What is PCOS?

by Deborah Maragopoulos FNP | Jan 16, 2023 | Blog, PCOS | 0 comments

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects 10% of women of reproductive age. Polycystic ovary syndrome is characterized by high male hormone levels and low progesterone levels, which leaves estrogen unopposed.

Usually PCOS is first diagnosed in young women.Bbut can be missed early in life and not diagnosed until you’re premenopausal.

PCOS was first named in 1935 by Stein and Leventhal. However, in 1721 Vallisneri, an Italian scientist, described a married, infertile woman with shiny ovaries with a white surface, and the size of pigeon eggs.

So, PCOS is not a new disorder.

Yet polycystic ovary syndrome is rather a misnomer.

While it was first noted in women with many cysts on their ovaries, their hormonal imbalance was believed to be derived from the cystic ovaries. But that is not the case.

The hormonal imbalance in polycystic ovary syndrome derives from the hypothalamus.

Your hypothalamus controls all of your sex hormones and your adrenal hormones, as well as all the rest of the hormones in your body. It also controls your inflammation, or the inflammatory markers in your body.

PCOS is characterized by high male hormones both testosterone and DHEA as well as high inflammatory markers. Women with polycystic ovary syndrome may have insulin resistance, which causes metabolic inflammation. polycystic ovary syndrome is a metabolic disease of young women and metabolic diseases originate in the hypothalamus.

When your hypothalamus becomes out of balance, due to high stress, poor nutrition, and toxins, you can develop metabolic issues like polycystic ovary syndrome. Your adrenal glands produce stress hormones, including DHEA.

High levels of stress can be one of the risk factors of developing polycystic ovary syndrome.

Another risk factor for developing polycystic ovary syndrome is familial. We're not sure if this is hereditary, or if it runs in the family because of behavior. But if your mother or sisters had polycystic ovary syndrome, and oftentimes your mother may not have been diagnosed. they just had infertility issues, maybe early miscarriages, maybe trouble with facial hair, maybe central obesity which is classic in PCOS, then you are more likely to develop polycystic ovary syndrome.

Environmental exposures like to xenoestroegens and endocrine disrupters affect your genetics and may contribute to developing PCOS.

Women with PCOS may have infrequent or prolonged menstrual periods and excess male hormone (androgen) levels. Their ovaries may develop numerous follicles which fill with fluid and become cysts. Women with PCOS do not ovulate regularly and may be infertile or have difficulty getting pregnant or miscarry early.

One-third of women with PCOS also have features of metabolic syndrome, including insulin resistance, obesity, and dyslipidemia.

It’s insulin resistance which inhibits your liver’s ability to produce sex hormone-binding globulin (SHBG). SHBG keeps your testosterone levels in check.

Insulin resistance stimulates ovarian and adrenal androgen secretion.

Dysfunctional white adipose tissue has been identified as a major contributing factor for insulin resistance in PCOS.

Women tend to accumulate white adipose tissue in gynoid distribution- hips, buttocks and thighs. Where women with PCOS gain fat in the android distribution around the abdomen. This dysfunctional white adipose tissue seen in PCOS increases the risk of developing type 2 diabetes and cardiovascular disease.

While some women with polycystic ovary syndrome have multiple cysts on her ovaries due to lack of ovulation and increased follicle stimulation. Cystic ovaries are often caused by a hypothalamic pituitary ovarian imbalance.

The high androgens in PCOS are caused by a hypothalamic-pituitary-adrenal imbalance.

High stress revs up your adrenal glands and increases the output of DHEA which gets converted into into testosterone. High stress will interfere with your fertility, which will decrease your likelihood of ovulation which results in low progesterone.

Lower progesterone levels, which have a calming effect and an anti-inflammatory effect in the body, are characteristic in polycystic ovary syndrome. Without ovulating and lowering the inflammation every month with adequate production of progesterone, you can develop multiple cysts on your ovaries follicles that continue to get stimulated by high levels of follicle stimulating hormone, which puts your estrogen to progesterone ratio off creating estrogen dominance. And those follicles eventually develop into theca cells, which produce high levels of testosterone.

