How do I know if I have PCOS for sure?

If you suspect you may have PCOS, the most important step is to speak with your GP. PCOS is what’s called a diagnosis of exclusion – this means other conditions need to be ruled out first. Only a healthcare professional can make the diagnosis, so it’s important to get checked rather than relying on self-assessment.

Things to reflect on before seeing your GP

While you cannot diagnose PCOS yourself, thinking about your symptoms can help you prepare for the appointment. For example:

• If you’re not on hormonal contraception, are your periods irregular or sometimes absent?
• Do you experience excess hair growth on your face or body, or persistent acne?
• Have you noticed recent weight changes that don’t seem linked to diet or lifestyle?
• Do other women in your family have a PCOS diagnosis?

If you answered “yes” to some of these questions, it may be worth discussing them with your GP.

Keeping a symptoms diary

Before your appointment, it can be useful to keep a record of your symptoms. This can help you and your GP look for patterns. You might want to note:

• Period dates, cycle length, and how heavy or light they are
• Whether ovulation is absent (if you’re tracking with ovulation kits or trying to conceive)
• Weight changes
• Excess hair growth (face, chest, stomach, thighs, etc.)
• Thinning hair on the head
• Acne or oily skin
• Skin changes such as tags or dark, velvety patches (known as acanthosis nigricans)
• Mood changes, anxiety, low mood, or worsening PMS
• Fertility challenges or recurrent miscarriage
• Fatigue or low energy

What guidelines say about diagnosis

According to current NICE guidance:

In adults (over 20 years old), a diagnosis of PCOS may be considered if two out of the following three are present, once other causes have been ruled out:

• Signs of high androgen levels (either clinical or shown in blood tests)
• Ovulatory dysfunction (irregular or absent periods)
• Polycystic ovarian appearance on ultrasound

Or, put more simply:

• A blood test showing raised androgens
• Irregular or absent periods
• Multiple “cysts” on ovaries visible on ultrasound

In adolescents (under 20 years old), diagnosis is based on hormone levels and irregular or absent periods. Ultrasound is not usually recommended at this stage, as it is not considered reliable for diagnosis in younger women.

Adolescents with some PCOS features, but who do not meet the full diagnostic criteria, may be considered at increased risk. Guidelines suggest reassessment at or before full reproductive maturity (approximately eight years after the first period).

Depending on your age and symptoms, your GP may recommend blood tests and/or an ultrasound scan as part of the diagnostic process.

Important note
Nutrition and lifestyle approaches can support general wellbeing if you have PCOS symptoms, but they cannot replace medical diagnosis or treatment. Always seek advice from your GP if you are concerned about your symptoms.

What is PCOS?

Polycystic Ovary Syndrome (PCOS) affects an estimated 1 in 10 women in the UK, making it one of the most common hormone-related conditions in women of reproductive age and a leading cause of ovulatory infertility. Worldwide, it’s thought to affect over 100 million women.

The name “PCOS” can be misleading. It’s actually a collection of symptoms that may have different underlying drivers – and not everyone with PCOS has cysts on their ovaries. In fact, around 20% of women without PCOS have cysts, while about 30% of women with PCOS do not.

So, what is it?
PCOS is often described as a complex endocrine condition involving hormonal and inflammatory changes that can disrupt the development of ovarian follicles. This can lead to delayed or absent ovulation, resulting in irregular or missed periods. In practice, PCOS may affect menstrual cycles, weight regulation, fertility, and other aspects of health.

Research suggests women with PCOS may also have a higher risk of metabolic complications such as insulin resistance, type 2 diabetes, altered cholesterol (dyslipidaemia), and potentially cardiovascular concerns.

Some of the more common symptoms of PCOS include:

• Insulin resistance
• Elevated androgens (or ‘male hormones’)
• Mid-cycle or ovulatory pain
• Acne or oily skin
• Unwanted hair growth on the face or body (hirsutism)
• Male-pattern hair thinning or hair loss
• Unwanted weight gain or difficulty losing weight
• Mood changes such as low mood, anxiety or irritability
• Sleep issues, including sleep apnoea

What are androgens?

