PCOS (Polycystic Ovarian Syndrome) Symptoms, Causes, Treatment
Polycystic ovarian syndrome (PCOS) affects one in 10 women of childbirth age.
Shelby Hatcher tried everything.
She used various methods of birth control: the pills and intrauterine device (IUD) for 10 years. She was irregular since she was a teenager, but she was not diagnosed with polycystic ovarian syndrome (PCOS) until she had a baby.
After deleting IUD in May 2024, Hatcher-Gosnell had a period of 45 days and began experiencing PCOS symptoms such as fatigue and irregular menstrual cycles.
She was placed on letrozole to adjust her duration. She worked by lowering estrogen levels in the body, but it had no effect. Her Obgyn told her she has two options: try to conceive again or “lose weight” before going back to birth control and adjusting hormones.
catch? Weight loss helps reduce PCOS symptoms, but does not necessarily address the hormonal imbalances associated with this condition. This makes it difficult to lose weight.
PCOS affects 8%-18% of women of reproductive age. On average, women visit three or more medical professionals before a diagnosis is established. Because women with PCOS often suffer from weight-centered healthcare, weight and gender bias play an important role in this diagnosis delay.
If PCOS is left untreated, women are at increased risk for hypertension, cardiovascular disease, gestational diabetes, and high cholesterol. Women with PCOS may be at a higher risk of type 2 diabetes if they experience insulin resistance, which can cause elevated blood sugar levels.
Dr. Hayley Miller, medical director at Nurx Weight Management, says GLP-1 such as Ozempic and Mounjaro are viable treatment options for managing PCOS metabolic symptoms, but most insurers are not going to cover them without Food and Drug Administration (FDA) approval.
In April 2025, Hatcher sought a prescription for GLP-1 from an external weight management provider. She’s firing $1,400 for three months of supply.
Similarly, 35-year-old Tahira Adaya says Zepbound is a “miraculous solution” for a decades-long struggle between PCOS and irregular periods. Adaya has a PCOS on the diagnostic code, but will pay $350 a month for GLP-1 drugs through the online pharmacy Lillydirect.
“I hope that insurance will change soon, but I’m happy to have it on my record now,” Adaya says. “It should be enough for one in ten people who have a PCOS to move the needle into something covered in insurance, but that’s a messy system.”
For those who can afford to pay out-of-pocket expenses, the GLP-1 is “worthy,” says Adaya. However, when treatment costs break the bank, other patients are either looking for a loophole in their insurance or stuck without drugs.
Women’s health is understudied and lacking
The FDA approves the drug for condition-specific use and notifies the insurance company’s coverage policy. Even if the drug is covered, the insurance company may also refuse to cover certain conditions.
However, there is a lack of management when it comes to device testing and clinical trials of medical products sold to women.
“We feel that this system doesn’t really think specifically about the very specific needs of women’s bodies and doesn’t do enough research into this,” FDA committee member Marty McCurry told Politico in July 2025.
WISP Chief Medical Officer, Dr. Jennifer Pena, says there is a lack of data on women, particularly reproductive age.
“As a large part of what we have is about older adults and diabetes, there’s really a need for research focusing on the use of GLP-1 in this particular patient population,” she says.
Another popular drug for treating PCOS is metformin, both Hatcher and Adaya use. Hatcher calls it “the worst medicine I’ve ever taken,” but it’s “infinitely cheaper” than GLP-1, and deals with insulin resistance as well, says Peña.
Pena says that if metformin does not work, GLP-1 is a valid next step. Her main concern is when they are offered as first choice solutions.
“PCOS is not in all size types, so it’s not possible to say that GLP fixes the entire problem,” says Peña. “GLP plays an important role, but you have to be considerate about how you use it to personalize it to your patients.”
GLP-1 is useful for PCOS symptoms, but stigma remains
Online, PCOS women look to Subreddits and Facebook Support Groups for advice on GLP-1. They provide encouragement and security to each other in comments on posts from new GLP-1 users, and provide practical advice to those struggling to get affordable prescriptions. However, offline, Adaya says there is still stigma and people don’t understand that she is taking medication to treat her PCOS symptoms.
“When you tell people that you’re taking it for PCOS, they still think you’re doing it for vanity reasons,” she says.
Adaya was diagnosed with PCOS at the age of 27 after several visits with primary care professionals, gynecologists and endocrinologists, but her main symptoms were always irregular periods. Her weight fluctuated, but she was never obese. She has lost weight since she began Zepbound in 2024, but she says it’s not as dramatic as others have experienced.
“For me, it’s mostly balanced my hormones,” she says. “My period has never been in my life up until this year, and it feels like a miraculous drug and solution to me.”
Adaya frequently thinks about costs. She lives in New York, where she already has a high cost of living, comparing $350 a month to what she can spend on car payments and savings.
However, she tries to see the silver lining.
“Take this medication probably means I spend less on my overall health in the future,” she says. “My irregular cycles have been a source of great stress for me. For the first time in my life I am living without this huge stress.”
