The Wellness Collective

Why PCOS Is Still So Misunderstood — Even by Doctors

Reviewed by Adam Gardner, Licensed Pharmacist & COO of TelyRx

A woman performs her self-care routine with nail polish and acne cream.
A woman performs her self-care routine with nail polish and acne cream.

Table of Contents

Here’s something that might surprise you: Polycystic Ovary Syndrome (PCOS) affects roughly 1 in 10 people assigned female at birth—that’s an estimated 6–13% of reproductive-aged women.

Yet somehow, countless patients spend years bouncing between doctors, being undiagnosed or misdiagnosed, receiving conflicting information, or being told their symptoms are “just part of being a woman.” Sound familiar?

Even with increased awareness in recent years, PCOS still remains deeply misunderstood — not just among the general public, but within the healthcare system itself. Misconceptions, outdated training, weight bias, and a lack of research funding have all contributed to widespread diagnostic delays and treatment gaps.

Let’s explore the complex nature of PCOS, what a delayed diagnosis actually costs women both emotionally and physically, and how we can all push for the care, validation, and positive outcomes that everyone deserves.

what is pcos — and why is it so complex?

what is pcos infographic via TelyRx
An infographic explaining PCOS via TelyRx.

Simply put, PCOS, or Polycystic Ovary Syndrome, is a hormonal and metabolic disorder that affects ovulation, insulin regulation, and androgen (male associated hormone) levels. Despite being called “Polycystic Ovary Syndrome,” not everyone with PCOS actually has ovarian cysts — and not all cysts indicate PCOS either. Confusing, right?

Diagnosis is often based on a system called the Rotterdam Criteria, which requires you to have two of the following three symptoms:

  • Irregular or absent menstrual cycles
  • Signs of excess androgens (acne, facial/body hair, hair thinning)
  • Polycystic ovaries seen on ultrasound

Because PCOS is a syndrome, it looks different from person to person. Some may struggle with infertility and irregular periods. Others may have regular cycles but battle severe acne, insulin resistance, or mood swings.

Common PCOS symptoms include:

  • Irregular periods or no periods at all
  • Weight gain or difficulty losing weight
  • Persistent acne and oily skin
  • Excess hair growth on the face, chest, or back
  • Thinning hair on the scalp
  • Constant fatigue
  • Mood changes, anxiety, or depression
  • Insulin resistance or prediabetes

This huge range of symptoms is exactly why it can be so hard to directly diagnose PCOS. It’s also why you can spend months or years treating the wrong condition.

PCOS is even more frequently missed in patients of color, trans or nonbinary individuals, and people in larger bodies, due to both implicit bias and the narrow lens of traditional medical training.

why pcos is often missed or dismissed

A doctor consults a patient on PCOS symptoms.
A doctor consults a patient on PCOS symptoms.

Despite its prevalence, up to 70% of people with PCOS remain undiagnosed, according to the U.S. Department of Veterans Affairs. To make matters worse, a PCOS diagnosis takes 3 or more doctors over the course of over two years, on average, to accomplish.

Why the delay?

  • Medical dismissal – Many patients are told to “just lose weight” or are handed birth control without further explanation
  • Provider gaps – PCOS isn’t emphasized enough in medical education unless a provider specializes in endocrinology or reproductive medicine
  • Racial disparities – Black and Hispanic patients face longer diagnostic delays and are less likely to receive specialized care

Unsurprisingly, with factors like these at play, a PubMed study showed 60% of women said they were not given any information about PCOS, even after being presented with a diagnosis.  And yet, most of the participants in the study had a strong understanding of PCOS — but not because their doctor explained it to them.

Instead, they said they had to piece it together themselves through independent research. For many, this isn’t just frustrating — it’s traumatic. Patients spend years questioning themselves, googling their symptoms, trying diet after diet, and wondering why they feel so out of sync with their own bodies. The emotional toll is immense, especially when they get no answers from the medical professionals whom they turn to for help.

why even doctors get pcos wrong

The root of the problem starts in medical school, where most providers receive limited training in female-specific endocrinology, let alone nuanced care for syndromes like PCOS.

Let’s look at some of the biggest polycystic ovary syndrome myths that trip up even the most well-meaning doctors, and how these myths impact patient care:

Myth 1: PCOS is solely a fertility issue

PCOS is often discussed only in relation to infertility, when in reality, it’s a lifelong metabolic and hormonal condition that requires ongoing care. Patients who aren’t trying to conceive are often ignored or told to “come back when they want kids.” While likely unintentional, this approach sends the message that a woman’s hormone health is only worth optimizing when it serves a reproductive purpose.

Myth 2: Weight is always the problem  

Many providers automatically blame excess weight for PCOS symptoms without further investigation. Too often, this leads to superficial advice (“lose weight”) rather than addressing underlying insulin resistance or hormonal imbalances. It also discourages patients in smaller bodies from being taken seriously.

Myth 3: Normal labs rule out PCOS

There’s no single blood test for PCOS. Diagnosis is clinical, which means it’s based on the presence of certain symptoms and the exclusion of other conditions. Still, some providers will dismiss PCOS if testosterone or other hormone levels appear “normal,” even though many PCOS patients have normal-range results. 

Myth 4: If it looks like something else, it can’t be PCOS  

PCOS symptoms overlap with other issues like hypothyroidism, depression, or perimenopause. Without a holistic view, providers often miss the diagnosis completely or focus on the wrong condition.  

Myth 5: Old knowledge is good enough

Medical understanding of PCOS keeps evolving, but some providers are still relying on outdated criteria or ignoring newer research about the role that inflammation, gut health, and androgens play in a woman’s health.