Androgens are hormones such as testosterone, androstenedione, and dehydroepiandrosterone (DHEA). It’s normal to have some androgens – they support mood, libido, and bone health.

In PCOS, higher-than-average androgen levels (hyperandrogenism) are common. This is linked with difficulties ovulating, irregular periods, weight changes, unwanted hair growth, and acne. Hyperandrogenism is therefore considered both a clinical feature and a contributing factor in PCOS.

Factors which may contribute to PCOS

Family history

• PCOS can run in families. If a close female relative has PCOS, your likelihood of developing it may be higher.
• Genes may increase susceptibility, while environment and lifestyle may influence how strongly these genes are expressed.

Insulin and blood sugar balance

• High insulin levels may reduce sex hormone-binding globulin (SHBG), leaving more free testosterone available and contributing to symptoms.
• Insulin can also stimulate the ovaries and pituitary gland, influencing androgen production.
• Diets high in sugar and refined carbohydrates, combined with other factors such as stress, smoking, alcohol, sleep deprivation, some medications, and environmental exposures, may contribute to insulin resistance over time.

Inflammation

• Chronic low-grade inflammation is common in PCOS and may influence ovarian function and androgen production.
• Visceral fat (fat stored around the abdomen) can secrete inflammatory molecules, which in turn may worsen insulin resistance, creating a cycle that fuels symptoms.
• Lifestyle factors such as smoking, alcohol, ultra-processed foods, and chronic stress can add to overall inflammatory load.
• Gut health, infections, autoimmune activity, and food intolerances may also play a role in some cases.

Adrenal androgens and stress

• The adrenal glands produce stress hormones and some androgens. In PCOS, adrenal androgens may account for 20–30% of the elevated hormone levels seen.
• Ongoing stress may therefore play a role in symptom expression, even in women who are not insulin resistant or do not have ovarian cysts.
• Research suggests cortisol regulation may be altered in PCOS, potentially contributing to changes in weight, appetite, menstrual cycles, and immunity.

Exposure to endocrine-disrupting chemicals

• Certain environmental chemicals, sometimes called xenoestrogens (such as BPA in plastics), may mimic or interfere with hormone activity.
• Studies suggest they may contribute to insulin resistance, inflammation, and hormone imbalance, although more research is needed.

Post-pill hormone changes

• Some people notice PCOS-like symptoms after stopping the contraceptive pill. This does not mean the pill causes PCOS, but rather that hormonal shifts can temporarily mimic or unmask symptoms. PCOS itself is a longer-term condition with complex causes.

In reality, PCOS is often the result of a combination of these factors, with different drivers in different individuals.

Next steps

If you’d like to learn more about PCOS and explore nutrition and lifestyle approaches that may support your symptoms, you’re welcome to book a free call here.

Please note: we do not diagnose or treat PCOS. Nutrition and lifestyle support can complement medical care, but it is important to consult your GP for diagnosis, medical advice, and management.

5 Natural Ways to Support GLP 1 in PCOS

Not everyone with PCOS wants to take medication. GLP-1 receptor agonists such as semaglutide (Wegovy, Ozempic) and liraglutide (Saxenda) may help with weight loss and insulin resistance, but they are not the only way to influence the GLP-1 pathway.

The body naturally produces GLP-1 in response to food and gut signalling. This hormone helps regulate blood sugar, slow gastric emptying, and promote satiety – all functions that are sometimes disrupted in PCOS. So, it makes sense to explore how nutrition and lifestyle can enhance your body’s own GLP-1 production and responsiveness.

Here are five evidence-based strategies that may support GLP-1 naturally, and benefit PCOS symptoms in the process:

1. Include foods rich in soluble fibre

Soluble fibre slows digestion, helps to balance blood glucose, and supports your gut microbiome – which all in turn can help to enhance GLP-1 secretion. Soluble fibre also plays a role in improving insulin sensitivity and reducing circulating androgens (male hormones, like testosterone).

