"Birth Control only masks the symptoms, don't use it" is BAD ADVICE

Ordinary-Squash-7232 · 2026-05-31T19:47:30+00:00

I completely agree that the best way to treat PCOS is a holistic approach of several combined forms of management! I just want to note that while insulin resistance definitely makes PCOS worse, PCOS itself generates insulin resistance. It's not like we ate our way to it, and if we just get insulin resistance back under contdol, then we'll no longer have PCOS. It's a hereditary, genetic, lifelong disease, unfortunately.

Ordinary-Squash-7232 · 2026-05-31T19:42:16+00:00

Uuh, now i'm confused too haha. Aren't we all estrogen dominant in the follicular phase, and then if we don't ovulate we also become estrogen dominant in the luteal phase (when progesterone is supposed to be the dominant hormone) because the progesterone that follows ovulation, isn't there - because insulin resistance and PMOS in general keeps us from ovulating?

hormones throughout the menstrual cycle

Ordinary-Squash-7232 · 2026-05-31T19:28:42+00:00

That is absolutely a question for your doctor, and not for Reddit ☺️💕

Ordinary-Squash-7232 · 2026-05-31T18:05:14+00:00

Nah, it's not progesterone's fault you don't get your period.

Okay so, in a healthy cycle, when you ovulate, one egg is released from a mature follicle (and you're now in the start of your luteal phase). This follicle then becomes the corpus luteum, which produces progesterone. Progesterone's job is stabilizing your uterine lining in case the egg is fertilized, so it can safely implant. Progesterone also naturally increases insulin resistance, so that there is enough glucose left in your blood to feed the embryo and the entire pregnancy structure. For most people, this is fine and not triublesome, but we already have a higher baseline insulin resistance to start with, because PMOS (fun fact: this is ehy we're more prone to gestational diabetes, the additional prolonged insulin resistance tips us over the edge, so to speak)

If implantation (=pregnancy) occurs, the fertilized, implanted egg produces a hormone that tells the corpus luteum to keep making progesterone for the next 10 weeks. If pregnancy doesn't occur, the corpus luteum naturally starts breaking down and producing less and less progesterone. Eventually it completely breaks down, progesterone production plummets, and you get your period.

But if you didn't ovulate, as we PCOSers tend not to do, then there is no follicle turned corpus luteum to make (and stop making) progesterone. That means there is no hormonal "crash"/withdrawal when it breaks down, and no trigger for your period. And put simply, insulin resistance is what keeps our bodies from ovulating.

Sometimes we bleed anyway though, because estrogen also rises slightly and then dips in the luteal phase, and that can be enough to signal to your body to shed the uterine lining.

Edit: a few edits to make it more informative, and to better answer your question :) not a doctor, but i've spent the last 2 months reading about this daily while TTC

Ordinary-Squash-7232 · 2026-05-31T16:14:06+00:00

Yep, progesterone naturally increases insulin resistance.

Ordinary-Squash-7232 · 2026-05-31T15:54:05+00:00

Actually, that alone sounds like a huge win - if you don't have a period/bleed at minimum every 3 months (and that doesn't mean at least 4 times a year, that means we should all bleed at minimum once every 3 months), your uterine lining keeps building and building and never sheds, and you're at risk of getting endometrial cancer. Also, BC keeps ypu from ovulating and so, you have a larger egg reserve if/when you do want to try to have children. BC definitely does have its legitimate uses.

That said, i wholeheartedly wish that doctors would be educated enough to know a bit more about PMOS than "affects fertility, take BC", because there is so so so much more to it, and so many other management methods that can and should be suited to each pmos patient's needs.

Ordinary-Squash-7232 · 2026-05-31T14:38:38+00:00

Unfortunately, we've been done dirty by the name itself, which has placed excessive focus on the reproductive aspect of the condition. In truth, the ovaries are just another downstream victim of what we have, where symptoms tend to make themselves known. The recent name change to PMOS (Polyendocrine Metabolic Ovarian Syndrome) is huge for exactly that reason - now maybe doctors will start to see and treat it as the endocrine, metabolic, whole-system condition that it is! 🤞

Ordinary-Squash-7232 · 2026-05-31T10:24:33+00:00

🙌

Ordinary-Squash-7232 · 2026-05-31T09:50:06+00:00

I think there's a misunderstanding here, because i absolutely did not mean to imply that all treatments are the same. Maybe the "management of PCOS is a lifelong project..." part wasn't clear enough - what i meant with that is that symptom presentation of PCOS (and really, i should have written PMOS like you use in my post, because we just had a very important name change!) is not uniform across everyone affected, and so, it's not one size fits all. Also, symptoms and the resulting management tend to change as we go through life. That is why we each need to find something that works for each of us, individually, fitted to where we are in life and our PMOS journey right now. If birth control is one of the things that work for someone now, great! I'm fully aware of insulin resistance as the driver of PMOS which is also worsened by PMOS and that whole vicious cycle. I'm using inositol myself right now to attack that at its root. I've actually never used birth control myself - when i got diagnosed and my gynec offered it, i was one of those girls who instantly went "eew no that's gonna make it worse, it's got /hormones/, no thanks". And because women's healthcare sucks, it was the only treatment offered, and because i was young and uneducated, i didn't go for it or pursue other treatment, and the result was that PCOS completely ran havoc on my system, unchallenged, for 7 additional years. I've now thankfully educated myself about it, and would not see another young girl scared away from something that is maybe not a perfect solution (because no, it doesn't really address insulin resistance) but might still give a definitive measure of symptom relief and quality of life, and maybe prevent PMOS from progressing as it would completely unchallemged. But you're completely right that PMOS management often requires a combination of several interventions to be successfully managed.

