PCOS Treatment in Ontario

Polycystic Ovary Syndrome (PCOS) — recently renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS) — is a complex metabolic and hormonal condition that affects multiple systems in the body.

At Harmony Health & Hormones, care focuses on identifying underlying drivers, restoring hormonal balance, and improving long-term metabolic health.

Treatment is personalized and longitudinal, with an emphasis on both symptom relief and prevention of future health risks.

Understanding PCOS/PMOS

Despite its name, PCOS/PMOS is not primarily a condition of ovarian cysts.

It is best understood as a metabolic and endocrine disorder involving:

• insulin dysregulation
• androgen excess
• disrupted ovulation
• altered signalling between the brain and ovaries

These factors interact to affect reproductive, metabolic, and psychological health.

Common Signs of PCOS/PMOS

PCOS/PMOS can present differently in each individual.

PCOS/PMOS can also occur in individuals with normal body weight (“lean PCOS”).

What Is Happening Physiologically

PCOS/PMOS is driven by interconnected pathways:

Insulin Resistance

Many individuals with PCOS/PMOS have elevated insulin levels.

Higher circulating insulin:

• promotes fat storage
• disrupts normal ovulation
• stimulates ovarian androgen production

Androgen Excess

Increased androgens (including testosterone) contribute to:

• acne
• hirsutism
• scalp hair thinning

The ovaries are particularly sensitive to these hormonal signals.

Disrupted Ovulation

Hormonal imbalance interferes with normal follicular development, leading to:

• irregular cycles
• anovulation
• some people may have the characteristic “polycystic” ovarian appearance on ultrasound

Inflammation

Low-grade inflammation may contribute to:

• insulin resistance
• increased androgen production
• metabolic dysfunction

Co-Occurring Conditions

PCOS/PMOS is associated with increased risk of:

• insulin resistance and type 2 diabetes
• non-alcoholic fatty liver disease
• dyslipidemia
• sleep apnea
• anxiety and depression
• infertility
• endometrial hyperplasia and cancer

Early identification allows for targeted prevention.

How We Diagnose PCOS/PMOS

There is no single test.

Diagnosis is based on a combination of:

• menstrual history
• clinical signs (e.g., acne, hirsutism)
• laboratory assessment (androgens, metabolic markers)
• imaging when indicated

Diagnostic criteria typically include at least two of the following:

• irregular or absent ovulation
• clinical or biochemical signs of androgen excess
• polycystic ovarian morphology on ultrasound

PCOS/PMOS Across Life Stages

Adolescents

Diagnosis in teens requires careful evaluation, as cycle irregularity can be normal early after menarche.

Persistent symptoms such as:

• ongoing irregular cycles
• significant acne
• signs of androgen excess

may warrant further assessment.

Early intervention can reduce long-term metabolic risk.

Reproductive Years

PCOS/PMOS may present with:

• cycle irregularity
• difficulty conceiving
• metabolic symptoms

Many individuals conceive successfully with appropriate hormonal and metabolic support.

Later in Life

Some individuals are diagnosed later when patterns become clearer.

Even after menopause, underlying metabolic features of PCOS/PMOS may persist and continue to influence long-term health.

How We Treat PCOS/PMOS

Treatment is individualized based on symptoms, goals, and metabolic profile.

Metabolic Optimization

• addressing insulin resistance
• nutrition and lifestyle strategies
• targeted supplementation when appropriate

Hormonal Regulation

• cycle regulation strategies
• ovulatory support when indicated
• androgen management

Skin & Androgen Symptom Support

• acne management
• hair-related concerns

Fertility Support (when applicable)

• optimizing ovulation
• coordinating care where needed

Long-Term Risk Reduction

• monitoring glucose and insulin
• cardiovascular risk assessment
• endometrial protection when indicated

A Continuity Care Model

PCOS/PMOS is a long-term condition that benefits from ongoing care.

Your treatment includes:

• regular follow-up
• lab monitoring
• adjustment of therapies over time
• support through different life stages

Expected Outcomes

With appropriate care, many individuals experience:

• more regular menstrual cycles
• improved skin and hair symptoms
• improved energy and metabolic function
• better weight stability
• improved fertility outcomes
• reduced long-term health risks

Book a Consultation

PCOS/PMOS is common, affecting approximately 1 in 10 women and adolescents, yet it is often underdiagnosed or undertreated.

A comprehensive assessment can help clarify your diagnosis and guide a personalized plan.

Virtual care is available across Ontario.

References

Teede, H. J., et al. (2018). International evidence-based guideline for the assessment and management of PCOS.

Azziz, R., et al. (2016). Polycystic ovary syndrome.

Diamanti-Kandarakis, E., & Dunaif, A. (2012). Insulin resistance and PCOS.

Legro, R. S., et al. (2013). Diagnosis and treatment of PCOS: Endocrine Society guideline.