Good sources include oats, ground flaxseed, chia seeds, cooked apples and pears (with the skin), beans, lentils, avocado and carrots. Aim to include 10g soluble fibre food in your diet every day.

2. Don’t overlook eggs

Research shows that eggs are a source of bioactive peptides that appear to stimulate GLP-1 secretion. In a randomised crossover study, participants who ate eggs for breakfast had significantly higher GLP-1 levels post-meal compared to those who consumed cereal or a croissant-based meal.

Eggs also provide high-quality protein, choline and B vitamins – all of which support hormone balance, liver detoxification, and brain function.

If you don’t eat eggs, other protein sources like tofu, tempeh, fish and legumes may offer similar benefits, although their GLP-1 response has been less studied.

3. Try intermittent fasting – cautiously and mindfully

Time-restricted eating (such as a 10- or 12-hour eating window) may enhance GLP-1 sensitivity and improve insulin signalling. Several small studies suggest that intermittent fasting protocols can lead to increased GLP-1 levels and improved glycaemic control.

However, fasting isn’t suitable for everyone. In women with PCOS who are underweight, have disordered eating patterns, or experience blood sugar crashes, fasting may do more harm than good. It should be approached carefully and always personalised.

4. Incorporate bitter foods and herbs

Bitter compounds stimulate receptors in the gut and tongue that may increase GLP-1 secretion and slow gastric emptying. This includes foods like rocket, chicory, dandelion greens, grapefruit, endive, and radicchio.

Herbal bitters such as gentian and artichoke extract are also under investigation for their potential effects on satiety and post-meal glucose control, although more research is needed in women with PCOS specifically.

5. Support the gut microbiome

Short-chain fatty acids (SCFAs), produced by the fermentation of dietary fibre by gut bacteria, have been shown to stimulate GLP-1 release via interaction with intestinal receptors. A healthy and diverse microbiome may therefore play a central role in regulating GLP-1 naturally.

To support this, include a variety of prebiotic-rich foods (onion, garlic, leeks, asparagus, oats, flaxseed), fermented foods (sauerkraut, kefir, yoghurt, miso), and polyphenol-rich foods such as berries and green tea.

For women with PCOS who prefer a natural or food-first approach, there are several well-researched ways to support GLP-1 signalling without medication. These strategies may help with appetite regulation, insulin sensitivity and hormone balance – particularly when combined with a personalised nutrition plan. If you are interested in finding out more, why not book a free call with us here?

**This article is for general information only and is not intended to diagnose, treat or advise on medical conditions. Always speak to your GP or a qualified health professional before starting supplements or changing your medication. BANT-registered nutrition professionals do not diagnose or treat medical conditions, nor do they recommend, prescribe or alter any medication**

Smoked Salmon, Quinoa and Avocado Salad with Lemon-Tahini Dressing

Many women with PCOS are exploring GLP-1 receptor agonists such as Wegovy or Ozempic to help with weight management and insulin resistance. These medications work by mimicking the hormone GLP-1, which helps slow digestion and reduce appetite. For some, this can lead to significantly reduced food intake – sometimes making it harder to get enough protein, fibre and nutrients across the day.

But even if you’re not using GLP-1 medication, balancing blood sugar and appetite through food is one of the most effective ways to manage PCOS symptoms. This recipe has been developed to support satiety, hormone balance and digestive health.

It’s rich in protein, healthy fats and soluble fibre, with ingredients that naturally support GLP-1 production in the body. It also offers a good amount of micronutrients that are particularly relevant for women with PCOS, including magnesium, B vitamins and omega-3 fats.

Serves 2

Ingredients: 

• 100g quinoa
• 1 smoked salmon fillet (around 120g)
• 2 eggs
• 1 ripe avocado
• a large handful of salad leaves or spinach
• a small handful of chopped herbs
• 1 tbsp tahini
• juice of ½ lemon
• 1 tsp olive oil
• salt and pepper

Method: 

• Cook the quinoa, boil or poach the eggs, and slice the salmon and avocado. 
• Mix the tahini, lemon juice, and olive oil to make a dressing. 
• Assemble everything over salad leaves, drizzle with dressing, and serve.
• Enjoy!