While polycystic ovary syndrome is considered a medical diagnosis, and is treated by allopathic physicians with medications, there are more natural ways to treat polycystic ovary syndrome that allow you to be able to have a return of your fertility, normalization of your periods and balancing of your hypothalamic pituitary adrenal axis which will lower your inflammation.

If you want to learn more about PCOS, please join my free Hormone Reboot Training.

Reference: The Polycystic Ovary Syndrome and the Metabolic Syndrome: A Possible Chronobiotic-Cytoprotective Adjuvant Therapy, International Journal of Endocrinology https://www.hindawi.com/journals/ije/2018/1349868/

Frequently Asked Questions:

Can your hypothalamus cause weight gain?

Yes. The hypothalamus is the master regulator of metabolism, controlling how your body stores and burns energy through its signaling to the thyroid, adrenals, and pancreas. When the hypothalamus becomes dysregulated by chronic stress, poor sleep, inflammation, or blood sugar instability, it defends a higher weight "set point" — causing the body to hold onto fat regardless of diet or exercise. This makes hypothalamic dysfunction an upstream root cause of stubborn weight gain.

What is a weight set point and why won't mine move?

A weight set point is the body weight your hypothalamus works to defend, calibrated over time by stress, sleep, hormones, and inflammation. When you diet, the hypothalamus perceives scarcity and responds by slowing metabolism, increasing hunger hormones, and suppressing satiety signals to return you to that set point. This is why most people regain lost weight within two to five years of conventional dieting — the set point itself was never recalibrated, only temporarily overridden.

Why do I gain weight under stress even when I'm not eating more?

Chronic stress raises cortisol, which disrupts blood sugar regulation, promotes abdominal fat storage, and signals the hypothalamus that the body is under threat. In survival mode, the hypothalamus defends fat stores and slows metabolism — so weight can increase even without any change in calorie intake. The stress chemistry, not the food, is driving the weight gain, which is why stress reduction is essential to any lasting metabolic reset.

Why do I regain weight after stopping GLP-1 medications?

GLP-1 medications work peripherally on appetite and gastric signaling, but they do not address the underlying hypothalamic dysregulation that sets your defended weight. Because the hypothalamic set point is never recalibrated, the body resumes defending its original weight once the medication stops — leading to significant regain. Long-term success requires restoring hypothalamic regulation so the set point itself lowers, rather than relying on appetite suppression alone.

How long does it take to reset your metabolism?

Genuine metabolic recalibration takes a minimum of 90 days, because the hypothalamus needs consistent signals of safety and sufficiency before it will lower its defended set point. This differs from a diet, which produces temporary suppression the body quickly corrects. A 90-day reset typically moves through three phases: stabilizing stress chemistry (days 1–30), rebuilding metabolic efficiency (days 31–60), and lowering the weight set point (days 61–90).

Why does my thyroid feel slow even though my labs are "normal"?

Under chronic stress, the body converts thyroid hormone into reverse T3, which blocks active thyroid receptors and slows metabolism at the cellular level — even when standard lab values appear normal. This means you can experience genuine symptoms of slow metabolism, such as fatigue, cold intolerance, and brain fog, while your thyroid panel looks unremarkable. Addressing the upstream hypothalamic and stress signaling often improves thyroid conversion and symptoms.

Is stubborn weight gain a willpower problem?

No. Stubborn weight gain is a signaling problem, not a willpower problem. The hypothalamus governs weight through survival mechanisms that operate below conscious control — defending its set point by slowing metabolism and increasing hunger when it perceives threat. No amount of discipline can override this system; lasting change comes from restoring hypothalamic regulation through reduced stress, balanced blood sugar, restorative sleep, and targeted nutritional support.

About the Author - Deborah Maragopoulos FNP

Known as the Hormone Queen®️, I’ve made it my mission to help everyone - no matter their age - balance their hormones, and live the energy and joy their DNA and true destiny desires. See more about me my story here...

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Last Updated: January 11, 2023