Your Doctor Won't Treat Your PCOS and This Is Why
PCOS | April 30, 2025 | By Jessica Silver, APRN, FNP-C
"My doctor just prescribed birth control pills and told me to lose weight."
This is perhaps the most common statement I hear from women with Polycystic Ovary Syndrome (PCOS) who come to our practice seeking help. Despite affecting up to 15% of women and being the leading cause of female infertility, PCOS remains one of the most misunderstood and mistreated conditions in conventional medicine.
If you've been frustrated by cookie-cutter approaches that haven't resolved your symptoms, understanding why conventional PCOS treatment often fails—and how a personalized approach can succeed—could transform your results.
Why Conventional PCOS Treatment Falls Short
The One-Size-Fits-All Approach
The standard medical approach to PCOS typically involves:
- Birth control pills to regulate periods
- Metformin to address insulin resistance
- Spironolactone for excess hair growth
- General advice to "lose weight"
This standardized approach fails to recognize that PCOS is not a single condition but a syndrome with multiple types, each requiring a different treatment strategy. It's like prescribing the same antibiotic for every infection—it might work for some, but will inevitably fail for many others.
The Symptom-Management Mindset
Conventional treatment focuses on managing symptoms rather than addressing root causes. Birth control pills, for example, create artificial cycles but don't resolve the hormonal imbalances causing irregular periods. When you stop the pill, the underlying issues remain—and sometimes worsen.
Limited Testing
Most doctors order minimal testing for PCOS, typically limited to testosterone, DHEAS, and perhaps an ultrasound. This limited view misses critical information about your specific hormone patterns, metabolic health, inflammation levels, and nutrient status—all factors that influence which type of PCOS you have and how it should be treated.
Lack of Specialized Training
Most physicians receive minimal training on PCOS during medical school and residency. Family doctors, gynecologists, and even many endocrinologists lack specialized knowledge about the different PCOS types and current evidence-based approaches beyond basic medication management.
The Four Types of PCOS: Why Identification Matters
The game-changer in PCOS treatment is recognizing that there are four distinct types, each with different underlying causes and treatment needs:
1. Insulin-Resistant PCOS (70-80% of cases)
Primary Features:
- High insulin levels driving excess testosterone production
- Weight gain, especially around the midsection
- Skin tags, dark patches on skin (acanthosis nigricans)
- Cravings for carbs and sugar
- Fatigue after meals
Why Standard Treatment Fails:
While metformin addresses insulin resistance, the typical dose and monitoring are often inadequate. Additionally, many doctors miss the comprehensive approach needed, which includes specific dietary interventions, targeted supplements, and lifestyle modifications beyond just "eat less, move more."
Effective Approach:
- Comprehensive insulin resistance protocol
- Low glycemic impact diet with meal timing strategies
- Specific exercise protocols that improve insulin sensitivity
- Targeted supplements like inositol, berberine, and chromium
- Medication when needed, with proper dosing and monitoring
2. Inflammatory PCOS (10-20% of cases)
Primary Features:
- Elevated inflammatory markers
- Joint pain or body aches
- Headaches
- Bowel issues
- Fatigue not relieved by rest
- Skin issues beyond acne (eczema, psoriasis)
Why Standard Treatment Fails:
Conventional PCOS treatment completely overlooks inflammation as a root cause. Birth control pills and metformin do nothing to address inflammatory drivers, and some medications may actually increase inflammation.
Effective Approach:
- Identifying and addressing inflammatory triggers (food sensitivities, gut issues, environmental exposures)
- Anti-inflammatory dietary approach
- Specific supplement protocols to reduce inflammation
- Stress management techniques
- Gut health optimization
3. Adrenal PCOS (10% of cases)
Primary Features:
- Normal ovaries on ultrasound
- Elevated DHEA-S but normal testosterone
- Significant stress component
- Sleep disturbances
- Anxiety or feeling "wired but tired"
Why Standard Treatment Fails:
Standard PCOS medications don't address the adrenal component driving this type. Birth control pills can sometimes worsen symptoms by further disrupting the HPA axis (hypothalamic-pituitary-adrenal).
Effective Approach:
- Adrenal support protocols
- Stress management techniques
- Sleep optimization
- Adaptogenic herbs
- Specific nutrient support
- Cortisol rhythm restoration
4. Post-Pill PCOS (varies)
Primary Features:
- PCOS symptoms that appear after discontinuing hormonal birth control
- No history of PCOS before starting birth control
- Often temporary if properly addressed
Why Standard Treatment Fails:
Ironically, conventional medicine typically prescribes the very thing that triggered the problem—birth control pills—rather than supporting the body's natural hormone regulation recovery.
Effective Approach:
- Temporary support to restore natural hormone production
- Liver support for detoxification
- Nutrient repletion (birth control depletes several nutrients)
- Cycle support supplements
- Patience and monitoring as natural regulation returns
The Personalized PCOS Solution
Effective PCOS treatment begins with identifying your specific type through comprehensive testing and symptom analysis. This includes:
- Complete Hormone Panel: Beyond basic testosterone, a full panel including estrogen, progesterone, DHEA-S, androstenedione, and metabolites
- Metabolic Assessment: Fasting insulin (not just glucose), HbA1c, lipid panel with particle size, and oral glucose tolerance test when indicated
- Inflammation Markers: hsCRP, homocysteine, and other inflammatory indicators
- Nutrient Status: Key vitamins and minerals that affect hormone balance and insulin sensitivity
- Thyroid Function: Complete thyroid panel (25% of women with PCOS have thyroid dysfunction)
Based on this comprehensive assessment, a personalized treatment protocol addresses your specific PCOS type and underlying factors.
Your Path to Real PCOS Solutions
If you've been frustrated by one-size-fits-all PCOS treatment that hasn't resolved your symptoms, know that a more personalized approach exists. At ReNu'd You, we specialize in identifying your specific PCOS type and creating customized protocols that address the root causes of your symptoms.
Our telehealth approach makes this specialized care accessible regardless of your location. Don't settle for symptom management when real solutions are available. Schedule a consultation today to discover your PCOS type and begin your personalized treatment journey.