5 Top Nutrition Tips While Taking GLP-1 Agonists for PCOS

GLP-1 receptor agonists – including semaglutide (Wegovy, Ozempic) and liraglutide (Saxenda) – are growing in popularity among women with PCOS, particularly those who are struggling with insulin resistance and weight management. These medications mimic the body’s natural GLP-1 hormone, which helps regulate blood sugar, slow digestion, and reduce appetite.

While these effects can be beneficial, they also raise important questions about nutrition. With significantly reduced appetite, how can you ensure you’re getting enough nutrients to support energy, hormones and long-term health? And are there specific foods that can support how these medications work?

Here are some evidence-based strategies to help you stay well-nourished while taking GLP-1 agonists.

1. Prioritise protein – even if you're eating less

GLP-1 agonists can make it difficult to eat full meals. This can unintentionally lead to low protein intake, especially if you’re snacking or eating very small portions. However, protein is essential for preserving muscle mass, supporting metabolic rate, regulating blood sugar, and aiding hormone production.

Research suggests women with PCOS may benefit from a protein intake of around 1.2–1.6 g per kg of body weight per day. This is higher than the standard RNI, especially during periods of weight loss. If appetite is low, aim to include 20–30g of protein at each meal – even if the meal is small.

Easy protein-rich options include eggs, fish, Greek yoghurt, tofu, tempeh, pulses, lean poultry, and protein powders made from pea or whey.

2. Don’t forget fibre – especially the soluble kind

Soluble fibre supports digestion, blood sugar regulation and appetite control – all crucial for women with PCOS. It’s also known to stimulate the body’s own GLP-1 release, supporting the same pathway as the medications.

Sources include oats, flaxseed, chia seeds, apples, pears, cooked carrots, beans and lentils. If you’re struggling with volume, a tablespoon of ground flaxseed stirred into porridge, yoghurt or a smoothie is an easy way to increase soluble fibre without adding bulk.

Increased fibre intake is associated with improved insulin sensitivity and lower androgens in PCOS. It also supports gut microbiome diversity – an area increasingly linked with hormone regulation and mood.

3. Watch for micronutrient shortfalls

Reduced appetite and slower digestion can increase the risk of missing out on key vitamins and minerals. Early evidence suggests that long-term GLP-1 agonist use may impact the absorption of B12 and fat-soluble vitamins such as A, D, E and K – particularly in those with existing digestive issues.

Common nutrient deficiencies in PCOS include magnesium, vitamin D, iron, folate and B12. If you’re experiencing fatigue, mood changes or digestive discomfort while on medication, speak with your GP or nutritionist about testing or supplement support.

Eating smaller meals that are nutrient-dense – such as a quinoa salad with avocado and salmon, or a smoothie with spinach, berries and protein powder – can help you meet your needs more easily.

4. Hydration matters – especially with slower digestion

GLP-1 agonists slow the emptying of the stomach, which may increase bloating, nausea or constipation for some women. Staying well hydrated can support digestion and reduce discomfort.

Aim for at least 1.5–2 litres of water daily, and consider herbal teas such as ginger, peppermint or fennel to ease digestive symptoms. A small amount of lemon juice or apple cider vinegar before meals may also support stomach acid and enzyme release – although this should be avoided if you have reflux or gastritis.

If constipation becomes a concern, increasing both soluble fibre and fluid together is key. 

5. Build in rest and nourishment – not just weight loss goals

It can be tempting to see rapid weight loss as the main goal while on a GLP-1 agonist. But from a Functional Medicine perspective, weight is only one part of a much bigger picture. Hormone balance, ovulation, stress resilience, gut health and sleep all play critical roles in PCOS outcomes.

Skipping meals, undereating or ignoring hunger signals (even if they’re rare) can leave the body undernourished and stressed – potentially worsening hormone imbalances over time. Wherever possible, choose foods that feel grounding, satisfying and nutrient-rich, even in small amounts.

