Polycystic ovary syndrome (PCOS) is one of the most common conditions affecting women between the ages of 15 and 55. PCOS impacts a woman’s hormones, which can affect the menstrual cycle in a big way. That’s why many PCOS symptoms have to do with the reproductive system, like irregular or missing periods, heavy menstrual bleeding, infertility, recurring miscarriages, ovarian cysts, and even pain during ovulation.
When people think of pain around the uterus, their minds usually jump to endometriosis. However, PCOS abdominal pain, especially around ovulation, is really common. So, in this post, I wanted to explain why Cysters experience ovulation pain. Then, I’ll break down how you can naturally ease pain by addressing the root issue of the discomfort.
Yes, there is something you can do about the pain! And that doesn’t involve hormonal birth control, nerve blockers, injections, surgical interventions like hysterectomy or oophorectomy, or even a ton of anti-inflammatories (like ibuprofen or aspirin). There’s hope, Cysters!
Here’s what you should know about ovulation pain and PCOS:
What Is PCOS Ovulation Pain?
Ovulation pain is when your pelvic area or lower abdomen hurts around ovulation. Anyone can feel some discomfort during ovulation. However, for women with PCOS, the pain can be more intense, long-lasting, and unpredictable.
Is Ovulation Pain a Sign of PCOS?
Ovulation pain on its own doesn’t mean you have PCOS. It could be endometriosis, pelvic inflammatory disease (PID), pelvic floor tension, uterine fibroids, irritable bowel syndrome (IBS), or a variety of other health conditions. That said, if ovulation pain shows up alongside other known PCOS symptoms, it may be part of a larger hormonal pattern worth talking to a doctor about.
One of the main drivers of PCOS symptoms is elevated androgen levels. These are male sex hormones like testosterone that, in excess, mess with normal communication between the brain and ovaries. When signaling is disrupted, the ovaries never get the message that only one follicle is meant to fully mature.
2: Follicles get “stuck” and don’t mature normally.
As a result, instead of one dominant follicle developing properly, lots of follicles start growing. Eventually, errors in the process cause most of them to stop developing long before maturation. So, when it comes time for releasing the egg into the fallopian tube, there’s an obvious problem in the ovaries. This is what gives ovaries their signature “polycystic” appearance.
3: The ovary stretches and builds pressure.
As immature follicles linger, the ovary can become enlarged. This stretching increases pressure within the ovary and its outer capsule. There are plenty of nerve endings in this area, which can make ovulation with PCOS painful or uncomfortable.
4: Ovulation is delayed, irregular, or more forceful when it happens.
Because of ongoing communication issues between the brain and ovaries—and stalled follicle growth—ovulation often doesn’t happen on schedule. Instead, the body waits until it finally perceives a follicle as mature enough. When ovulation does occur, it’s often later than expected and can feel more intense. This is because irregular egg development may cause the follicle wall to rupture unevenly or more forcefully, increasing pain.
5: Fluid release and inflammation irritate the surrounding tissue.
During ovulation, follicular fluid is released into the pelvic cavity. This is normal. However, if inflammation is already present (which is common with PCOS), that fluid can irritate nearby tissues. The pelvic lining, bowel, or uterine ligaments may become painful simply because they’re more sensitive.
Inflammation is a chronic root issue in PCOS. High androgen levels worsen it, along with other hormonal imbalances. Essentially, ongoing hormone dysregulation signals to the body that something is wrong, triggering an overactive immune response. This can contribute to widespread symptoms—including pain. Here’s more on the signs of inflammation with PCOS.
6: You feel ovulation pain (sharp, achy, one-sided, or radiating).
All of this pressure, irritation, and inflammation can show up as sharp pain, a dull ache, one-sided pelvic discomfort, or pain radiating into the lower back, hips, or thighs. For some Cysters, ovulation pain lasts a few hours. For others, it can linger for days.
How to Deal with Painful Ovulation with PCOS
Lower androgen levels and ease inflammation.
Since high androgen levels and inflammation are the root issues behind painful ovulation (along with plenty of other PCOS symptoms), that’s where you need to start. Take steps to lower androgens and ease inflammation naturally by:
For PCOS-friendly recipes, workouts, and resources, download The Cysterhood app.
Manage stress levels.
I say all the time that stress isn’t just a feeling. Instead, it’s actually a chemical process in the body that signals us to take action. When we feel overwhelmed, cortisol levels rise, triggering a domino effect of hormonal imbalances and inflammation.
To better manage stress, focus on practices that actively lower cortisol. Try slow, intentional breathing, getting morning sunlight, limiting caffeine, stretching, journaling, setting clear boundaries, and making rest non-negotiable. Anything you can do to relieve your mental load and bring cortisol levels down.
Stay hydrated.
Drinking plenty of water is one of the simplest ways to ease ovulation discomfort. Proper hydration helps the body clear excess hormones (including androgens) and supports healthy circulation. It also helps regulate inflammation, which may soothe irritation around the ovaries and surrounding pelvic tissue.
When you’re well hydrated, your muscles are less likely to tense up and amplify pain. So drink up—even if that means using a fun cup or adding a sugar-free flavor to make it easier to stay consistent.
Try yoga or other gentle movements.
Gentle movement from exercises like slow-weighted workouts, yoga, Pilates, swimming, and walking can help reduce ovulation pain in lots of ways. It improves circulation and relaxes tense muscles (like the effects of proper hydration!). However, it also helps regulate the nervous system. The result? Less stress and inflammation—and less severe PCOS pelvic pain.
Since a lot of ovulation pain with PCOS comes from pressure, try sleeping on your side instead of on your back or stomach. This can help align your pelvic area, improve circulation, and relieve pressure. If you struggle to lie on your side, try using a body pillow! It’s actually really comfortable and supportive. Plus, breaking the habit of sleeping on your front or back is worth the reduced pain.
Use castor oil packs and heat therapy.
Castor oil packs are a simple, at-home topical option for pain relief. Warm castor oil is applied to the body with a cloth to help increase circulation and relax muscles in the pelvic area. (Probably noticing a theme here, right?) Here’s how to make castor oil packs for PCOS.
For additional natural, DIY relief, turn to other forms of heat therapy. While these aren’t permanent solutions, they can help ease discomfort in the moment—whether that’s a heating pad, warm bath, or heated blanket.
PCOS can cause ovulation pain, but you can treat it naturally.
Ovulation pain with PCOS isn’t random, and it isn’t something you have to brush off. It’s often the result of elevated androgens, irregular follicle development, and underlying inflammation. When you focus on correcting those root issues—rather than just masking symptoms—you can have pain-free cycles again!
Polycystic ovary syndrome (PCOS) is one of the most common conditions women of reproductive age face. However, medical experts estimate that up to 70% of cases could be going undiagnosed. That’s a heartbreaking statistic! Luckily, as awareness about PCOS spreads, women can better understand their symptoms, diagnose the problem, and advocate for their healing journey.
If you think you may have PCOS, you’ve come to the right place. I am a Cyster myself, as well as a PCOS dietitian that’s here to help you figure out if you have PCOS—and how to reverse it if you do. In this post, I’ll break down common symptoms, similar medical conditions, and trusted diagnostic methods. Ready to jump in? Here’s how to know if you have PCOS:
How to Know If You Have PCOS: A Guide to Symptoms and Testing
There are a lot of reasons PCOS often goes undiagnosed. Symptoms vary widely from Cyster to Cyster, and many of them can be treated individually rather than holistically, making it difficult to see connections between side effects. Plus, many doctors aren’t well educated on the condition, and no single test can definitively detect PCOS.
That may all sound bleak, but you’re in the right place! You can be sure whether or not you have PCOS with a little research, some symptom tracking, a few strategic tests, and a knowledgeable healthcare professional.
What Is PCOS?
Polycystic ovary syndrome (PCOS) is an endocrine and metabolic condition that affects women of reproductive age. While the exact cause of PCOS is still unknown, it’s driven by insulin resistance, hormonal imbalances, and chronic inflammation. Research is now also examining whether there could be a genetic component, meaning it may run in families.
PCOS affects far more than just the ovaries. (In fact, many women with PCOS don’t have cystic ovaries at all.) It impacts how the body produces and responds to hormones, regulates blood sugar, and functions over all. Because these systems are so closely connected, PCOS can influence long-term metabolic health, fertility, and hormone balance throughout different stages of life. Additionally, there’s a lengthy list of common chronic symptoms that many Cysters manage daily. Some of them are:
Common Symptoms of PCOS
Irregular, missed, very heavy, or very light periods
Yes! PCOS is often misdiagnosed. I’ve already touched on a few reasons, but here’s a full list:
Symptoms vary from person to person
Doctors often treat symptoms individually instead of looking at the full pattern
No single test can definitively diagnose PCOS
Standard hormone panels may appear “normal”
Insulin resistance is frequently under-tested or missed
Ultrasounds don’t always show ovarian cysts (or you may not have any)
Birth control pills can mask underlying hormone imbalances
Physicians often blame symptoms on stress, lifestyle, weight, or aging
Many patients don’t know which symptoms are relevant to report
Other Conditions Similar to PCOS
Thyroid Disorders (Hypothyroidism or Hyperthyroidism)
Thyroid disorders affect how the body regulates metabolism, energy, and hormones. They’re often mistaken for PCOS because they can cause irregular periods, weight changes, fatigue, hair loss, and fertility issues.
HA occurs when the brain suppresses ovulation due to stress, under-eating, excessive exercise, or extreme weight loss. It’s often confused with PCOS because both can involve missing periods and disrupted ovulation. That said, HA stems from low hormone signaling rather than excess hormone activity.
Hyperprolactinemia
This condition involves elevated prolactin levels, which interfere with ovulation and menstrual cycles. It’s mistaken for PCOS because it can cause excessive hair growth, acne, irregular periods, and trouble getting pregnant.
Congenital Adrenal Hyperplasia (Non-Classic CAH)
Non-classic CAH is a genetic condition that affects adrenal hormone production and can increase male sex hormone levels. It closely mimics PCOS due to shared symptoms like excess hair growth, acne, and irregular cycles.
