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Let's Talk About PCOS - Symptoms, Testing + Treatments
PCOS affects 1 in 10 women yet often goes undiagnosed. Learn the symptoms, how it's diagnosed and natural ways to balance hormones, fertility and skin.
Written and medically reviewed by Dr. Courtney Ranieri, ND, a licensed naturopathic doctor registered with the College of Naturopaths of Ontario (Reg. #3726). Last reviewed July 2026.
It's estimated that Polycystic Ovarian Syndrome (PCOS) impacts 1 in 10 women, yet less than 50% are properly diagnosed, delaying treatment. PCOS is complex and multifaceted, but there's a lot we can do to help manage symptoms like infertility, acne, hair loss, insulin dysregulation and weight gain.
What causes PCOS?
The exact cause is unknown, but it involves a combination of genetics, environment, diet and hormones. PCOS is often thought of as secondary to obesity, however women at a normal weight can also have it. We believe high insulin levels and insulin resistance are at the root: high insulin causes the ovary to release more testosterone, preventing normal ovulation (which can lead to infertility) and causing acne, male-pattern baldness and increased hair growth.
Symptoms of PCOS
- irregular or absent cycles (usually longer than 35 days or shorter than 21 days apart)
- acne on the face, body, jawline or neck
- increased hair growth on the body or face
- weight gain or difficulty losing weight
- difficulty becoming pregnant
- thinning hair on the head
- oily skin
- ovarian cysts
How is it diagnosed?
Despite the name, you don't actually have to have polycystic ovaries to have PCOS; it's only 1 of 3 criteria. The 3 Rotterdam Criteria are: irregular or anovulatory cycles; hyper-androgenism (clinical signs like acne and hair growth, or biochemical, like high testosterone and DHEAs); and polycystic ovaries on ultrasound. You must have 2 of the 3 to be diagnosed. I usually run further testing to understand the type of PCOS each woman is experiencing.
PCOS and fertility
PCOS is one of the most common causes of infertility, because irregular cycles may mean you're not ovulating. The good news is we can work to regulate your cycle and improve your chances.
Natural Treatments
There's no 'cure' for PCOS, but specific nutrition, supplements and lifestyle changes can regulate cycles, improve fertility and manage symptoms. As a Naturopathic Doctor, treatments are tailored to each patient:
- Nutrition: a PCOS-specific diet to help manage blood sugar, insulin, hormones and inflammation.
- Regulate hormones: to help regulate the cycle and manage high testosterone, insulin and skin symptoms.
- Comprehensive lab testing: which can include Estrogen, LH:FSH ratio, Progesterone, Insulin and/or HbA1C, TSH, free testosterone, DHEAS, Cortisol and AMH.
- Botanicals and supplements: Vitamin D, magnesium, chromium, vitex, fish oils, N-acetyl cysteine, berberine and inositol have all been shown to help.
- Optimizing a healthy hormone lifestyle: sleep, energy, mood, exercise and acupuncture.
Book your hormone discovery appointment now.
If you are interested in optimizing your hormonal health, fertility or looking for support with PCOS, I provide virtual naturopathic care across Ontario and would love to help you reach your health goals.
About the author
Dr. Courtney Ranieri, ND is a board-licensed naturopathic doctor and the founder of Somewhere Health. She earned her Doctor of Naturopathic Medicine at the Canadian College of Naturopathic Medicine in Toronto and holds an Honours Bachelor of Science from the University of Western Ontario. Her clinical focus spans hormonal health, fertility, digestion, and women's health, with advanced training in pelvic floor therapy and integrative fertility care.