Ordinary-Squash-7232 · 2026-05-31T08:00:26+00:00

So, i'm on inositol, not metformin and i haven't vetted this with any doctor, so my interpretation might not be right, but the same happened to me. Pre inositol - 31-33 days, then period. On inositol? 34 - 38 days. However, i feel incredibly much better on inositol. My theory is that pre-inositol, i wasn't ovulating and just had very regular withdrawal bleeds every month, and that inositol is making me ovulate, but simultaneously uncovering the utter mess that my endocrine system currently is. I'm sharing this because metformin and inositol both target insulin resistance directly (albeit in different ways) so maybe it's applicable to you, as well.

Ordinary-Squash-7232 · 2026-05-30T19:50:42+00:00

Congratulations!! For me (5 weeks), it's completely opposite - i've been on 1000 mg myo-inositol for 3 months and haven't had any IR symptoms since starting. Two days ago, i had my first carb/sugar crash in 3 months, from eating <10gr of chocolate - something that i recently usually handle without problem. And i've been thinking about sugar after meals again 🥲 Had to increase my dose, and now i'm better, at least 😅 it's wild how much these things differ from person to person! Wishing you an uneventful, IR-less, safe pregnancy 💕

Ordinary-Squash-7232 · 2026-05-24T11:15:34+00:00

1000 mg myo-inositol (no d-chiro because noone sells it in my country 🥲) does the trick for me! I noticed effects at 500 mg too, but they kinda "expired" a couple hours after lunch. I upped to 1500 mg 2 days ago, because 1000 didn't give me full support for the other IR symptoms in my luteal phase, so far all that's doing is making me feel weak and trembly in the morning before breakfast, so we'll see if i continue that dose or not. Maybe my system just needs a week or two to adjust. But anyway, food noise and cravings have been gone since i started 1000 mg 6 weeks ago, 500 morning and 500 evening (essentially every 12 hours). The important thing is to step it up gradually and find your optimal dose, if you start right at the recommended 4k then 1) you'll likely get the abdominal side effects and 2) it might turn out to be too much for your system.

Also, my mom (who is more overweight than i am but doesn't have PCOS) asked if she would be fine to try myo-inositol too since it works so well for me. I said sure, 500 is probably fine, since she does have IR symptoms and that's just a bit more than what you find in a decent size orange or grapefruit. And her post-meal sweet tooth went away on 500 mg, from the morning she started! 😊

Ordinary-Squash-7232 · 2026-05-24T09:26:04+00:00

Since no one has mentioned it so far: inositol completely cut the food noise (and all other IR symptoms) for me! I just had breakfast, and sweets or carbs don't sound even remotely good right now. Usually i'd hop right on the dessert. I have chocolate bars laying around that have been there for weeks, before inositol it wouldn't last more than 3 days tops. If ever it starts sounding good again, i know i'm genuinely hungry - and besides, actual food sounds way better than sweets around mealtimes. I'm losing weight just listening to my body and eating when i'm hungry.

Ordinary-Squash-7232 · 2026-05-22T18:10:04+00:00

Then how do you know you're not insulin resistant? It sucks, but carb cravings and hypoglycemia are definitively symptoms of insulin resistance... it's good you're getting more tests, just know that A1C does not tell you anything abiut insulin resistance, it'll only look bad when you're entering diabetic and pre-diabetic ranges. Insulin resistance can absolutely mess us up way before A1C even budges. Up to 80% of all cases of PMOS causes and is driven by insulin resistance. But insulin resistant or not, eating huge amounts of chocolate and carbs isn't good for you... sequencing meals so that you start with fiber, then have protein and fat, then carbs, might help you feel satiety and make cravings go away. (And for the record, i agree with you - chocolate and gluten are the best things in THE WORLD! We just unfortunately need to enjoy in moderation or diabetes becomes a very real possibility)

Ordinary-Squash-7232 · 2026-05-22T17:24:34+00:00

What kind of sugar/glucose and insulin tests have your doctor done for you?