Cushing’s Syndrome
Cushing’s Syndrome results from chronically elevated cortisol levels and affects metabolism, weight distribution, and hormone levels. It’s often confused with PCOS because both can cause weight gain, insulin resistance, irregular periods, and mood changes.
Primary Ovarian Insufficiency (POI)
POI occurs when the ovaries stop functioning normally before age 40. It can resemble PCOS early on because of irregular or missing periods. However, POI involves low estrogen rather than hormone excess.
Insulin Resistance
Insulin resistance affects how the body handles blood sugar and is a major driver of PCOS—but it can also exist on its own. When present without other diagnostic criteria, it may be mistaken for PCOS due to shared metabolic symptoms.
Endometriosis
Endometriosis happens when tissue similar to the uterine lining grows outside the uterus, leading to inflammation and pain. It’s often confused with PCOS because both conditions can cause irregular or painful periods, fertility challenges, and chronic pelvic pain. Ultimately, however, endometriosis is a result of tissue overgrowth and inflammation, not hormone-driven ovulation or androgen imbalance.
Androgen-Secreting Ovarian or Adrenal Tumors (Rare)
These rare tumors produce excess testosterone and other androgens, which can trigger a rapid onset of PCOS-like symptoms. They’re mistaken for PCOS because of sudden hair growth, acne, and cycle disruption, though symptoms usually appear more aggressively.
How to Know If You Have PCOS at Home
Step One: Track your menstrual cycle.
A vast majority of people with PCOS have irregular periods. This is largely due to high levels of a hormone called androgen (male sex hormones), which are common with PCOS. They disrupt or even stop ovulation, which throws off the whole menstrual cycle.
So, one of the first ways to determine if you have PCOS is to examine your periods. Track the start date, duration, and any notable symptoms. If your periods are longer than 35 days apart or you only experience periods every 2-6 months, you may have PCOS. Periods with PCOS can also be heavy and painful.
Step Two: Check for common PCOS symptoms.
Next, look for common signs and symptoms of PCOS. Review the list above and identify which symptoms you experience regularly. The more that applies to you, the more likely you are to have PCOS.
Step Three: Look for signs of insulin resistance.
Insulin resistance is present in up to 80% of Cysters, which is when your body doesn’t respond to glucose properly. Instead of turning the sugar into energy, it’s stored as fat and absorbed into the bloodstream. This increases your risk of high blood pressure, heart disease, and type 2 diabetes, while contributing to these common PCOS symptoms:
One of the best ways to detect PCOS at home is by using a hormone test kit like this one from EquiLife. It’s comprehensive and sensitive enough to measure a variety of hormone levels that contribute to PCOS symptoms. Here’s what you need to test for:
Review all the information you’ve collected on your symptoms, periods, metabolic situation, and hormone levels. Then determine whether there’s enough evidence to support PCOS. If you think there is, the next step is to seek professional help.
Step Six: Follow up with a healthcare provider.
You can’t definitively determine whether or not you have PCOS on your own. However, with the information you’ve gathered and the right doctor, you can work toward an official diagnosis. There are a variety of healthcare professionals who can accurately detect PCOS and help you manage your symptoms. Here are the best types of doctors to see for PCOS:
OB-GYN
Endocrinologist
Reproductive Endocrinologist
Functional Medicine Doctor
Integrative or Holistic Physician
Fertility Specialist
Step Seven: Start PCOS-healing lifestyle habits.
Whether you’ve received a PCOS diagnosis or are still waiting on results, it’s time to start making simple lifestyle changes to reverse your symptoms. Many of these new healthy habits support hormone and metabolic health for anyone, not just Cysters! So, adopting these new routines won’t hurt you if PCOS turns out to be the wrong diagnosis. That said, focusing on a PCOS-friendly diet, slow-weighted movement, and other daily rituals that stabilize blood sugar and regulate hormones can help support healing and symptom improvement over time.
How Is PCOS Diagnosed? Understanding the Rotterdam Criteria
PCOS is typically diagnosed using something called the Rotterdam Criteria, the most widely accepted diagnostic framework. Instead of relying on one single test, doctors look at the bigger picture and evaluate a combination of symptoms, lab work, blood tests, and imaging.
Under the Rotterdam Criteria, clinicians diagnose PCOS after confirming specific criteria and ruling out other conditions. To get diagnosed with PCOS, you must have two of the following: irregular or absent ovulation, elevated androgen levels, and polycystic ovaries. This approach helps account for how differently PCOS can show up from person to person!
PCOS is a unique condition, but it can be clearly diagnosed with the right criteria and testing.
If PCOS has been on your radar, trust that curiosity. It’s often the first step toward clarity! Understanding your symptoms, getting the right tests, and working with a knowledgeable provider can make a huge difference in how you confidently and strategically move forward. PCOS may be complex, but with the right information and support, it’s absolutely something you can manage and improve. For more guidance on naturally healing PCOS and reversing symptoms, explore the PCOS Weight Loss blog and listen to the A Cyster and Her Mister Podcast.
Getting a PCOS diagnosis isn’t always straightforward. For many women, it can take up to 7 years after their first symptoms appear to give this condition a name. Yes, 7 YEARS. That delay often happens for many reasons. Symptoms are brushed off as “normal,” hormonal birth control pills mask underlying issues, and there’s no single test that can definitively diagnose polycystic ovary syndrome (PCOS).
To make things even more confusing, standard bloodwork may come back “normal,” even when you don’t feel normal at all. Broad reference ranges don’t always reflect what’s actually optimal for your body, which leaves many women struggling with symptoms without clear answers.
That’s why hormone testing is such an important step for women with PCOS. A more detailed hormone panel can help you connect the dots between suboptimal hormone levels and the symptoms you’re experiencing. Once you have that clarity, you can work with a doctor (or go at it on your own) to naturally support hormone balance and heal your body.
Your hormones can tell you a lot about what’s really going on with your PCOS. But it’s not just about whether your hormone levels fall outside a “normal” range. It’s also about how your body is metabolizing, detoxing, and excreting those hormones—and whether they’re being cleared properly or recirculating and contributing to symptoms.
Additionally, just because hormone levels are “in range” doesn’t mean they’re not the source of your problem. It’s all a lot more nuanced than that. To help you make sense of it all, here’s what you need to know about PCOS hormone testing:
Can You Have PCOS With “Normal” Hormone Levels?
The short answer: yes. Hormones are tricky. Lab values show what your hormone levels look like at a single point in time. However, they don’t show how those hormones are actually behaving inside your body.
For example, let’s say you’re experiencing symptoms of hyperandrogenism, like irregular periods, acne, or hair thinning. You get your hormones tested, and your androgen levels come back “normal.” So what’s going on?
First, standard hormone tests use very broad reference ranges. Even if your hormones fall within that range, they may still be suboptimal for your body. But let’s say your levels truly are optimal. Symptoms can still happen if androgens are interacting with your body differently. For example, they may be more active at the tissue level, converting into a more potent form. Or maybe the ratio of free testosterone may be off even though total testosterone looks normal. See what I mean?
The same concept applies to A1C, estrogen, and nearly every other hormone. It’s not just about how much of a hormone your adrenal glands or ovaries are producing. Instead, it’s about how your entire endocrine system is regulating, metabolizing, and responding to those hormones. That’s why even “normal” hormone panels can still be associated with health conditions like PCOS.
What Hormone Levels Indicate PCOS
Estradoil
Estrogen (Estradiol E2) levels in women with PCOS are usually normal or high. Even when it’s normal, though, it’s usually functionally dominant. In other words, it’s overactive and causing symptoms like:
Irregular or heavy periods
PMS or mood swings
Difficulty losing weight
Breast tenderness
Bloating
Progesterone
Often, Cysters are low in progesterone because of irregular or absent ovulation. When you have low progesterone, you experience a variety of symptoms, including:
Irregular or absent periods
Anxiety
Sleep issues
Infertility
Testosterone
Most women with PCOS have high levels of testosterone—and free testosterone is especially high. These androgens (aka male hormones) trigger a lot of chronic issues, such as:
DHEA-S is a precursor hormone, which means it converts into other hormones—most commonly testosterone and estrogen. Many Cysters have elevated DHEA-S, which can drive androgen excess. The result? Symptoms of high testosterone.
Cortisol
Cortisol is our stress hormone. Women with PCOS can have very high, dysregulated cortisol levels, which can make them experience:
Fatigue
Weight gain
Anxiety and irritability
Sleep issues
Blood sugar instability
Want to learn more about this connection (and ways to help it)? Listen to the episode of A Cyster and Her Mister called “High Cortisol Survival Kit.”
Insulin
Insulin levels are almost always elevated with PCOS. Polycystic ovary syndrome is a hormone disorder, but it’s also a metabolic one. Insulin resistance triggers a chain of problems, including inflammation, high blood pressure, high cholesterol, and other hormonal imbalances. It’s the source of quite a few side effects, including:
Intense cravings
Weight gain or inability to lose weight
Fatigue after meals
Brain fog
Acne
Irregular menstrual cycles
Hemoglobin A1C
Hemoglobin A1C essentially measures your body’s glucose levels. But unlike measuring blood sugar at a single point in time, A1C represents long-term blood sugar levels. Many Cysters have elevated A1C levels, which further contribute to symptoms of insulin resistance.
Thyroid
The thyroid has three major hormones: TSH, T4, and T3. Thyroid-stimulating hormone (TSH) is usually high while T4 and T3 are low. This is a result of insulin resistance and inflammation, which suppresses the thyroid and causes symptoms like:
To get the most comprehensive testing for PCOS, you can work with a holistic practitioner. Common examples include a functional medicine doctor (MD/DO), naturopathic doctor (ND), integrative hormone specialist, or a registered dietitian (if they run labs).
This is often the best approach for diagnosing PCOS, addressing root issues, and finding long-term symptom relief. However, it’s typically not covered by insurance, which means it can be expensive for many Cysters.
Primary Care Doctor
A primary care doctor can also order basic bloodwork. Since this is normally covered by insurance, it’s often the most affordable option! These labs can be helpful as a starting point and are often used to rule out major issues. However, they only offer a broad overview of what’s going on. They’re not usually detailed enough for targeted healing or symptom management.
