⚕️ This article is for informational purposes only and does not substitute for medical consultation. Always consult your gynecologist with any questions.

Last reviewed: June 2026 · 10 min read

Polycystic Ovaries: What They Are, How They Affect Your Menstruation, and What You Can Do

The period that arrives every 45 days, or every three months, or that simply disappears for weeks without warning. The acne that has no explanation at 28 years old. The blood test that confirms what you already suspected: polycystic ovaries, or Polycystic Ovary Syndrome (PCOS). The diagnosis finally arrives, but the questions about menstruation, fertility, and how to manage all this daily do not disappear with it.

In this guide, you will find out exactly what polycystic ovaries are, how they affect your cycle and fertility, and what real options you have to live better with this syndrome. No unnecessary technicalities, with verified information and the perspective of thousands of people who have already gone through this.

What are Polycystic Ovaries? Clear Definition

If you have just received the diagnosis, the first thing you feel is that you need someone to explain it to you properly, not with the doctor's note that you don't fully understand. Let's get into it.

Definition and Characteristics of PCOS

The Polycystic Ovary Syndrome (PCOS) is the most common hormonal disorder in individuals with ovaries of reproductive age. It affects between 8% and 13% of the global female population, according to the World Health Organization, making it one of the most common causes of menstrual irregularities and difficulty conceiving.

Despite its name, PCOS does not necessarily mean you have cysts on your ovaries. The "cysts" that appear on the ultrasound are actually immature follicles that have not released an egg — in other words, ovulation has not occurred. Understanding this is important because it completely changes the mental image you have of the problem.

To diagnose PCOS, the so-called Rotterdam criteria are used: at least two of the following three criteria are needed:

• Irregularities in the menstrual cycle (very spaced or absent periods)
• Excess androgens (male hormones), either in blood tests or with visible symptoms such as acne or excessive hair
• Polycystic-appearing ovaries on ultrasound

Who does PCOS affect?

PCOS can appear at any time from the first period until menopause. However, it is most frequently diagnosed between the ages of 20 and 30, often when the individual starts trying to get pregnant or when their cycle draws attention due to its irregularity.

There is also a significant genetic basis: if your mother or sister has PCOS, your chances of having it are significantly higher. Chronic stress and premenstrual emotional imbalances may also be related to the intensity of symptoms, although they are not the direct cause of the syndrome.

How PCOS Affects the Menstrual Cycle: The Real Mechanism

When your period arrives whenever it wants, or doesn't arrive at all, your mind tends to seek a simple explanation. With PCOS, the explanation lies in a hormonal imbalance that affects the entire axis regulating your cycle.

In a normal cycle, FSH (follicle-stimulating hormone) causes the ovarian follicles to mature, one of which releases an egg, and if there is no fertilization, menstruation occurs. In PCOS, this process is interrupted:

1. The ovaries produce too many androgens (testosterone, among others)
2. This excess prevents the follicles from maturing properly
3. Ovulation does not occur or is irregular (anovulation or oligovulation)
4. Without ovulation, the endometrium continues to thicken without shedding, leading to irregular, very light, or absent periods for months

There is another factor that exacerbates all of this: insulin resistance, which appears in a significant portion of individuals with PCOS. When cells do not respond well to insulin, the pancreas produces more, and this excess insulin further stimulates androgen production in the ovaries. It is a self-reinforcing cycle.

And what does this have to do with bloating during your period or with the pain being worse than usual? When menstruation finally arrives after a long absence, the endometrium is thicker than normal, which can result in heavier, longer, and more painful periods.

Symptoms and signs: when to suspect you have PCOS

PCOS does not have a single face. Some people discover it by chance during an ultrasound, while others have been experiencing symptoms for years without knowing they were related. Here are the most common signs:

PCOS and fertility: everything you need to know

This is the part that causes the most fear when you receive the diagnosis. The good news is that having PCOS does not mean you won't be able to get pregnant. The reality is more nuanced, and more hopeful, than what the initial diagnosis sometimes suggests.

Does PCOS affect fertility?

PCOS is the most common cause of ovulatory infertility: approximately 70-80% of people with PCOS who have difficulty conceiving have this syndrome as the main factor. However, it is important to differentiate between difficulty getting pregnant naturally and inability.

The main issue is irregular or absent ovulation. If there is no egg released, there can be no fertilization. But with the right treatment, many people with PCOS are able to ovulate and conceive without the need for assisted reproductive techniques.

What if I don't want to get pregnant right now?

If you are not trying to conceive, managing PCOS focuses on regulating the cycle (usually with hormonal contraceptives), controlling symptoms from excess androgens, and reducing the risk of long-term complications like endometrial hyperplasia, which can occur when there are very long periods without menstruation.

How to manage PCOS in daily life

Having a diagnosis is the first step, but what matters is what you do with it. At PapayaCup, we have been supporting people with all types of menstruation for years, and PCOS frequently comes up in the inquiries we receive. Here’s what really works.

Before you start: what you need to be clear about

PCOS has no cure, but it can be managed. This means that the goal is not to eliminate it, but to reduce its impact on your daily life and long-term health. Each person responds differently, so what works for your friend may not be optimal for you.

The most important thing before making any changes is to have a good diagnosis: complete hormonal analysis (FSH, LH, testosterone, SHBG, fasting insulin, glucose), transvaginal ultrasound, and if there are symptoms of insulin resistance, a glucose tolerance test. With that foundation, your gynecologist can personalize the treatment.

Step by step: what you can do today

• Track your cycle. Use an app or a notebook to note when your period starts, how long it lasts, what the flow is like, and how you feel. That information is gold for your doctor and for you.
• Anti-inflammatory diet. Reducing ultra-processed foods and simple sugars improves insulin sensitivity and can help regulate your cycle. There's no need for a restrictive diet: it's about making better choices, not starving yourself.
• Regular exercise, but without excess. Moderate exercise (150 minutes per week of moderate activity) reduces insulin and androgen levels. Be careful: overtraining can also disrupt your cycle.
• Manage stress. Elevated cortisol worsens hormonal balance. Meditation, yoga, or simply going for a walk have evidence behind them.
• Adapted menstrual protection. When your period arrives, it can be heavy and unpredictable. The PapayaCup menstrual cup lasts up to 12 hours without changes and has a greater capacity than conventional tampons, making it ideal for irregular but heavy flows. If you prefer something with even more capacity, the menstrual disc is a great option.
• Follow medical guidance. People with PCOS have a higher risk of type 2 diabetes, hypertension, and, in the long term, endometrial cancer if their cycles are very irregular for years. Annual follow-up with blood tests is essential.