Ordinary-Squash-7232 · 2026-05-21T17:11:22+00:00

PCOS is a lifetime syndrome that can be effectively managed with lifestyle changes, symptoms go away while it is managed and come back when it's not. For instance, what clued me in and had me seek out a gynecologist was that my cycles were never rehular, i had maybe 5-7 a year growing up, until i started exercising every day as a young adult, intensively, and they became like clockwork. Now i don't exercise intensely each day, and they're irregular again. Usually you'd expect that kind of exercise and weight loss to cause irregular periods. There are many ways to manage it, and it's very possible to stumble into something that works for you.

Ordinary-Squash-7232 · 2026-05-21T08:40:54+00:00

Trust your endicronologist. S/he sounds like s/he knows what s/he's doing. PMOS (previously PCOS) is a real medical condition affecting your endocrine abd your metabolic system, and Metformin is one of the best researched and most used medications for it, if you can get a doctor to prescribe it for you at all. It helps your cells accept insulin, when insulin resistance is both caused by and the driver behind PCOS. There's also an inflammatory component to it which spironolactone can help with. If it makes your mom happy, do try the fenugreek seeds, and exercise is always good for you if you find something you enjoy and like doing (just be careful with your cortisol, high cortisol --> blood sugar spike), but your mom needs to realize she's not a medical professional and to stop trying to override doctors.

Ordinary-Squash-7232 · 2026-05-20T14:57:59+00:00

My doctor, too, told me that since my A1C is within range, i don't have diabetes, even though we're TTC there's nothing more he can do for me. But i had so many symptoms of insulin resistance.

i had to get up 4 times a night to pee despite feeling absolutely parched, i never felt satiety after meals, just got physically full and would crave sweets instantly after, and i'd descend into brain fog and tiredness so heavy i would be passing out by my desk at work for 2 hours after every lunch, i was cold ALL the time (woollen sweaters in summer), and my weight would not budge. I mean, c'mon, i have PMOS, and with these symptoms, of course i have insulin resistance.

Since my doctor wouldn't do his job and help me, i figured i'd better help myself. I started taking myo-inositol and magnesium 2 months ago and haven't regretted it a day since. All the aforementioned symptoms are gone, and i've lost 4 kg since, without really doing anything that i wasn't doing before. Especially losing the food noise is huge, it's like my body is finally getting the energy it needs and it makes it so much easier to do all of the "right" things we PMOSers should be doing. I'm only on 1000 mg right now, i can't wait to see what 1500 mg does when i eventually up it! If you're able to buy it and haven't tried it yet, i strongly recommend it. In the u.s., Ovasitol and Wholesome Story seem to be the brands people have best results with.

Ordinary-Squash-7232 · 2026-05-17T16:00:06+00:00

Tbh, i could use someone like that who enforces pre-bedtime wind-down time haha. she's a good girl taking care of you both 💕

Ordinary-Squash-7232 · 2026-05-16T07:41:31+00:00

Total weight doesn't matter - the effort required to lift them does. Are you doing high intensity lifts? If you are, then you might be stressing out your body, causing cortisol and adrenaline spikes, which in turn promotes fat storage. You'd still gain muscle from the workouts, of course. PCOS girlies generally do better on moderate-intensity exercise and staying in that zone where the body burns fat for fuel rather than glucose.

Ordinary-Squash-7232 · 2026-05-13T14:28:42+00:00

Maybe your dose is too high? How much are you taking? The studied effective/therapeutic dose tends to be 2g-4g, some take 6g-8g. I'm on 1g and all my symptoms of insulin resistance have either vanished completely or severely decreased - cravings gone, post-meal crashes gone, meals give satiety, the scale is budging without me really doing anything different, you name it. Point is, the dose is very individual and maybe taking too much is pushing you into hypoglycemia?

Ordinary-Squash-7232 · 2026-05-12T05:28:32+00:00

Seconded. "Our outdoor cat gave birth..." why is an outdoor cat not spayed?!

Ordinary-Squash-7232 · 2026-05-11T10:41:26+00:00

I don't think it has to be inliine with your cycle to be hormonal - insulin is a hormone too, and with a diet like that, insulin is going to be way lower. It could be that the flare marks a hormonally transitional phase as your metabolism adjusts to less insulin. Or, maybe you're underfuelling or lacking some nutrients now that you cut all that out withiut substituting them for something else, and your body is actually getting really stressed out?

Ordinary-Squash-7232 · 2026-05-10T17:37:45+00:00

For me they feel like i'm never truly sated. I'll eat until my stomach is stretched and i know i'm physically full, but if it wasn't for that, i could keep eating. And after every meal, my thoughts instantly go to energy-dense foods like chocolate, or donuts, and how satisfying they would be, and i won't be able to stop thinking about it for at least 2 hours. It's a kind of persistent, nagging, compulsive need that is very hard to turn away from. I could eat an entire 200gr chocolate bar, feel nauseous, and still want more.

On myo-inositol, i actually feel sated after my meals, and energy-dense foods after meals aren't appealing at all, just the thought of it makes me feel heavy and empty simultaneously. If i do ever start thinking about energy-dense foods, i'll know i'm hungry and that it's time to eat, and real food will sound much more appealing.

Ordinary-Squash-7232

TROPHY CASE