OBGYN or Fertility Clinics
Because PCOS directly impacts the reproductive system, OBGYNs and fertility specialists are another common route for testing. This is where many Cysters first find out they have PCOS!
Testing at OBGYN offices or fertility clinics is usually more comprehensive than what a primary care doctor orders. In addition to basic labs, they often test anti-müllerian hormone (AMH), prolactin, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) levels. These can be really helpful, especially if improving fertility is your goal.
These tests are often covered by insurance and provide more insight than standard bloodwork, though still not as in-depth as functional testing.
At-Home Lab Test Companies
You can also order bloodwork from home, depending on where you live. EquiLife even offers lab test kits designed specifically to assess PCOS-related hormone imbalances and nutrient deficiencies. (You can even get it 50% off for being a part of The Cysterhood.)
These tests are very convenient and often more affordable than lab tests from a functional doctor. (That said, you still have to pay out of pocket.)
The main downside is that you don’t have a provider to guide you through the results or help you create an informed, personalized action plan. EquiLife and other companies do offer that as an add-on. However, they won’t be long-term providers for you, and it ultimately increases the final cost.
What Kind of Labs Do You Need for Hormone Testing?
Dried Urine Hormone Test
A dried urine hormone test shows how your body processes and clears hormones, not just how much you have. Instead of a single snapshot, it shows hormone patterns over time. This reveals whether hormones are being properly detoxed or recirculating like they’re supposed to.
Stool Hormone Test
Your gut plays a big role in hormone balance. (Here’s more on PCOS and gut health.) A stool test looks at digestion and the microbiome to see whether hormones (especially estrogen) are being properly eliminated. When gut health is off, hormones can be reabsorbed and worsen PCOS symptoms.
Hair/Tissue Mineral Analysis
Hair or tissue mineral testing shows your mineral status over time, not just in the moment. Since minerals support hormone production, stress response, and insulin sensitivity, it’s important to know about potential imbalances!
Comprehensive Bloodwork
Comprehensive blood tests provide a baseline look not only at hormones but also at metabolic markers. While these labs don’t tell the full story, they are an essential piece of the puzzle for identifying red flags, supporting diagnosis of PCOS, and tracking progress.
Get your hormone levels tested in multiple ways to help you manage your PCOS symptoms.
PCOS healing is totally possible. Do you need lab work to reverse your condition? No. But it is super helpful for knowing exactly what root issues to target and for mapping your progress. A great first step is learning about PCOS and talking to your doctor about your symptoms.
From there, we can support you through your healing journey! By downloading The Cysterhood app, you’ll unlock hundreds of PCOS resources like meal plans, exercise routines, educational materials, and an incredibly supportive community. These tools can help you find permanent relief from even your most challenging PCOS symptoms!
If you think you have PCOS and the hormone imbalances that go with it, read (or listen to) these guides next to kickstart your healing journey:
If you’re looking for a warm, comforting, nutrient-dense recipe to support your PCOS lifestyle, this Butternut Squash Soup is the perfect cozy option. Made with simple whole-food ingredients, anti-inflammatory flavors, and naturally rich vitamins and minerals, this dish is a delicious way to nourish your body, especially during colder months.
Butternut squash is an excellent source of fiber, vitamin A, antioxidants, and slow-digesting carbohydrates that support steady blood sugar levels. Pair that with aromatics like ginger and garlic, plus a creamy dairy-free finish, and you have a satisfying soup that feels indulgent while still being supportive of hormone health.p
Although we recommend this recipe as a side dish (it hasn’t been adjusted for different carb ranges), it pairs beautifully with a protein—think roasted chicken, baked salmon, or a high-protein salad.
Let’s get into the recipe!
Hormone-Healthy Butternut Squash Soup for PCOS
Why Butternut Squash Soup Is Great for PCOS
There’s a lot to love about this recipe, especially if you’re managing PCOS through nutrition:
Low glycemic index: Butternut squash provides slow-release energy that supports blood sugar balance.
Anti-inflammatory properties: Ginger, garlic, and olive oil bring anti-inflammatory support—key for PCOS.
Fiber-rich: Helps keep you full, supports digestion, and stabilizes blood sugars.
Dairy-free option: Using dairy-free heavy cream makes this gentle on digestion and great for those who avoid dairy due to inflammation.
Nutrient dense: Packed with essential nutrients like vitamin A, vitamin C, potassium, and antioxidants.
Note: This recipe is intended as a side dish and has not been modified for specific carb ranges.
Step 1: Sauté the aromatics
In a large pot, heat olive oil (or ghee) over medium heat. Add the chopped onion and sauté until translucent.
Step 2: Add garlic and ginger
Stir in the garlic and ginger, cooking for about 30 seconds until fragrant.
Step 3: Add the squash
Add the butternut squash and stir to coat. Optionally, deglaze the pot with a splash of white wine and let it reduce for 1–2 minutes.
Step 4: Add liquids and spices
Pour in the broth, vanilla extract, and cayenne. Cook over medium heat until the squash is soft and tender.
Step 5: Blend the soup
Using an immersion blender, puree everything until smooth and velvety.
Step 6: Add cream
Mix in the dairy-free heavy cream and adjust salt to taste.
Step 7: Prepare the pancetta (optional)
In a small pan, cook pancetta until crispy. Remove with a slotted spoon and place on a paper towel.
Step 8: Optional sage topping
Add fresh sage leaves to the remaining pancetta fat; crisp for about one minute. Remove and drain on a towel.
Step 9: Serve
Ladle the soup into bowls and top with crisp pancetta and sage if desired. Enjoy warm!
Start healing your PCOS symptoms from the inside out, beginning with your diet.
With just a few thoughtful pairings, this comforting butternut squash soup can be more than a side—it can be part of a delicious, PCOS-friendly meal that nourishes your body and supports your hormone health. For even more PCOS-friendly recipes and meal inspiration, be sure to check out the Cysterhood app!
When we talk about getting healthy, most of us focus on what we eat and how we exercise. Sure, those are two crucial pillars of wellness—but the third, often overlooked, pillar is sleep. Quality sleep supports every system in the body: it balances hormones, regulates metabolism, eases inflammation, and so much more. So, when you’re managing PCOS, good sleep isn’t just nice to have . . . it’s essential.
However, getting quality rest with polycystic ovary syndrome (PCOS) is easier said than done. Research shows that women with PCOS are up to six times more likely to experience sleep disturbances than those without the condition. And here’s the frustrating part: poor sleep can exacerbate PCOS symptoms, creating a cycle that feels almost impossible to break.
In this post, we’ll crack the code to better sleep with PCOS. A consistent nighttime routine paired with a few smart lifestyle changes can make a huge difference. Once you start sleeping better, your body finds balance again, and symptoms often improve too. Then, you’ll rest easier knowing you’re finally on the right path!
What Is a PCOS Sleep Routine?
A PCOS sleep routine helps regulate your internal clock, improving sleep quality and supporting overall health. For someone with this condition, though, healthy habits go beyond when you go to bed and wake up. It’s also about practicing good sleep hygiene throughout the entire day.
Things like spending time in nature and managing your sugar intake are just two examples of how daytime habits can influence nighttime rest. I’ll dive into all the healthy sleep habits in a bit, but first, let’s explore how PCOS affects sleep.
How Does PCOS Affect Sleep?
High Androgen Levels
Most women with PCOS have high androgen levels. These are elevated male sex hormones that are responsible for symptoms like hirsutism, hair loss, acne, irregular menstrual cycles, and even poor sleep! Elevated androgen levels can increase neural excitability and alter circadian rhythm signaling. As a result, the brain is more alert at night, which hinders restorative sleep.
Insulin resistance is when your body doesn’t process glucose correctly, leading to big swings in blood sugar levels. This can cause spikes in cortisol and adrenaline at night, which can keep you wide awake even when you feel tired.
Chronic Inflammation
Cysters often experience inflammation as well, which goes hand-in-hand with high cortisol and insulin resistance. When our bodies sense stress, they activate all defenses, triggering the immune system’s inflammatory response.
What begins as temporary inflammation can become chronic, with immune cells sometimes attacking healthy tissue. This leaves you feeling run-down and sore. Despite this fatigue, inflammatory proteins can cross the blood-brain barrier and disrupt the brain’s sleep-regulation system, making it harder to fall asleep and stay asleep.
High Body Weight
The increased insulin resistance and hormonal imbalance that many Cysters face make it easy to gain weight and hard to lose it. (Even when you’re really trying.) And if your body weight reaches a certain point, it can really affect your sleep. Excess fat around the neck and abdomen can restrict airflow, increasing the chances of developing obstructive sleep apnea and other sleep disorders.
When your menstrual cycles are irregular with PCOS, it can lower the production of progesterone. This causes a few chronic symptoms—one of which is poor quality of sleep. This is because progesterone has a naturally relaxing effect on the brain that is important for winding down at night. Without it, you stay wired, which makes it really hard to fall asleep.
Irregular Luteinizing Rhythms
Irregular luteinizing hormone (LH) rhythms are another reason sleep can be disrupted in women with PCOS. LH normally follows a daily rhythm, rising and falling in sync with the body’s internal clock. But in PCOS, LH levels tend to stay elevated and lose their natural rhythm. This hormonal imbalance can interfere with melatonin production and overall circadian timing, making it harder to fall asleep, stay asleep, and wake feeling refreshed.
High Cortisol Levels
Cortisol is the “stress hormone.” It’s meant to be balanced with our melatonin level. The two together help us feel alert and focused yet calm and relaxed. However, internal and external stress can raise cortisol levels, making us wired, anxious, and restless. At night, it even suppresses melatonin secretion—stress takes over everything! Of course, when you’re feeling panicked and overwhelmed, it’s hard to fall asleep.
Disrupted Melatonin Level
As I said, melatonin is the natural foil to cortisol. When the two are balanced well, you have a productive sleep-wake cycle. However, low or mistimed melatonin can delay sleep and make it harder to get deep, restorative rest. Things like high androgens, low progesterone, chronic inflammation, and stress all disrupt your natural melatonin levels.
