal detoxes can help reduce accumulated toxin burden.

    For those looking to go deeper, we also offer resources on advanced detoxification strategies that can be particularly helpful for PCOS patients.

    The Gut-Hormone Connection

    The gut microbiome plays a critical role in hormone health, affecting:

    • Inflammation levels throughout the body
    • How efficiently hormones are metabolized and eliminated
    • Insulin sensitivity
    • Weight regulation

    Supporting gut health with appropriate probiotics, prebiotics, and an anti-inflammatory diet can significantly improve PCOS symptoms by addressing these connections. For more information on how gut health impacts overall wellbeing, explore my nutrition resources and learn about science-backed superfoods that can support your journey to better health.

    PCOS & Future Fertility

    For many young women, concerns about future fertility are paramount. The good news is that addressing PCOS early can substantially improve reproductive outcomes by:

    • Restoring regular ovulation through better metabolic health
    • Reducing inflammation that can affect egg quality
    • Balancing hormones naturally
    • Supporting overall reproductive function

    The earlier these issues are addressed, the better the outcomes tend to be.

    A Practical PCOS Recovery Plan

    If you’re struggling with PCOS symptoms, consider this step-by-step approach:

    1. Comprehensive testing: Look beyond basic hormone panels to assess insulin resistance, inflammatory markers, nutrient status, and potential toxin exposure.
    2. Dietary foundation: Focus on whole, unprocessed foods while eliminating refined sugars and personal inflammatory triggers.
    3. Targeted supplementation: Consider evidence-based supplements like inositol, berberine, magnesium, vitamin D, and omega-3 fatty acids based on your specific needs.
    4. Environmental cleanup: Reduce exposure to hormone-disrupting chemicals in personal-care products, household items, and food packaging.
    5. Gut health optimization: Address any dysbiosis or intestinal permeability issues that might be contributing to inflammation.
    6. Stress management: Implement effective stress-reduction practices, as chronic stress worsens both insulin resistance and inflammation.
    7. Professional guidance: Work with a healthcare provider knowledgeable about functional-medicine approaches to PCOS.

    The Importance of Early Intervention

    PCOS typically begins during adolescence, with research showing the highest incidence between ages 15–19[2]. However, awareness of PCOS among adolescent girls is surprisingly low at just 4.5%, compared to 84.9% awareness among young adult women[4]. This awareness gap means many suffer for years without proper diagnosis or treatment.

    Early intervention is crucial because PCOS isn’t just about irregular periods. If left unaddressed, it can lead to significant long-term health consequences:

    • Increased risk of type 2 diabetes
    • Higher rates of cardiovascular disease
    • Elevated risk of endometrial cancer
    • Greater likelihood of anxiety and depression
    • Potential fertility challenges

    From my clinical experience, addressing PCOS in the teenage or early adult years provides the best opportunity for significant improvement or reversal of symptoms.

    Yes…There is Hope

    For young women experiencing PCOS symptoms, there is reason for optimism. By addressing the underlying causes—insulin resistance, inflammation, gut health, and environmental factors—many experience substantial improvement in their symptoms.

    Your body has a remarkable healing capacity when given proper support. The key is taking action sooner rather than later.

    If you found this article helpful, please share it with others who might benefit from this information.

    Take Control of Your Hormonal Health with Expert Support

    Are you tired of being told that birth control pills and symptom management are your only options for PCOS?

    At Richmond Integrative & Functional Medicine, we understand the frustration of dealing with hormonal imbalances that affect every aspect of your life. Our newest provider, Veronica Porterfield, MS, LN, MPAS, PA-C, brings specialized expertise in women’s hormonal health and complex chronic conditions.

    Why Choose Our Approach to PCOS?

    Our functional-medicine team offers:

    • Root-cause investigation that looks beyond symptoms to identify what’s truly driving your PCOS
    • Personalized treatment plans addressing your unique metabolic, inflammatory, and hormonal needs
    • Extended appointments (60–120 minutes initially) that give us time to truly understand your health journey
    • Science-backed solutions that combine the best of conventional and functional medicine

    “I believe in every body’s ability to heal… and I try to bring curiosity & compassion to every patient to support their path to wellness,”

    — Veronica Porterfield

    Don’t wait until your symptoms worsen or fertility challenges develop. Meet Veronica Porterfield and discover how her unique approach can help restore your hormonal balance.

    APPLY FOR MEMBERSHIP TODAY

    References

    1. World Health Organization. (2025, February 7). Polycystic ovary syndrome. WHO Fact Sheets. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome
    2. Li,R., Zhang,Q., Yang,?D., Li,S., Lu,S., Wu,X., et al. (2021). Measuring the global disease burden of polycystic ovary syndrome in 194 countries: Global Burden of Disease Study 2017. Human Reproduction, 36 (4), 1108–1119. https://academic.oup.com/humrep/article/36/4/1108/6120666
    3. Al Haddad,A.H.I., Khani,A., Al Ali,M.T., Al Baluchi, M., Al Yazidi, M., & Khani, A.?F. (2023). Prevalence of Polycystic Ovary Syndrome (PCOS) and Its Associated Risk Factors among Medical Students in Two Countries. International Journal of Environmental Research and Public Health, 21 (9), 1165. https://www.mdpi.com/1660-4601/21/9/1165
    4. Nanjundan, P., Arunachalam, D., Swaminathan, K., & Zameer, K. S. (2022). Polycystic Ovarian Syndrome: Prevalence, Predisposing Factors, and Awareness Among Adolescent and Young Girls of South India. Cureus, 14 (9), e28909. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9464521/