Slowing down at mealtimes, chewing well and tuning into your body’s cues can also improve digestion and nutrient absorption.

GLP-1 receptor agonists may offer useful support for women with PCOS, particularly where insulin resistance is a key driver. But medications are most effective when paired with thoughtful, individualised nutrition. Prioritising protein, fibre and nutrient density – even in small portions – helps protect your long-term health and hormone balance. If you’re unsure where to start, speak to your GP or feel free to get in touch with us here.

**As always, this article is for educational purposes only and does not replace personalised medical advice. Nutritional therapists do not diagnose or treat medical conditions or recommend medications. If you’re unsure about your nutrition needs while on a GLP-1 agonist, please speak with your GP and a qualified nutritional therapist registered with BANT**

GLP 1 Agonists and PCOS

Weighing Up the Pros and Cons

GLP-1 receptor agonists – such as semaglutide (Ozempic, Wegovy) or liraglutide (Saxenda) – are gaining attention for their effects on weight loss, blood sugar regulation, and insulin resistance. All of these are key issues in PCOS, but these medications were never designed specifically for PCOS. So, how relevant are they, and what does the research say about their benefits and risks to those of us with PCOS?

What are GLP-1 receptor agonists?

GLP-1 (glucagon-like peptide-1) is a hormone naturally produced in the gut, released in response to food, and it plays several important roles - regulating blood sugar, insulin release, appetite and digestion. GLP-1 receptor agonists are medications that mimic the action of this hormone. They were originally developed for type 2 diabetes but are now increasingly prescribed off-label for weight loss and insulin resistance.

GLP-1 agonists work by helping to lower blood glucose by increasing insulin secretion and decreasing glucagon (a hormone that raises blood sugar). They also slow gastric emptying and promote a feeling of fullness, which can lead to reduced food intake and weight loss.

Why are they being used for PCOS?

Some women with PCOS experience insulin resistance, difficulty with weight loss, and increased appetite. There’s a growing body of research suggesting that GLP-1 receptor agonists may improve metabolic, hormonal, and reproductive parameters in PCOS.

Potential benefits:

• Weight loss – especially in those living with obesity or severe insulin resistance
• Improved insulin sensitivity and lower fasting insulin - especially in those with severe insulin resistance
• Reduced appetite 

Potential drawbacks:

• Side effects: nausea, constipation, vomiting, gallbladder issues, and fatigue are commonly reported
• Nutrient deficiencies: reduced appetite can lead to low intake of protein, iron, B12, and fibre
• Loss of muscle mass: rapid weight loss may lead to a decline in lean mass if not well supported
• Cost and access: these medications are not always available on the NHS for PCOS and can be expensive privately
• Unknown long-term effects: most studies in PCOS are under 1 year, and there is no data yet on long-term safety or fertility outcomes

Things to consider

GLP-1 agonists are not a quick fix – they should be paired with dietary and lifestyle strategies to avoid potential nutritional deficiencies or any potential rebound weight gain when stopping the medication. Appetite suppression can also make it hard to eat enough protein or vegetables, which are key for ongoing health.

Also, they are not suitable for everyone. People with a history of pancreatitis, certain thyroid conditions, or gallbladder disease should avoid them. And they should never be used during pregnancy or while trying to conceive.

The research shows that GLP-1 agonists may offer real benefits to some women with PCOS – particularly those who have struggled with insulin resistance and weight for a long time – but they are not without risk. They don’t replace the foundations of hormone support: blood sugar balance, stress regulation, nutrient-dense meals, and regular movement.

If you’re considering medication, it’s important to speak with your GP or endocrinologist. If you’re interested in supporting your body’s own production of GLP-1, check out my blog here.

**This article is for educational purposes only and is not a substitute for medical advice. BANT-registered nutrition practitioners do not diagnose or treat medical conditions, nor do they prescribe or alter medication. Always consult your GP before making any changes to your medications or supplements**