Mental Health Struggles
Unmanaged PCOS can really lower a Cyster’s quality of life. Things like infertility, difficulty losing weight, chronic fatigue, and body pain can make every day feel impossible. Because of this, up to 50% of women with PCOS have depression and/or anxiety—some studies put the number as high as 83%. And these mental health struggles elevate cortisol, dysregulate serotonin, and fragment your sleep cycle.
Do Women with PCOS Need More Sleep?
Yes and no. On one hand, individuals with PCOS do struggle to get truly restorative sleep. So, sleeping another hour or so can help you get enough quality rest to balance hormones, regulate insulin, and lower inflammation.
That said, there’s no evidence that people with PCOS biologically need more sleep than others. If you’re struggling with fatigue and poor sleep, there are probably other lifestyle factors that need to change to support your body’s ability to rest well. (More on that in a minute.)
Given that, get a couple extra hours of sleep for now if you need to. But as you move further along in your PCOS healing journey, your energy will naturally improve. And, trust me, you’ll find you’re waking up refreshed with less sleep.
How Many Hours of Sleep Should Someone with PCOS Get?
Shoot for 7–9 hours of quality sleep every night. The keyword there is quality. It’s not just about how long you’re in bed—it’s about how deeply your body rests and repairs. To get truly restorative sleep, you need to focus on healing the root causes behind your PCOS.
Developing a strong, consistent PCOS sleep routine—with good sleep hygiene, stress management, and daily movement—will help your body regulate naturally. This means your rest will become deeper, more refreshing, and generally restorative.
What Are the Most Common PCOS Sleep Disorders?
Sleep Apnea
Insomnia
Circadian Rhythm Disruption
Restless Legs Syndrome (RLS)
Excessive Daytime Sleepiness
How to Get Better Sleep with PCOS
Get morning sunlight exposure.
Getting sunlight within the first hour of waking helps reset your circadian rhythm, balance melatonin production, and boost serotonin levels. And, you guessed it, this makes falling asleep at night much easier! So, for healthy sleep, try heading out for a morning walk and see how you feel by nighttime.
Maintain a consistent sleep schedule.
Remember earlier when I mentioned how good sleep hygiene isn’t just about when you go to bed and wake up? That’s still true—but it does help. Maintaining a schedule helps regulate your internal clock, stabilizing hormones like cortisol and melatonin for a more restful sleep.
Do slow-weighted workouts.
Gentle, slow-weighted workouts reduce insulin resistance and cortisol levels without overstressing your body. This can help you fall asleep faster and sleep more soundly. For PCOS-friendly exercise routines, download The Cysterhood app.
Practice daily stress relief.
Chronic stress raises cortisol, which can keep your body in “fight-or-flight” mode at night. Simple stress management techniques, such as walking, journaling, or deep breathing can calm your nervous system before bed.
Balance blood sugar before bed.
Eating balanced meals and including protein or healthy fat in your evening snack helps keep blood sugar stable overnight. In turn, this helps prevent energy spikes that disrupt sleep. Here are some PCOS-friendly snack ideas.
Blue light from phones and TVs suppresses melatonin. Try turning off screens an hour before bed or using blue-light filters to help your body wind down naturally.
Establish a relaxing wind-down routine.
Create a nightly ritual that signals to your body it’s time to rest. Include activities like reading, stretching, or sipping on herbal tea. Consistency helps train your brain to associate these habits with sleep.
Try mindfulness or guided sleep meditations.
Meditation or breathing exercises before bed can quiet racing thoughts, lower heart rate, and improve your ability to drift off peacefully. It’s all about winding down the right way.
Create a calming bedroom oasis.
Keep your sleep space cool, dark, and clutter-free. Use calming scents like lavender or chamomile to make your room a place that your body associates with rest.
Keep your bedroom cool.
A cooler room temperature (around 65–68°F) helps your body naturally lower its core temperature. That lower temperature signals that it’s time to fall (and stay) asleep.
A PCOS sleep routine can help you get better rest and find symptom relief.
Getting quality sleep is one of the most powerful tools you have for managing PCOS. By addressing the root causes behind your symptoms and building a consistent, supportive sleep routine, you can wake up feeling genuinely rested.
For more tips, guides, and practical advice on thriving with PCOS, visit PCOS Weight Loss blog to take back control of your health. Sleep well, Cysters!
One of the most common reasons for infertility is polycystic ovarian syndrome (PCOS). Women with PCOS deal with several sex hormone imbalances that impact the reproductive system in a big way. In fact, up to 80% of Cysters trying to conceive experience infertility.
Fertility symptoms of PCOS include irregular or absent periods, lack of ovulation, ovarian cysts, difficulties with implantation, poor egg quality, recurring miscarriages, and more. Obviously, with a long list like that, it totally makes sense why getting pregnant with PCOS is difficult.
Because of these struggles, many Cysters opt for assisted reproductive technology like in vitro fertilization (IVF). This kind of support can greatly increase a Cyster’s chance of conceiving! And starting a family is something incredibly important to so many women out there, so I’m in full support of these fertility treatments.
That said, the challenges of PCOS are still at play even when doing IVF. High androgens, low progesterone, and imbalances of estrogen can prevent conception and hinder early development. So, in this post, I want to offer some tips to increase your chances of a successful IVF journey when you have polycystic ovary syndrome (PCOS).
Here’s what you need to do:
PCOS and IVF: How to Increase Your Chances of Success
In vitro fertilization (IVF) has helped millions of couples start a family. It’s a great option for Cysters as it bypasses a lot of the usual hurdles to conception associated with PCOS. It can also be combined with other natural fertility treatments (I love those!) for a compounding effect!
IVF works by stimulating the ovaries to produce multiple eggs, which are then retrieved through a minor surgical procedure. Sperm is collected, and then the eggs are fertilized in a lab with that semen. Over the next 3-5 days, the fertilized eggs grow into embryos. Healthy embryos are then implanted into the uterus.
Pretty cool, right? Technology can do some amazing things. In this post, we’ll discuss more about how PCOS causes infertility, why IVF is a good fertility treatment option, and how to improve your odds of a viable pregnancy.
Can PCOS Cause Infertility?
Yes! Nearly all the hormonal imbalances associated with PCOS affect fertility either directly or indirectly. As long as these dysregulated hormones go unmanaged, conception and full-term pregnancy can be really difficult for many Cysters.
These are the hormones you’re dealing with:
High Androgens:Can disrupt ovulation and prevent follicle development
Imbalanced Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH): Can disrupt ovulation and prevent follicle development
High Insulin:Can trigger androgen production, which lowers egg quality and ovulation
Low Progesterone: Can thin the uterine lining, preventing proper implantation
High Cortisol: Can make the body prioritize other functions over reproduction, disrupting ovulation
Does IVF Work for PCOS?
Yes! With IVF, eggs are taken directly from the ovaries, so regular ovulation isn’t a necessity. This fertility treatment also allows for controlled hormone environments and intentional egg selection. This, ultimately, can boost the chance of conception and successful pregnancy.
However, there are some risks involved. Women with PCOS are at a higher risk of ovarian hyperstimulation syndrome (OHSS). This is when the ovaries are too responsive to fertility medications, and they release a bunch of eggs all at once. Experiencing this can be painful and cause intense hormonal shifts. That said, doctors will monitor PCOS patients closely during IVF to manage and prevent OHSS.
Beyond OHSS, it’s important to note that you should address the hormonal issues behind your PCOS. Doing so before and during the IVF process ensures that the treatment has a better chance of being effective. Also, remember: Conception isn’t the only hurdle to a full-term pregnancy. Proper fetal development is essential to positive birth outcomes.
So, to reduce your chances of miscarriage and foster the perfect home for your little one while they wait to be born, make necessary lifestyle changes. You can read my guide to naturally managing PCOS, but I’ll share the habits that’ll make the biggest impact below!
Women undergoing IVF also have a lower chance of having multiple births than with IUI. This is good because multiples can be much harder on your body and lower the chances of a viable pregnancy.
What IVF Protocol Is Best for PCOS?
Antagonist Protocol (GnRH Antagonist Cycle)
You can ask your doctor about the details of the medical procedure, but this is the procedure most often used for women with PCOS. It prevents your body from ovulating too early, which is safer for your ovaries and helps lower OHSS risk. It’s also a shorter, more gentle ovarian stimulation protocol that tends to have fewer negative side effects.
Mild or “Low-Dose” Stimulation Protocol
This method is all about “less is more.” It uses lower doses of medication to help your ovaries grow just 5-10 eggs at a time (rather than 15-25). Basically, instead of aiming for a large number of follicles, this protocol prioritizes fewer, higher-quality eggs. Since this whole process requires less medication, it’s also gentle and lowers your risk of OHSS.
“Freeze-All” Strategy
This last one is a longer process, but it can be worthwhile. In this protocol, eggs are retrieved and immediately frozen. This actually gives your ovaries time to recover from the procedure, which helps prevent OHSS and other negative outcomes. When it’s time to transfer eggs, you undergo a hormonally controlled cycle to increase your chances of a successful transfer.
How to Improve Egg Quality for IVF: PCOS Edition
Eat a balanced anti-inflammatory diet.
Since insulin resistance can make it harder to conceive, balancing your metabolism can be super beneficial to your pregnancy goals. An anti-inflammatory, gluten- and dairy-free diet is key to increasing insulin sensitivity with PCOS.
This improvement in insulin levels supports weight loss and balances hormones—two major hurdles to fertility! Plus, getting your blood sugar in check can reduce the risk of pregnancy complications like gestational diabetes, preeclampsia, and high birth weight.
Take fertility-supporting supplements.
There are lots of supplements that can help balance hormones, improve insulin sensitivity, and boost fertility overall. Some of the best fertility supplements for PCOS include Inositol, CoQ10, omega-3, and, of course, a high-quality prenatal vitamin. You can find all these on Ovafit, which is a supplement line specifically formulated for women with PCOS!
Lower your stress levels.
Stress leads to hormonal imbalances. When we get stressed, our cortisol levels rise—which is why it’s called the “stress hormone.” If those levels become elevated, it sends our bodies into emergency mode.
