PCOS Awareness Month: Are We Really Supporting Women?

In light of PCOS Awareness Month, I always find myself reflecting on the progress being made. Are we moving closer to providing women with the support that they deserve—or further away? Honestly, I believe there’s still such a long way to go.

In clinic, I often see GP letters confirming a diagnosis of PCOS. What usually follows is the number one recommendation: a prescription for a oral contraceptive pill. A class of drugs that shuts down communication between the brain and ovaries, effectively stopping ovulation altogether.

This is the same recommendation that was given to me 15 years ago when I was first diagnosed with PCOS. And it shows just how little has changed in all that time.

Here’s the irony: PCOS is the most common cause of anovulation (meaning–no ovulation), accounting for nearly 30% of female infertility cases. Many women with PCOS have long, irregular cycles and struggle to ovulate. If a woman is diagnosed with PCOS while trying to conceive, she wouldn’t be prescribed the pill—because no ovulation means no egg released, and no egg means no chance of pregnancy. Instead, she’d likely be prescribed a fertility drug that stimulates ovulation.

So why is shutting down ovulation the very process for most women? To me, this is a failure to women when prescribed alone and is a serious ethical issue.

Women are often told, “Here’s the pill—it will regulate your periods” making it sound like it fixes everything. In reality, it shuts down one of the body’s most important systems: ovulation. Many women are prescribed this without the full understanding of the consequences. Later, when they come off the pill to try for children, they are often met with even more struggles—irregular cycles, poor ovulation, and fertility challenges that could have been mitigated with earlier, more thoughtful care. Along with many other possible side effects.

I’ll never forget the line from my own gynaecologist’s letter to my GP after my diagnosis at 15: “I have recommended Ginet (OCP) to regulate her cycle.”

Let me be very clear here, because this is a common misconception: the pill does not regulate your cycle. It causes a withdrawal bleed from the synthetic hormones, which may reduce endometrial thickening, but it does not address the root cause.

A true menstrual cycle only happens after ovulation. When an egg is released, the endometrial lining thickens, and if fertilisation doesn’t occur, that lining is shed. The “bleed” you get on the pill isn’t a real period—it’s simply a withdrawal bleed when you stop taking the active pills that contain the drug. While it may reduce the risk of endometrial thickening (and therefore endometrial cancer), it doesn’t regulate, cure, or restore natural ovulation. It simply suppresses what’s happening underneath and many women find more issues can arise. Symptoms return once the pill is stopped, and it doesn’t treat insulin resistance, weight gain, or prevent type 2 diabetes.

Metformin—a medication originally developed for diabetes—is sometimes prescribed for PCOS to improve insulin sensitivity and support weight management. While it can help some women, it’s not a complete solution. Many patients I see struggle with the digestive side effects, including bloating and diarrhoea, and are often looking for gentler alternatives.

For women trying to conceive, specialists may suggest ovulation induction medications such as clomiphene (Clomid) or letrozole. These drugs can stimulate ovulation, but they don’t work for everyone with PCOS, and some women experience side effects that make them unsuitable.

This is where naturopathy can play a key role. Diet and lifestyle support are fundamental: personalised guidance can help women eat in a realistic, sustainable way tailored to their lifestyle and preferences. Naturopaths coach on achievable changes, provide accountability, and support long-term success. This approach often leads to improved weight management, insulin sensitivity, hormone regulation, and overall wellbeing.

In addition, targeted practitioner-level nutritional and herbal medicines can further support hormone balance. Research now shows that alternatives like berberine and inositol can be as effective as metformin in improving insulin sensitivity and promoting ovulation:

• Berberine has been shown to improve insulin resistance, reduce androgen levels, and support weight management, with some studies suggesting it may outperform metformin in certain metabolic outcomes.

• Inositol (especially the myo-inositol + D-chiro-inositol 40:1 combination) can improve insulin sensitivity, restore ovulation, and support fertility, often with fewer side effects than metformin.

These naturopathic options can help break the hormonal patterns women with PCOS are often stuck in, supporting ovulation, reducing excess hair growth and acne, and improving fertility outcomes—helping women regain control over their health in a natural, sustainable way.

It’s also important to note that PCOS can sometimes be confused with hypothalamic amenorrhoea (HA). In HA, periods may stop due to under-eating or over-exercising and can present with mild acne, excess hair growth, and polycystic ovaries on ultrasound. Misdiagnosis is common, and treatment differs significantly. A key difference is the LH:FSH ratio: in PCOS, luteinising hormone (LH) can be 2–3 times higher than follicle-stimulating hormone (FSH), while in HA, LH is often much lower than FSH.

Let me leave you with this – Ovulation isn’t just about fertility, it’s crucial for mental health, hormone balance, and the overall health and wellbeing of a woman. Women with PCOS are eight times more likely to experience depression, and some studies show that certain oral contraceptives may increase that risk further. Supporting natural ovulation through diet, lifestyle, and targeted therapies can improve long-term health outcomes.

I believe the treatment offered to women with PCOS today is still far below the standard they deserve. We need to do better. That means:

• Supporting women to restore ovulation rather than shutting it down and ensuring they understand the medication offered and how it will impact them later in life.

• Educating girls on how their cycles actually work much earlier on—not scaring them into thinking they can get pregnant every single day of the month.

• Teaching women how to identify ovulation signs and understand their bodies so that they can have full bodily attonomy and feel empowered in their decisions.

• Providing care that supports and improves their health markers, rather than suppresses and temporally makes everything look fine on the outside.

• Addressing root causes such as insulin resistance, inflammation, stress, and nutritional deficiencies.

The number of women I see who were put on the pill for PCOS—only to come off it years later and face fertility struggles—is heartbreaking. It highlights the lack of care, awareness, and education in this area still ongoing today.

This PCOS Awareness Month in 2025, let’s move toward real solutions from a whole body perspective. Ones that support women’s autonomy, restore their cycles, and prioritise their long-term health. Women deserve this.

If you’re unsure whether you have PCOS or are struggling to conceive, please get in touch for a free discovery call to chat about how I can support you.

Em x