So You’ve Been Diagnosed with PCOS…Now What?

Understanding goals and treatment options for managing polycystic ovarian syndrome (PCOS), a common hormonal condition

Written By Rachel Manciagli, NP

Being diagnosed with PCOS can bring some mixed feelings. Sometimes people feel relieved that they have an explanation for their symptoms and other times people are overwhelmed or confused about what this means for their health and future. Let’s explore some options for what the next steps can look like. 

Our Goal: Helping You Understand the Health Implications of PCOS

Endometrial health — The inner lining of your uterus is called the endometrium. In a “normal” menstrual period, the endometrium builds up and thickens throughout the month, then sheds itself leading to menstrual bleeding. With PCOS this process is not always occurring on a regular basis. The endometrial lining being too thick for too long can lead to endometrial changes, the most concerning of which is endometrial cancer. To protect the health of the endometrium it is important for the endometrium to remain a normal thickness either through regular shedding with menstrual periods or by suppressing its growth through the use of medications. 

Metabolic health — People with PCOS have a higher risk of developing other medical conditions such as type 2 diabetes, high cholesterol, and obesity. Maintaining a healthy lifestyle is especially important in this population, whether through diet and exercise or the use of medications. Your OBGYN team along with your other healthcare providers such as primary care, cardiology, and/ or endocrinology, can help to work towards these goals. 

What Is Your Goal?

For some people a PCOS diagnosis comes while trying for pregnancy. PCOS can sometimes show up as irregular menstrual periods or not ovulating on a predictable schedule. Taking at-home Ovulation Prediction Tests can help to get an idea of if your body is releasing an egg every month. A common first line treatment for folks with PCOS who desire pregnancy is the use of a daily medication called Metformin. Metformin is working to change the way your body processes insulin, which in turn has an effect on the reproductive hormones and can help promote regular ovulation. If pregnancy is not achieved within a few months of starting Metformin, then we can move on to other steps. 

For others with PCOS the most troublesome symptom is irregular or absent menstrual periods. While maintaining a healthy weight and lifestyle can help with regulating cycles, hormonal contraception is a common tool for folks who do not desire pregnancy in the immediate future. Hormonal birth control is used to either make periods more predictable or to suppress your menstrual cycles altogether. Options include pills, patches, rings, Depo Provera injections, or a hormonal IUD. 

Finally, others find the cosmetic effects of PCOS to be distressing. Some people with PCOS can have more hair growth or acne on the face, chest, or stomach, and sometimes PCOS can make maintaining a healthy weight more difficult. Medications like spironolactone can help with acne and unwanted hair growth and weight loss medications like GLP1s or oral options can be useful tools, though these sometimes require the use of reliable birth control due to risks of use during pregnancy and will need to be managed by your primary care provider. 

Wrap Up

PCOS can have an effect in many areas of your life and can span a lifetime. Covington Women’s Health Specialists is here to help on your journey to diagnosis and management and will help on the journey to your healthiest, happiest life. If you have a diagnosis of PCOS or suspect you may have it, schedule an appointment with one of our women’s health providers today so we can begin your care together!

Parking Update for Our Patients

At Covington Women’s Health Specialists, we are committed to making your visit as smooth and stress-free as possible. Due to our location on the Piedmont Newton campus, parking availability is currently limited.

We kindly ask all patients to plan ahead and allow extra time to find parking prior to their appointment. As a reminder, patients should continue to arrive 15 minutes before their scheduled appointment time to ensure a timely and efficient check-in process.

To help support our OB patients during this time, partners are welcome to drop patients off at the entrance so they can arrive on time, then park and join the appointment as soon as they are able.

We understand that this situation may be frustrating, and we truly appreciate your patience and flexibility as we work toward longer-term solutions. Your care and experience remain our top priorities.

Understanding the Impact Menopause Has on Your Bones

Previously, we discussed how menopause brings changes to your muscles. As we continue exploring the ways menopause affects the body, it is important to highlight its impact on bone health, another significant change that often happens quietly behind the scenes.

Bone loss during menopause is common, but it is not inevitable. Understanding what happens and how to respond can help you protect your strength and independence for years to come.

Why Does Menopause Affect Bone Health?

Estrogen plays a critical role in maintaining bone density. Throughout our reproductive years, estrogen helps keep a healthy balance between bone breakdown and bone rebuilding.

When estrogen levels decline during perimenopause and menopause, that balance shifts. Bone is broken down more quickly than it is rebuilt. As a result, women can lose bone density at an accelerated rate, particularly in the first several years after menopause.

This natural process increases the risk of osteopenia (mild bone loss) and osteoporosis (more significant bone thinning), which can raise the likelihood of fractures.

How Much Bone Loss Is Normal?

Some bone loss is expected with aging. However, women can lose up to 20% of their bone density in the first five years after menopause. After that, bone loss continues at a slower pace.

Because bone loss does not cause symptoms, many women are unaware it is happening until a fracture occurs. That is why screening and prevention are so important.

Risk Factors for Osteoporosis

While menopause itself is a major risk factor, other factors can increase a woman’s risk of bone loss, including:

  • Family history of osteoporosis
  • Small body frame
  • Smoking
  • Excess alcohol use
  • Low calcium or vitamin D intake
  • Sedentary lifestyle
  • Certain medications, including long-term steroid use

Understanding your personal risk factors helps guide decisions about screening and prevention.

The Importance of Bone Density Testing

A bone density scan (DEXA scan) is a simple, noninvasive test that measures bone strength. Most women are advised to begin screening at age 65, but earlier testing may be recommended if risk factors are present.

This test allows us to detect bone loss early — before fractures occur — and create a plan to protect your long-term health.

What You Can Do to Protect Your Bones

The good news is that there are effective strategies to support bone health during and after menopause.

Strength Training and Weight-Bearing Exercise

Just as muscles respond to resistance, bones do as well. Weight-bearing activities such as walking, strength training, and resistance exercises stimulate bone formation and help maintain bone density.

Adequate Calcium and Vitamin D

Calcium provides the building blocks for bone, while vitamin D helps the body absorb it. Many women do not get enough of either. We can help determine whether dietary changes or supplementation may be appropriate.

Lifestyle Choices

Avoiding smoking, limiting alcohol, and maintaining a healthy weight all contribute to stronger bones.

Medical Therapies

For some women, medication may be recommended to slow bone loss or reduce fracture risk. Hormone therapy may also be considered in appropriate candidates, as estrogen plays a direct role in bone preservation.

Treatment decisions are individualized and based on overall health, risk factors, and personal preferences.

A Long-Term View of Women’s Health

Bone health is not just about preventing fractures, but also about preserving mobility, independence, and quality of life.

Menopause is a natural transition, but it is also an important time to reassess long-term health strategies. By addressing bone health early, we can help prevent complications later.

If you are approaching menopause, currently experiencing it, or have questions about your bone health, we encourage you to schedule a visit. Together, we can evaluate your risk factors, discuss screening, and create a personalized plan to support your strength for years to come.