And when we’re in this state, our systems stop prioritizing reproduction, worsening all fertility markers. That’s why reducing stress through self-care is so important for supporting better egg quality and a healthy pregnancy!
Do slow-weighted workouts.
Exercise can boost fertility by helping your body reach a healthy weight, balance hormones, and lower stress. I recommend slow-weighted workouts that keep your heart rate and cortisol levels steady.
These workouts also build muscle, support fat loss, and improve overall body composition—giving you bigger health benefits overall. For PCOS-friendly routines, check out The Cysterhood app!
Improve your sleep hygiene.
Sleep is essential for hormone balance. When we sleep, our bodies undergo specific processes that help manage important fertility hormones like cortisol, testosterone, estrogen, and progesterone.
Herbal teas have incredible hormone-balancing properties. I recommend drinking an herbal tea blend like Testosterone Relief Tea. This blend includes ten different herbal teas that have been shown to help lower androgen levels in women with PCOS. That means this tea could help regulate menstrual cycles, normalize ovulation, improve egg quality, and more!
IVF can be a great way for Cysters struggling with infertility to conceive!
PCOS may make the path to motherhood more challenging, but it doesn’t close the door. Both intentional lifestyle changes and medical interventions can help you conceive and have a successful pregnancy. Just remember, the key to improving your fertility with PCOS is mending hormonal imbalances—which you have the power to do! For more ways to find relief and get pregnant with PCOS, check out these PCOS Weight Loss resources next:
By now, we’ve all heard about Ozempic and its weight management benefits. For many with polycystic ovary syndrome (PCOS), it can sound like a miracle drug. But as more people use Ozempic and other semaglutide prescriptions off-label for weight loss, the drawbacks are becoming clearer. And the truth is, Ozempic isn’t a long-term solution. It just doesn’t address the root causes behind your PCOS symptoms—and often leaves you with lingering side effects that outweigh the benefits.
That said, everyone’s journey looks different. If you’re on Ozempic and also making intentional lifestyle changes to support your health, I’m here to celebrate your progress with you! Still, it’s not just Ozempic’s side effects you need to keep in mind. This medication can also interact with others you may be taking—reducing their effectiveness, worsening side effects, or even putting your health at risk.
If you’re on levothyroxine—or your doctor is considering prescribing it—it’s important to understand how these two drugs might interact. Knowing the potential risks and drawbacks can help you make an informed decision about your symptom management plan.
Here’s what you need to know about levothyroxine and Ozempic for PCOS:
Can I Take Ozempic With Levothyroxine for PCOS?
In most cases, yes, you can take levothyroxine and Ozempic (semaglutide) for PCOS. However, there is evidence that these medications do interact with one another in certain individuals. Even though Ozempic is for improving insulin resistance and levothyroxine is for thyroid hormone management, they both can have a big impact on the digestive system. We’ll get into more details about this below!
That said, this combination should be used selectively. mainly when managing hypothyroidism alongside PCOS, Type 2 diabetes, or obesity. In these cases, Ozempic and levothyroxine together may be helpful for improving blood sugar control, supporting thyroid health, boosting metabolism, increasing energy, balancing hormones, and reducing your risk of thyroid cancer, type 2 diabetes, and other long-term complications.
Of course, always discuss everything with your doctor. They’ll have the best understanding of how these medications may work together for people managing PCOS and thyroid issues.
Important note: Never use Ozempic if you have a personal or family history of Multiple Endocrine Neoplasia Syndrome type 2 (MEN2). This rare genetic disorder significantly increases the risk of developing medullary thyroid cancer! In fact, studies have shown that semaglutide can raise the risk of thyroid tumors, especially in those with a family history of medullary thyroid cancer. If you’ve been diagnosed with either, steer clear of Ozempic.
What Is Levothyroxine Used for?
Levothyroxine is FDA-approved for treating hypothyroidism, which is when your thyroid gland fails to produce adequate thyroid hormones. The underactive thyroid causes a chain reaction of hormonal imbalances, leading to weight gain, fatigue, cold intolerance, dry skin, mood issues, and more. Levothyroxine works by replacing the missing thyroid hormones to restore balance.
This can be especially important for women with PCOS, since hypothyroidism is more common in Cysters. In fact, it’s one of the four types of PCOS! Research shows thyroid disorders show up almost twice as often in people with PCOS compared to everyone else. So, if you’re using Ozempic to improve insulin resistance while taking levothyroxine for thyroid hormone support, you may find success in relieving chronic symptoms. (Here’s more on PCOS and thyroid health.)
Beyond hypothyroidism, levothyroxine is also prescribed for other thyroid-related issues, including goiter, thyroid cancer, and certain thyroid conditions during pregnancy. Essentially, if your thyroid isn’t producing enough hormones, levothyroxine can step in to fill the gap and help relieve symptoms.
That said, it’s important to remember that this medication isn’t a cure—it only works as long as you take it. This is why it’s essential to make diet, exercise, and lifestyle changes to improve hypothyroidism and PCOS for good!
Does Ozempic Interact With Levothyroxine?
Ozempic has the potential to interfere with levothyroxine (and vice versa). One of the ways Ozempic works is by slowing down digestion, which helps food move more gradually through your system to support weight loss. While that can be helpful for blood sugar and appetite control, it also creates a challenge when paired with levothyroxine.
Levothyroxine needs to be absorbed at a specific point in your digestive tract to work properly. If Ozempic is slowing down gastric emptying, it can delay or reduce levothyroxine’s absorption. That means the thyroid medication is less effective!
Because of this, it’s important to have a clear treatment plan in place with your doctor if you’re prescribed both medications. Timing, dosage, and monitoring really matter here.
Here are some helpful resources for managing blood sugar levels and thyroid hormones:
How to Take Ozempic and Levothyroxine Together for PCOS
Step One: Take levothyroxine first thing in the morning.
Levothyroxine works best on an empty stomach. Taking it first thing in the morning helps your body absorb the hormone properly. At the same time, this ensures your thyroid levels stay consistent throughout the day.
Step Two: Don’t eat or drink for at least 30 minutes.
After taking Levothyroxine, wait at least 30-60 minutes before eating or drinking anything besides water. Food, coffee, or supplements like calcium and iron can interfere with absorption and reduce the medication’s effectiveness.
Step Three: Administer your Ozempic injections weekly at the same time each day.
Ozempic is taken once a week, so stick to the same day and time to keep your blood sugar steady. Just be sure it doesn’t overlap with your morning levothyroxine. Try scheduling your Ozempic shot in the afternoon or evening! Not only does this help with consistency, but it’s an easy way to make sure you’re pairing it with meals.
Step Four: Get thyroid labs done more frequently.
Since you are taking levothyroxine, regular thyroid blood tests (TSH, T4) help your doctor make sure your dose is correct. Labs may be needed more frequently when starting treatment or adjusting doses. I recommend Equilife’s Stress, Mood & Metabolism Test for regular bloodwork!
Step Five: Track your side effects and symptoms.
Keep track of any side effects you experience while taking Ozempic and levothyroxine. For Ozempic, watch for nausea, vomiting, or digestive changes. For levothyroxine, note symptoms of over- or under-treatment, like rapid heartbeat, jitteriness, fatigue, or extreme weight changes. Monitoring your response helps your doctor adjust doses safely.
Step Six: Work on your long-term solution.
Remember, neither Ozempic nor Levothyroxine provides permanent results. They only work while you’re taking them! Once you stop, thyroid and metabolic issues will come right back. That’s why I personally believe every prescription (when possible) should come with an “exit plan.” You can raise your insulin sensitivity, balance your hormones, and support your thyroid health naturally—without relying forever on meds or expensive therapies.
For more on long-term healing, read my full guide to natural PCOS symptom management. In addition to this, I recommend starting with these key lifestyle changes:
Ozempic and levothyroxine can be taken together for short-term relief.
For decades, our relationship with healthcare has been: “there’s a pill for that.” However, we’ve all seen that this approach rarely brings true relief. Ultimately, it just means trading one set of side effects for another, relying on synthetic fixes instead of addressing the root cause. The side effects of Ozempic and levothyroxine, especially when taken long-term, can far outweigh the benefits. You deserve long-lasting relief and real results!
Changing just a few things about your lifestyle can have a profound effect on your health. And these results? They’re permanent! Stick with these new healthy habits, and you can reverse symptoms of PCOS and hypothyroidism for good.
Ozempic is a pretty new drug, but it’s quickly become one of the most recognizable prescription medications out there. It was originally created to help regulate blood sugar in people with type 2 diabetes. However, once people began revealing its weight management benefits, Ozempic (semaglutide) was suddenly seen as a miracle drug.
Since women with polycystic ovary syndrome (PCOS) often struggle with insulin resistance—a form of blood sugar dysregulation—it’s got lots of Cysters wondering if Ozempic is right for them. And honestly, with symptoms like weight gain, intense cravings, fatigue, brain fog, dark patches of skin, fertility issues, and more? It’s not surprising that Cysters are looking for answers.
However, Ozempic isn’t the key to healing PCOS. It can mask symptoms, but it doesn’t address the root problem. When you stop taking it, those insulin resistance symptoms usually come right back. And, with that in mind, people begin asking, “But do you have to get off it?” I believe that all medications should have an exit plan, if possible. Beyond that, though, you won’t be able to take Ozempic during pregnancy, and it’s not recommended while breastfeeding either.
In this post, I’m going to go over the potential effects Ozempic could have on you and your baby if taken while breastfeeding. I’ll also cover other options that are safer, side-effect-free, and permanent.
Here’s what you need to know:
Can You Take Ozempic While Breastfeeding With PCOS?
No, most doctors won’t approve the use of Ozempic while breastfeeding. There’s very little research on the effects right now, so better safe than sorry! It’s also important to note that Ozempic actually isn’t FDA-approved for anything but type 2 diabetes. It’s not made or well-studied for PCOS either, which is another reason I don’t recommend as a permanent PCOS solution.
What is Ozempic?