Until medical education prioritizes PCOS training, too many patients will continue to fall through the cracks.

the emotional and physical toll of delayed or misdiagnosed pcos

A frustrated woman doing her own research on PCOS.
A patient ordering medication for her PCOS symptoms through TelyRx.

The consequences of delayed PCOS care go far beyond missed periods. Many patients spend years living with unexplained symptoms — and that emotional burden can be just as damaging as the physical ones.

The impact on a patient’s mental health is staggering:

  • Symptoms often diminish the sense of physical satisfaction, femininity, and overall mental health.
  • Roughly 37% of women with PCOS report symptoms of depression (compared to just 14.2% of women without PCOS), and 42% report symptoms of anxiety — nearly five times higher than their peers.
  • Body image issues and disordered eating can develop as a result of weight fluctuations and unkind medical messaging.
  • Being dismissed repeatedly creates a cycle of medical mistrust, shame, and self-doubt.
  • One study found that nearly one-third of PCOS patients had considered stopping care entirely due to feeling unheard.

The physical consequences add up, too:

  • Increased risk of Type 2 diabetes and insulin resistance
  • Higher rates of cardiovascular disease and high cholesterol
  • Greater risk of endometrial cancer risk (due to unopposed estrogen and missed periods)
  • Chronic fatigue, inflammation, and increased risk of sleep apnea

Most current treatments focus on symptom control, such as prescribing birth control for irregular periods, without exploring the root causes of why those symptoms are happening.

how to advocate for yourself if you think you have pcos

If you’re experiencing unexplained symptoms, like irregular periods, acne, or fatigue, and you suspect PCOS, trust your instincts and know that your experience is valid. You don’t need to wait years for answers.

Here’s how to push for the care you deserve:

  • Keep a detailed symptom journal. Track your cycle, mood, energy, skin changes, and hair growth. Patterns tell a story
  • Ask for comprehensive hormone testing. This may include testosterone, DHEAS, LH, FSH, insulin, A1C, and thyroid panels
  • Request a transvaginal ultrasound to check for polycystic ovarian changes
  • Ask your provider if they’re familiar with the Rotterdam criteria. If they’re not, that’s a red flag
  • Seek a second opinion. While the doctor loop can be frustrating, endocrinologists or OB-GYNs with PCOS experience can offer more specialized care
  • Connect with advocacy groups like PCOS Challenge or online patient communities – you’re not alone in this

how telyrx supports patients with pcos

A patient ordering medication for her PCOS symptoms from TelyRx.
TelyRx’s licensed pharmacies dispense only FDA-approved, pre-filled GLP-1 weight loss medications.

We believe patients deserve to be taken seriously — with no judgment, no delay, and no one-size-fits-all approach. We offer access to licensed providers who can prescribe evidence-based treatment options that actually address PCOS symptoms.

We offer:

  • Fast, discreet delivery
  • No forced subscriptions — order only what you need
  • Transparent pricing with no surprise fees

While we are not a substitute for your primary provider, we can make accessing the medications that help you feel your best more affordable and convenient.

You don’t need to navigate this alone. TelyRx is here to help.
Starting at $24.99

Metformin

Metformin is used to help regulate menstrual cycles, improve ovulation, and potentially reduce androgen levels and associated symptoms like hirsutism.

View
Starting at $24.99

Spironolactone

Spironolactone may be used to treat moderate to severe acne and excess facial hair in females with PCOS.

View
Starting at $22.99

Norethindrone-Ethinyl Estradiol

A combined oral contraceptive of estrogen and progesterone used to prevent pregnancy and ease PCOS symptoms.

View
Starting at $24.99

Norethindrone

Norethindrone is a progesterone pill used to prevent pregnancy and ease PCOS symptoms. Preferred for those with migraines or high blood pressure.

View

what better care could (and should) look like

Improving PCOS care means shifting away from patchwork treatment and toward comprehensive, multidisciplinary support. A better care model would include:

  • Weight-neutral approaches that prioritize metabolic health and mental well-being over BMI
  • Continuing education for providers on the complexities of PCOS
  • Greater funding for PCOS research. Among the 315 medical conditions that get federal support, PCOS ranks near the bottom
  • Public awareness campaigns showing that PCOS affects more than just fertility, and impacts people across size, race, and gender identities

PCOS is so much more than just a list of symptoms. For millions of women, it’s an ongoing experience that deserves understanding.

you’re not alone. you deserve answers.

Living with PCOS can feel isolating and overwhelming — especially when the healthcare system keeps letting you down. But that isn’t your fault.

It’s the system that needs to change, and change is happening. With growing advocacy, research, and patient-led education, the tide is turning. More providers are listening. More treatments are becoming accessible. More patients are speaking up.

You deserve answers. You deserve care that treats you like a whole person, not a collection of symptoms to be dismissed.

If you’re still searching for clarity, don’t give up. Keep asking questions, seeking second opinions, and lean on support communities that understand what you’re going through. PCOS might be complex but navigating it shouldn’t be this hard.

Let’s keep pushing for better care, together.

Disclaimer

This blog post is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. The content provided here is not a substitute for professional medical advice, consultation, or care from a qualified healthcare provider. Always seek the guidance of your physician or another licensed health professional with any questions you may have regarding a medical condition or treatment. Do not disregard or delay seeking professional medical advice based on information read on this site. Learn more about our editorial standards here.

Get relief from your PCOS symptoms without the endless doctor loop.

Start Your Rx Journey for $22