Lately, maybe you’ve been asking: What is Ozempic? Ozempic is the brand name for the medication semaglutide, one of a few GLP-1 agonists. It works by mimicking a hormone called glucagon-like peptide-1 (GLP-1). Since it’s like a copy of this hormone, it’s considered a “GLP-1 receptor agonist.”
That’s nice and all, but now you’re probably asking: What does Ozempic actually do? It’s known for improving insulin sensitivity, reducing the amount of sugar your liver releases, and slowing stomach emptying. The results? Weight loss, reduced appetite, and sometimes improved fertility.
But, even if Ozempic helps you get pregnant, you can’t take the drug while pregnant, and it’s not recommended once the baby is born either. There’s concern that semaglutide could negatively impact breast milk quality and supply.
Here’s what medical professionals and researchers are worried about:
How Does Ozempic Affect Breastfeeding With PCOS?
May Disrupt the Infant’s Blood Sugar Levels
Some early studies have shown that Ozempic could enter breastmilk through the mother’s bloodstream. And since semaglutide is a protein, it wouldn’t break down until it reached the baby’s stomach. As a result, these trace amounts could theoretically then interfere with a baby’s blood sugar levels. The risk is even greater with premature infants, who generally have less effective immune systems than full-term babies.
Could Cause Digestive Issues in the Baby
Additionally, that protein may be hard to digest! Gastrointestinal issues like nausea, diarrhea, and constipation are already one of the main side effects of Ozempic in adults. So, if an infant were indirectly exposed through breast milk, there’s a chance they could experience similar issues.
Can Interfere With the Infant’s Nutrient Absorption
The semaglutide protein is designed to slow down metabolism—basically prolonging stomach emptying and digestion. This can delay the absorption of vitamins, minerals, and medications in your little one. It could also suppress their appetite, making it even harder for them to get the nutrients they need.
Side Effects May Lower Milk Production
Ozempic suppresses appetite, which can lead to lower calorie intake, slower nutrient absorption, and potential hormonal imbalances. If prolactin—the hormone that drives milk production—is affected and there isn’t enough food coming in, breastfeeding mothers could see a significant drop in milk supply if they continue taking Ozempic.
Ozempic and Breastfeeding With PCOS: What You Need to Know
It is not recommended when breastfeeding.
No medical professional recommends that breastfeeding women take Ozempic.
Some studies suggest it can pass through milk.
There’s limited research, but a few early studies show there’s a potential risk of drug transfer in breast milk. Even small amounts could be a risk to your baby, so it’s better to be safe than sorry!
There’s no significant safety data yet.
Though there’s no strong evidence that Ozempic is explicitly unsafe, there’s also no research proving it’s safe for breastfeeding mothers. To put it simply, there is currently no significant safety data for this demographic.
There are plenty of natural, breastfeeding-safe blood sugar management options.
Just because Ozempic is off the table doesn’t mean you can’t reduce your insulin resistance and find symptom relief. In fact, there are lots of ways to naturally and holistically get to the root of insulin resistance and support your body’s healing. In other words: real recovery, without the unwanted side effects. Most women with PCOS don’t need Ozempic or any other GLP-1 prescription!
Discuss all medications and supplements with your doctor when breastfeeding.
There are lots of safe medications and supplements you can take while breastfeeding. However, make sure you discuss your plans with a medical professional. Only take what the doctor prescribes!
Alternatives to Ozempic for PCOS While Breastfeeding
Have you heard of nature’s Ozempic? Berberine Advanced acts as a natural GLP-1 booster, helping your body release more of the hormone GLP-1. This hormone plays a key role in regulating blood sugar, improving insulin sensitivity, and controlling appetite, making it a powerful tool for managing PCOS naturally.
Beyond boosting GLP-1, Berberine Advanced delivers a range of powerful benefits. Its Berberine Phytosome™ formulation improves absorption, so your body can truly experience its effects—like reduced cravings, improved metabolism, and better hormonal balance. And, unlike Ozempic, it’s gentle on the digestive system, making it safe and effective for breastfeeding moms looking to manage PCOS without prescription drugs.
Do not take Ozempic while breastfeeding.
Ozempic is not my first recommendation for PCOS management, It’s just a bandaid! It doesn’t get to the root issue, and you have to stop while pregnant and breastfeeding. Which, ultimately, is often when women need the most support and consistency managing symptoms—espeically with healthy healing and sleep.
Instead of asking your doctor about Ozempic, ask him about Ovafit’s Berberine Advanced. It’s high-quality, NSF-certified, and specifically formulated with a PCOS body in mind. It’s the natural GLP-1 booster you need to reach your goals safely while breastfeeding.
You can get tons more PCOS healing strategies, resources, recipes, workouts, and handy tools on The Cysterhood app. Come join our community to find ways to live symptom-free with PCOS!
Most people know that polycystic ovary syndrome (PCOS) can affect your periods and fertility. But they don’t realize that its impact doesn’t stop once you conceive. It can follow you into pregnancy, increasing the risk of complications like gestational diabetes.
One of the main drivers behind a lot of PCOS symptoms is insulin resistance. It’s to blame for common struggles like fatigue, cravings, stubborn weight loss, brain fog, irregular cycles, hirsutism, fertility challenges, and more. If it goes unchecked, PCOS can even raise your risk for long-term health issues like heart disease and type 2 diabetes.
Since this condition already increases a Cyster’s risk of type 2 diabetes, it’s probably no surprise that women with PCOS are also more likely to develop gestational diabetes during pregnancy. I understand how this could cause anxiety in expecting Cysters out there, but don’t stress! There are ways to reduce your risk and have a healthy pregnancy.
To help you fully understand what’s happening, the risk factors, and how to manage those blood sugar levels, I’ve put together this guide to PCOS and Gestational Diabetes.
Here’s what you need to know:
PCOS & Gestational Diabetes: Understanding the Risk
Gestational diabetes often pops up in the second or third trimester, and it can impact both you and your baby. When blood sugar runs high during pregnancy, it can raise your chances of high blood pressure, preeclampsia, and other complications. It can also cause your baby to grow bigger than average, which can sometimes make delivery a challenge.
Even after your little one arrives, gestational diabetes can have lasting effects. For example, you may have a higher risk of developing type 2 diabetes later in life. At the same time, your baby could be more likely to experience low blood sugar and breathing issues at birth.
No one likes to talk about the potential of adverse pregnancy outcomes, making it a sensitive, anxiety-inducing topic. But knowing the details can help you take smart steps toward a healthier, happier pregnancy!
Are Women With PCOS More Likely to Have Gestational Diabetes?
Yes! Let’s first look at the basics. Gestational diabetes mellitus (GDM) is a type of diabetes that only develops during pregnancy. It happens when hormones that support your baby’s growth make your body less responsive to insulin. Basically, instead of glucose turning into energy in your cells, that sugar stays in your bloodstream and can get stored as fat.
Essentially, Cysters are already starting at a disadvantage. Since insulin resistance is already a challenge for most of us before pregnancy, this increases the risk of gestational diabetes. PCOS itself is considered an independent risk factor for GDM, regardless of age, family history, or BMI.
Previous studies have found that only 5% to 9% of women without PCOS develop gestational diabetes. Comparatively, between 14% and 28% of Cysters do develop it. In retrospect, this means that women with PCOS face a 56% to 460% higher risk of developing gestational diabetes. That’s a significantly increased risk.
How Does PCOS Cause Gestational Diabetes?
Insulin Resistance
As I mentioned, insulin resistance is the main thing to blame. It starts when a Cyster’s body struggles to process glucose. When your cells aren’t responding to insulin like they should, blood sugar levels rise, and your whole metabolic system becomes dysfunctional.
When you’re pregnant, the hormonal changes make your body even less responsive to insulin, potentially triggering gestational diabetes.
High Androgen Levels
Hormonal imbalance is another root issue of PCOS. One of the most common out-of-balance hormones is androgens (AKA male sex hormones). When androgen levels are high, it actually prompts your ovaries to produce more insulin. This, of course, boosts your chances of developing insulin resistance and gestational diabetes!
High androgen levels during pregnancy are a concern on their own, too. These irregular hormones can lead to difficulties with implantation, preterm birth, and issues with fetal development. That’s why it’s important for pregnant women with PCOS to be mindful of their androgen levels.
The last major root issue of PCOS is inflammation. Inflammation is your immune system’s way of fighting off illness or toxins in the body. Normally, it’s a temporary “emergency mode” that helps get your body back on track. But when inflammation becomes persistent, it can lead to chronic symptoms and a host of problems.
When your body is stuck in this survival mode, it can interfere with insulin signaling. Essentially, your body thinks something is wrong and responds by storing fat and energy for the future. This can lead to insulin resistance and significantly increase the incidence of GDM in women with PCOS.
How to Prevent Gestational Diabetes With PCOS
Be mindful of blood sugar balance before pregnancy, if possible.
As I’ve discussed, insulin resistance in women with PCOS often starts long before pregnancy. The sooner you recognize the symptoms and take action, the better your chances of improving your health now and setting yourself up for a complication-free pregnancy later. Once you are pregnant, your options for managing symptoms are more limited. Things like curbing cravings and staying active can become much harder or impractical.
If you’re not sure whether you’re dealing with insulin resistance, here are some of the common symptoms Cysters experience:
Fatigue or low energy
Difficulty losing weight or unexplained weight gain
Strong sugar or carb cravings
Brain fog or trouble concentrating
Irregular menstrual cycles
Excess facial or body hair (hirsutism)
Skin changes, like dark patches (acanthosis nigricans)
High blood pressure or cholesterol issues
Increased thirst or frequent urination
Sound familiar? If so, you probably have insulin-resistant PCOS. Below, we’ll get into exactly how to naturally manage blood sugar levels with PCOS.
Eat a gluten- and dairy-free anti-inflammatory diet.
The thing that has the biggest impact on your insulin sensitivity is the food you eat. Eating a lot of processed, sugary foods can make your body less responsive to insulin over time. So, if you’re a Cyster who already struggles with insulin resistance, a balanced and intentional diet can make all the difference.
Changing eating habits can be hard, but as a PCOS dietitian, I don’t advocate for highly restrictive diets or even super low-carb diets. They put so much stress on you and your body, and the outcome? More frustrating symptoms. Stress can actually increase insulin resistance, meaning a strict diet can backfire and worsen exactly what you’re trying to heal.
So, what should you do? Here are the core components of a PCOS-friendly diet:
Avoid inflammatory foods:
Remember, inflammation is not a friend to insulin sensitivity. So, cutting out inflammatory foods can help you keep chronic inflammation in check. Sugary snacks, refined carbs (like white bread, white rice, pastries, etc.), fried foods, prepackaged snacks, and processed meats are all good to cut out. I also recommend Cysters try cutting out gluten and dairy, since it’s a common trigger for women with PCOS.
Fiber and healthy fats help balance blood sugar and improve insulin sensitivity in PCOS. Fiber slows sugar absorption, while healthy fats reduce inflammation and support stable energy. As a result, both of these nutrients make it easier for your body to manage insulin.
Some high-fiber foods include broccoli, spinach, Brussels sprouts, berries, apples, lentils, chickpeas, oats, and quinoa. For healthy fats, aim for avocado, nuts, chia seeds, and fatty fish. Plenty of tasty ingredients to add to your daily meals.
This Mongolian beef recipe that I recently posted about is a great example of a PCOS-friendly meal. You can find plenty more like this both on the blog and in The Cysterhood app!
Up your protein intake:
Protein is a great way to keep blood sugar balanced with PCOS. It slows sugar absorption, helps you feel full longer, and curbs cravings. Including protein in every meal supports steady energy and healthier insulin levels.
Aiming for about 30 grams of protein per meal is a good rule of thumb, especially for breakfast. For a more precise daily target, multiply your body weight by 1–1.2 to get the total grams of protein you should eat each day.
You can get protein from lean meats like chicken, turkey, fatty fish (salmon, mackerel, sardines), and eggs. Plant-based options like lentils, chickpeas, black beans, quinoa, nuts, and seeds also work well. Additionally, you reach your daily goal with high-quality protein powders, too! It can be as simple as adding a few scoops to smoothies, yogurt, oatmeal, or muffins.
If you’re trying to get pregnant, alcohol is already off the table, so no worries there. (It’s not ideal for a PCOS diet either, since it spikes carbs and strains the liver.) But you’re also advised to limit your caffeine intake. Too much caffeine has been linked to lower birth weight, preterm birth, and, yes, high blood sugar.
Even when you’re not pregnant, caffeine raises stress hormone levels, keeping your body in that “emergency mode” I mentioned earlier. When your body feels anxious and wired, it floods your bloodstream with sugar and stores it as fat. Which, as you probably guessed, worsens insulin resistance. During pregnancy, hormone changes make caffeine’s effects even stronger.
The general guideline is to keep caffeine under 200 mg per day. Personally, I recommend going as low as possible to support insulin sensitivity. You’ll likely notice that with less caffeine and more water or other healthy alternatives, you actually feel more energized and focused.
Remember when I explained how high androgen levels can lead to insulin resistance? Luckily, herbal teas can help lower testosterone and balance other hormones. I recommend considering a switch from your usual morning pick-me-up, whether that’s a caffeinated tea or sugary soda, to herbal teas. There are plenty of ways to dress them up to suit your taste, and the hormone-balancing benefits are undeniable.
When you start looking for the best herbal teas for PCOS, the options can feel overwhelming. A strategic tea blend, however, can be just what you need to support insulin sensitivity. Try my Testosterone Relief Tea, an organic blend of research-backed herbs like spearmint, lemon balm, orange peel, chamomile, rosehip, peppermint, cinnamon, nettle, lavender, and calendula. These ingredients have been shown to help balance androgens and provide relief from PCOS symptoms. With this, you know you’re drinking something made specifically for Cysters.
Consider your carb tolerance:
I don’t like low-carb diets because our bodies need carbohydrates. They’re not all bad! Plus, eating too few carbs can increase stress hormones and worsen insulin resistance. And actually, you don’t even have to cut carbs as much as possible—it’s not a one-size-fits-all kind of thing. Instead, it’s better to figure out your carb tolerance. That way, you know how many carbs your body can handle to fuel energy without spiking blood sugar or triggering unwanted symptoms.
Here’s how to find your carb tolerance:
Start with around 15–30 grams of carbs per meal: That’s roughly ½ cup of cooked rice or quinoa, 1 slice of whole-grain bread, or ½ cup of oatmeal.
Pair with protein or fat: Examples include eggs, Greek yogurt, nuts, or avocado. This helps slow digestion and prevent blood sugar spikes.
Observe how you feel: Are you energized or crashing afterward? Optional: measure your blood sugar 1-2 hours after eating if you want more precise data.
Adjust gradually: Increase or decrease carb portions based on your energy, cravings, and blood sugar response.
Eat 3-4 meals a day:
When you’re trying to improve insulin resistance, eating only 3-4 meals per day helps keep insulin levels from staying persistently high. Every time you eat, your body releases insulin to move glucose into your cells. This means that grazing all day can actually make insulin resistance worse. On the other hand, spacing meals gives your body a chance to reset and respond better to insulin.
Fewer meals also give your body time to burn stored glucose and fat for energy. This can reduce cravings, lower inflammation, and improve hormonal balance, which are all important for increasing insulin sensitivity! If you’re wondering, intermittent fasting can be useful for PCOS, too.
Find reliable resources for managing your diet:
Finding PCOS-friendly dishes, meal planning, tracking protein, and measuring carbs can feel overwhelming—especially if you’re pregnant! Luckily, The Cysterhood app handles all of it for you. It offers hundreds of delicious PCOS-friendly meals, a meal plan builder, and helpful trackers to keep you on course.
Don’t believe there are tasty meals that actually fall in line with a gluten- and dairy-free anti-inflammatory diet? Here are some recipes you’ll find on the app:
Chicken Pot Pie
Chili Mac and Cheese
Chicken Alfredo
Pork & Bacon Meatballs
BBQ Chicken Pizza
Fish Taco Bowls
Ferrero Rocher Protein Smoothie
Chocolate Waffles
Hot Chocolate Cookies
Funfetti Cookies
Hibiscus Blackberry Virgin Margaritas
Strawberry Basil Slushie
Does that sound restrictive? Not at all. These meals are nutrient-dense, balanced, and delicious. Whether you’re trying to conceive or managing pregnancy cravings, The Cysterhood has something to satisfy your taste buds while supporting your healing journey.
Get moving every day with gentle, slow-weighted workouts.
Exercise isn’t just about weight loss or muscle building (though those are important for pregnancy, too). It’s more about improving insulin sensitivity and balancing hormones—both of which exercise helps with. Aim for at least 30 minutes a day of gentle, slow-weighted workouts. These exercises focus on lifting weights slowly, through controlled movements and longer muscle engagement. As a result, this maximizes muscle activation and helps your body use more glucose.
Unlike high-intensity or fast-paced workouts that can spike stress hormones like cortisol, slow-weighted training is gentler on the adrenal system. This matters for PCOS, since chronic stress hormone elevation can worsen insulin resistance and androgen imbalances. Plus, slow-strength training increases lean muscle mass, naturally boosting metabolism and supporting long-term blood sugar control.
Starting these exercises now also means your doctor is more likely to clear you to continue them throughout your pregnancy. You can find slow-weighted workout routines tailored for PCOS on The Cysterhood app!
Manage your stress levels with self-care.
As I’ve mentioned throughout this post, stress is harmful to your metabolism and hormone balance. Keeping cortisol levels in check is essential if you want to improve insulin sensitivity and manage PCOS symptoms. Beyond that, chronic stress can impact fetal development and birth outcomes. So, the earlier you can develop good stress management techniques, the better.
Here are some ways you can reduce stress with PCOS:
Gentle movement: Slow-weighted workouts, walking, swimming, or yoga
Mindfulness practices: Meditation, acupuncture, deep breathing, or journaling
Social support: Connect with friends, family, or PCOS communities
Relaxation rituals: Warm baths, calming music, or reading
Set boundaries: Limit exposure to unnecessary stressors when possible
Prioritize 7-9 hours of great-quality sleep.
Sleep is a powerful tool for managing insulin resistance and reducing the risk of gestational diabetes. Poor or insufficient sleep can increase cortisol levels, worsen insulin sensitivity, and disrupt hormone balance, making it harder for your body to regulate blood sugar.
By aiming for 7-9 hours of restorative sleep each night, you give your body the chance to recover, stabilize glucose levels, and balance hormones. I know this probably sounds easier said than done, since Cysters are way more likely to experience sleep disturbance than women without PCOS. To help you get optimal rest, here’s how to sleep better with PCOS.
Talk to your doctor about insulin-sensitizing supplements.
Supplements are a great way to fill nutritional gaps and address common PCOS deficiencies. Many of these vitamins and minerals are essential for supporting insulin sensitivity, hormone balance, and overall metabolic health, so don’t skip them! Also, make sure to choose high-quality, NSF-certified, PCOS-friendly options like the ones offered by Ovafit.
Here are some of the best supplements for managing insulin resistance and lowering your risk of gestational diabetes:
Inositol Complete: Combines myo-inositol and D-chiro-inositol in a 40:1 ratio to improve insulin signaling, regulate menstrual cycles, and support ovarian health.
Berberine Advanced: Natural GLP-1 booster that enhances insulin sensitivity and supports healthy blood sugar levels
Omega-3 Fatty Acids: Reduce inflammation and support healthy insulin-producing cell function, aiding blood sugar control.
Prenatals: Prenatal vitamins can provide essential nutrients like chromium and vitamin D, which support insulin action, secretion, and sensitivity. These nutrients, along with folate, iron, and iodine, help support fertility, hormone balance, and healthy fetal development.
Before starting new supplements, make sure to talk with your doctor to make sure they’re the right fit for you.
Consider continuous glucose monitoring.
Continuous glucose monitoring, or CGM, can be a total game-changer for seeing how your body reacts to food, exercise, and even stress. It lets you track your blood sugar in real time, spot any spikes, and make small tweaks to your meals and daily routine.
If you have PCOS or are at risk for gestational diabetes, CGM gives you practical insights to help keep your blood sugar steady and avoid potential complications. Is regular finger-pricking a pain? Yes, but it may be worthwhile if you want to really understand your progress managing insulin sensitivity.
PCOS means you’re more likely to have gestational diabetes, but you can naturally reduce your risk for a healthier pregnancy.
Having PCOS doesn’t have to mean a stressful pregnancy. With the right tools, like mindful eating, gentle movement, good sleep, and a little self-care—you can support your body, your baby, and your peace of mind.
Every small step you take adds up, helping you feel empowered, confident, and in control. Remember: you’re not just managing PCOS. You’re creating the healthiest, happiest start possible for you and your little one. You’ve got this!
If you’re looking for more resources, head over to the blog to find posts like:
Living with the symptoms of polycystic ovary syndrome (PCOS) isn’t easy. The daily struggles can feel overwhelming, and it’s totally normal to have moments where you feel defeated. You’re willing to research—maybe even try—just about anything to feel like yourself again. So, I’m sure you’ve all thought about Ozempic or metformin for PCOS—or maybe you’ve even thought about both.
Truthfully, you don’t need either prescription to heal your PCOS symptoms. Neither provides permanent results, and both come with unpleasant symptoms. This is why I recommend intentional lifestyle changes like adopting a PCOS-friendly diet and doing slow-weighted workouts, instead! These strategies can offer real healing and long-term relief from your symptoms.
However, if you’re wondering about these two popular medications, let’s talk about them. Since both lower insulin resistance, is it safe to take them together? Here’s what you need to know:
Can You Take Ozempic and Metformin Together for PCOS?
In this post, I’ll break down what metformin and Ozempic are, how they seem to help with PCOS, and whether it’s safe to take them together. All this information is super important to understand if you’re considering the medication route for symptom management.
What’s the Difference Between Metformin and Ozempic for PCOS?
Metformin and Ozempic can both help manage PCOS symptoms, but they work in different ways.
Metformin mainly helps reduce the amount of sugar your liver produces, which can lead to more stable blood sugar and insulin levels over time. It also helps your body become more sensitive to insulin, especially in the muscles. This can improve PCOS symptoms like irregular periods, weight gain, acne, hirsutism, hair thinning, and infertility.
Ozempic, on the other hand, works by mimicking a natural hormone called GLP-1. It helps your body release insulin, slows down digestion, and curbs your appetite. These changes are intended to support weight management and reduce type 2 diabetes symptoms.
So while metformin focuses mostly on improving insulin sensitivity to improve PCOS-specific symptoms, Ozempic only offers metabolic support focused on weight loss, diabetes-specific side effects, and long-term complications.
What Is Ozempic & How Does Ozempic Work for PCOS?
Ozempic is part of a class of medications called glucagon-like peptide-1 receptor agonists. These medications mimic GLP-1, a natural hormone in the body that helps regulate metabolism. The main ingredient of this GLP-1 receptor agonist is semaglutide, which was developed and approved by the Food and Drug Administration to help manage type 2 diabetes.
However, quickly after it came out, people saw its potential benefits for other things, too. In this case, we’re looking at improved systems and weight loss in people with PCOS. Because insulin resistance is one of the main drivers behind many PCOS symptoms like weight gain and fatigue, Ozempic can feel like a promising option. It helps support your metabolism and can make your body more sensitive to insulin. As long as you’re taking your weekly injections, that is.
What Is Metformin & How Does Metformin Work for PCOS?
Metformin, like Ozempic, is a medication originally designed for people with type 2 diabetes to stabilize blood glucose levels. However, it’s one of the main prescriptions used for PCOS symptom management. Specifically, it helps with irregular periods, acne, weight gain, and infertility. It does all this by increasing insulin sensitivity.
However, metformin doesn’t reduce insulin resistance in the same way Ozempic does. Unlike Ozempic, which mimics the GLP-1 hormone, metformin works by activating an enzyme called AMPK—an important metabolic regulator. This is like your metabolism’s on-and-off switch. So, when switched on, AMPK reduces glucose production in the liver and helps your cells become more responsive to insulin.
Just like Ozempic, metformin only works when you’re taking it. It doesn’t change anything permanently in your body to improve insulin sensitivity. That means once you get off metformin, you’ll likely see symptoms return if you haven’t made the necessary lifestyle changes. Here’s more on my thoughts on metformin for PCOS.
What Happens if You Take Metformin and Ozempic Together for PCOS?
You can take Ozempic and metformin together for PCOS, but you’ll need a healthcare provider with a good understanding of both drugs. A doctor will help determine the right dosage for each medication to make sure they work well together. While they can reduce insulin resistance, they can also lower your blood sugar or insulin levels too much. This is especially true if you’re not on the correct dosage or schedule.
The Good: Improve Insulin Resistance
Since Ozempic and metformin have different methods of improving insulin sensitivity, they can accelerate symptom relief and weight loss in people with PCOS. The GLP-1 and AMPK action combined helps reverse stubborn weight gain, reduce cravings, boost energy, and regulate menstrual cycles.
The Good: Balances Hormones
High insulin and blood sugar levels can signal the ovaries to produce more testosterone. High testosterone levels then disrupt ovulation, which throws off the rest of the cycle. When you don’t go through the other phase of your cycle correctly, estrogen and progesterone get off balance as well.
Therefore, significant improvements in insulin sensitivity can indirectly balance hormones as well. This can relieve symptoms like acne, hirsutism, hair loss, irregular periods, infertility, and mood swings.
The Good: Better Cholesterol Levels
When you reduce insulin resistance, you also lower your body’s need for cholesterol—and that’s exactly how Ozempic and metformin can work together to support heart health. Metformin helps your liver process sugar and fat more efficiently, which can bring down LDL cholesterol and triglycerides.
Ozempic supports weight loss, curbs cravings, and improves your body’s insulin response, all of which take pressure off your metabolism. When used together, they help lower excess insulin, which is a major driver of high cholesterol. So, taking metformin and Ozempic can help balance lipid levels and reduce the risk of heart complications associated with PCOS.
The Bad: GI Symptoms
One of the big problems with prescription solutions to symptom management is the long list of potential side effects. Basically, it can feel like trading one set of symptoms for another. Especially when you learn that gastrointestinal side effects like bloating, gas, nausea, and diarrhea are all common side effects of Ozempic and metformin. So, when taken together, it can amplify side effects and cause some pretty significant GI discomfort.
The Bad: Low Blood Sugar
Since both Ozempic and metformin lower blood sugar, if the dosing isn’t right (or you’re taking insulin-sensitizing supplements as well), the combination of medications can cause hypoglycemia. This is when your blood sugar drops too low, potentially causing fatigue, dizziness, shakiness, or even fainting.
People taking metformin are often warned about the risk of vitamin B12 deficiency because the medication can interfere with how your body absorbs B12 in the gut. Women with PCOS are usually encouraged to eat more B12-rich foods to help prevent this. However, since Ozempic can reduce your appetite, it might make it harder to get enough B12 from food alone. This, naturally, could worsen an already-present deficiency. If you’re low in B12, you may experience symptoms like fatigue, brain fog, irritability, mood swings, muscle weakness, and more.
The Bad: High Medication Costs
Both metformin and Ozempic are only FDA-approved to treat type 2 diabetes. Insurance often doesn’t like to cover meds that are being used off-label. So, using metformin or Ozempic for PCOS can be really expensive. Metformin is generally $10-$30 a month, but Ozempic injections are closer to $800-$1,500 a month without insurance.
How Do You Take Metformin and Ozempic Together for PCOS Effectively?
If you’re going to take medications like Ozempic and metformin, it’s important to do so with your long-term goals in mind. Here’s how to take metformin and Ozempic together:
Double-check that the medications are right for you.
Ozempic and metformin can be dangerous for people with certain medical issues or pre-existing conditions. So, make sure your doctor is fully informed about your current health and family history.
Don’t take metformin and Ozempic together if you:
Have a personal or family history of Multiple Endocrine Neoplasia Syndrome Type 2 (MEN2) or Medullary Thyroid Carcinoma (MTC)
Have Type 1 Diabetes
Have Severe Kidney or Liver Disease
Are Pregnant or Breastfeeding
Struggle with GI Issues
Find the right starting doses with your doctor.
A doctor will start you low and slow on your medications to see how your body reacts. Generally, that means 500 mg of metformin once or twice a day, and 0.25 mg of Ozempic once a week.
Take metformin with food.
To reduce the risk of GI symptoms, it’s important to take metformin with a meal. This is especially true with immediate-release metformin, when food can slow down the absorption rate.
Inject Ozempic once a week at the same time.
You don’t need to take Ozempic with a meal, but you should still stay on a schedule. Do your injections once a week at the same time for the best results.
At the end of the day, every medication should have an exit plan. I don’t recommend Ozempic or metformin for PCOS, because natural lifestyle changes can be more effective, offer permanent results, give you comprehensive symptom relief, and are totally side-effect free. However, even if you choose to take these medications, make positive lifestyle changes while on it. These lifestyle changes, ultimately, can reduce your body’s need for blood sugar support.
Try a gluten- and dairy-free anti-inflammatory diet
Cut back on alcohol and caffeine
Drink Testosterone Relief Tea
Stay hydrated
Take high-quality, PCOS-friendly supplements from Ovafit
Use probiotics
Do regular, slow-weighted workouts
Get better sleep
Reduce stress levels
Avoid endocrine disruptors
Consider acupuncture
You can find lasting relief and heal your PCOS naturally—without Ozempic or metformin!
Sometimes medications can seem like the only way forward when you’re dealing with conditions like PCOS. However, there are lots of natural ways to get to the root of your symptoms and support long-term healing. By reversing insulin resistance, balancing hormones, and reducing inflammation, you can find real relief without the side effects, risks, or high costs associated with medications like metformin and Ozempic.
Not sure where to start? Download The Cysterhood app. You’ll get access to PCOS-friendly recipes, targeted workouts, helpful resources, symptom-tracking tools, and a whole community of supportive Cysters who get exactly what you’re going through. We can’t wait to have you!
And, if weight loss specifically is your goal, check out these posts:
