Episode #191: Can You Actually Reverse PCOS?

Something that gets asked a lot is, can you reverse PCOS? It is one of the most searched questions in the entire PCOS web space, and depending on where you look, you will get very different answers.

Answer one: No, PCOS is a lifelong condition. You have it forever. Learn to manage it.

Answer two: Yes, follow this protocol and be completely cured in 30 days.

And if you’re like most women I talk to, neither of those answers has felt quite right, because one leaves you hopeless and the other leaves you confused when it doesn’t work. You also may not quite believe it when you’re seeing conflicting things every time you Google it.

So today, I want to offer the actual reality behind what’s going on with PCOS. What does healing and health with PCOS even mean? What are we talking about when we hear these buzzwords? And how do we understand what is true, scientifically backed information and what is marketing?

That’s what we’re going to get into today, so let’s dive in.

Welcome back to the PCOS Repair Podcast. Hi, I’m Ashlene. I’m your host here, and I’m really glad you’re here for this episode because this is something that I think trips people up and makes people, whether consciously or not, question if what they’re doing for their PCOS is actually going to work.

It also helps us set our expectations and develop the habits, lifestyle, and environment that our body needs in order to thrive and do well when we have PCOS.

If you’re new here, this is a place in the podcasting world where we talk about all things related to PCOS and its new name, PMOS, and all of the things that we can do to help manage our health.

No miracle promises. No doom and gloom. Just real, science-grounded conversations that are going to help you actually navigate what’s going on in your body.

So today, we are tackling a big question in the PCOS world: Can you actually reverse it?

Now, I like the phrase “reverse it” because when we use the word reverse, we’re really talking about the symptoms.

PCOS has a genetic component, but it’s really driven by our environment. When we change our environment, we can change the entire picture of what we’re dealing with when it comes to PCOS. It’s kind of crazy, really.

I think most people find that when they start eating better and getting enough sleep, they feel better. But when it comes to PCOS, not only do we feel better, we may stop getting as many new chin hairs, our cycle returns, and all sorts of things begin falling into place that were frustrating us before.

So let me start by addressing both ends of this conversation, because I think the extremes are where we tend to lose credibility in the online space.

First, there can be a very strict and rigid dialogue that says PCOS is forever. Your hormones are what they are, you have the genetics that you have, and what we need to work on is managing the symptoms.

I understand why this narrative exists because it is grounded in scientific fact. However, it’s a very short-sighted and not very well-educated scientific response to what is actually going on in the body when it comes to PCOS.

PCOS is very complex, and our bodies are very complex. This really comes down to the fact that, yes, it is a lifelong genetic condition, but there is also something called epigenetics.

Genetics actually respond differently in different environmental settings. So while our DNA doesn’t change, and our sensitivities to certain things don’t change, the way those genes are expressed can change.

In other words, if we went back to our old habits, our symptoms would probably return. But we can absolutely reverse those symptoms.

Now, that doesn’t mean that we’re completely free of every issue with our body. We may still be slightly more prone to hair loss. We may be more prone to hair growth and simply be a hairier person than someone else. We may be more prone to not having perfectly clockwork, extremely fertile cycles.

But we can take ourselves from where we’ve been—where we’re missing our cycle altogether—and get to a place where most of our cycles are healthy, fertile cycles.

These things really do change when we manage our PCOS from a lifestyle and environmental standpoint.

I think it’s really important to recognize this, and I think it does women a disservice when people get overly hung up on the “you cannot cure PCOS” conversation.

The word cure really shouldn’t be used because cure makes it sound like if you take a medication, everything goes poof and gets better, like waving a magic wand. And that’s not exactly true.

But if you completely change your environment, it can feel like you’ve waved a magic wand and everything begins improving.

Both of those ideas are scientifically based situations.

Now I want to dive into what it actually means and what is going on behind the scenes when people like me talk about reversing PCOS and what it means to be working on the healing phases of lifestyle adjustments and environmental changes to improve our PCOS hormones.

Because we are healing in a way.

We’re not curing, but people get frustrated with the words. Basically, what we’re doing is balancing those hormones, and we’re doing it from the root cause.

The things that were unbalanced, the things that were out of whack, begin coming back into balance. As we repair things from the root cause and support our body in the systems that are causing those superficial hormones to lead to all of these problems—acne, hair growth, hair loss, irregular cycles, fertility issues, and weight struggles—we begin changing the entire hormonal cascade.

If we get into those metabolic pathways and endocrine pathways and improve things, the whole cascade that follows begins to improve.

So when women are asking questions like, “How can I reverse my PCOS? Can I improve my PCOS? How can I feel better? Can my cycles be regular again? Can I get my energy back? How do I manage these cravings? Will I ever be able to have clear skin? Will I ever be someone who is actually able to ovulate without medication?”

The answer to all of these questions is yes.

Now, some women’s bodies respond more easily. Some bodies respond with more difficulty. And if your body is having a hard time responding, I would say that it’s probably because there are still some missing pieces.

Maybe you’re not fully understanding what’s going on in your body. Maybe we’re not addressing all of the root causes. Or maybe there’s something besides PCOS going on in addition.

Because if insulin is our problem and we improve our insulin sensitivity, it has been shown over and over among diabetic patients for decades that we can actually manage diabetes through lifestyle.

Now, some people have a difficult time doing that, but that doesn’t mean it doesn’t work. Some people have other things going on, or the disease process has progressed to a point where medications are necessary.

And there is no failure in needing some additional help beyond environmental changes alone.

But when we pinpoint what’s happening, these things work.

So if we’re struggling, it usually means something is still not working for our body.

Our body is also extremely adaptable. It’s one of the reasons we can function as well as we do with PCOS.

Now, we may not feel that way because we don’t like having chin hairs. We don’t like having a receding hairline. We don’t like acne. And when we want to get pregnant, we don’t like the cycle issues that come along with PCOS.

However, our body is functioning because it’s adapting to an environment that isn’t exactly working for it.

Sometimes, because of that, it can be difficult to pinpoint what is actually going on.

But as we start making improvements, our body is also very good at adapting back. It is able to reverse the symptoms that are bothering us.

This is one of the most amazing things about the human body. It’s one of the things that made me so excited while I was studying medicine and learning about the human body.

I think it’s incredible that our body is so adaptable to its environment.

I’ve seen women regain their cycle after not having a regular cycle for more than six years.

 

And I’ve seen women who have had energy returned to them in a way where they don’t even remember feeling like that before. Maybe they never did.

I’ve seen ovulation return. I’ve seen it myself. I wasn’t ovulating for over eight months before I had my first child. Even between my second and third pregnancies, I saw a point where, if my health was in one state, there were no regular cycles and no ovulation. As soon as I crossed that threshold, it was like, boom—my body worked again.

It’s kind of crazy.

For me, it’s actually a fairly narrow window where my body functions well. For some people, they actually have a wider window. It’s really a matter of finding that window and not getting too sucked into what other people say, but instead finding that window for yourself.

For example, people told me, “Oh, you’re already thin enough. You shouldn’t lose any more weight.” I actually have a really thin frame. I don’t have a very stocky build. So for me, the scale number and the BMI tend to be a little bit lower.

But when I actually go and check things with more advanced methods, like looking at my body fat percentage and really evaluating body composition—which is honestly much more reliable and much more useful than BMI—my numbers aren’t actually that great.

It’s not that I have to be extremely thin. It’s that BMI isn’t a great measurement for me because I don’t naturally carry very much muscle. I’m someone who has to work really hard to build muscle.

Doctors would look at my BMI and say, “Oh, your BMI is reasonable. You shouldn’t have to lose any more weight for your PCOS.”

But I personally know the window where my body is happiest.

It’s not an extremely low weight. It’s just slightly lower than where other people might think is necessary.

I also know other women who can be twenty or thirty pounds heavier than me, have a higher BMI than I do, and they do great there.

So it’s really about finding your own sweet spot—both in your weight, how strict your nutrition needs to be, how much sleep your body requires, and so many other things that influence how your body functions.

Some people’s bodies are very particular. They’re basically saying, “I’m not going to recover until we get to this point.”

Other people’s bodies are much more flexible. They’re like, “Oh yeah, I can handle that. That’s fine.”

It’s very individual.

So let’s talk a little bit about the physiology, because I think understanding this makes everything start to make more sense.

When we talk about hormones, these are basically little communication molecules. You can think of them as tiny text messages traveling around your body.

They’re also part of a series of feedback loops.

As these little chemical messengers travel throughout your body, they turn different systems on and off, a lot like a thermostat.

If we get enough of one hormone, it sends a message to stop making more of that hormone, while allowing other hormones to increase. Once those hormones reach the level they’re supposed to, they send messages to turn themselves off and activate the next step.

A simple example is what happens when we eat carbohydrates.

Let’s say you eat a candy bar. That candy bar is digested very quickly, and the sugar enters your bloodstream as glucose. Your blood sugar rises rapidly.

That increase sends a message through hormones telling your pancreas to release insulin.

Your pancreas releases insulin based on the magnitude of the message it receives—essentially, how much glucose your body now has to deal with.

Then it waits.

If the blood sugar doesn’t start coming down as quickly as expected, it releases a little more insulin.

That insulin sends messages to your cells—your muscle cells, brain cells, and all the other cells throughout your body—telling them to open up and take in glucose.

As those cells absorb the glucose, your blood sugar comes back down.

Then your blood sugar sends another message that says, “We’re good now. We don’t need any more insulin.”

That’s really what hormones are.

They’re these little communication molecules constantly talking back and forth throughout the body.

When we adjust our environment, we change those conversations.

Every input your body receives influences that communication. It tells your body how reactive it should be, how much of a hormone should be released, and over time, those communication systems can even become sluggish if they’re constantly receiving the same signals.

Think about talking to a young child—or even a dog.

If you keep saying the same thing over and over, eventually they start tuning you out.

If you tell your dog to sit one time and mean it, the communication stays very clear.

But if you’re constantly repeating commands over and over, eventually the dog just stops paying attention.

Our bodies can do something similar.

If our blood sugar stays high over and over and over again, our body keeps saying, “Release insulin. Release insulin. Release insulin.”

Eventually, the pancreas starts getting worn out. It’s almost like it’s saying, “You’re always asking me for more insulin.”

This is part of the progression toward insulin resistance.

Over time, insulin resistance can progress to type 2 diabetes, and eventually, for some people, to needing medications or even insulin itself.

The same concept applies to ovulation, energy, cycle regularity, cravings, inflammation, and metabolism.

These aren’t fixed systems.

They’re dynamic.

As our environment changes, the communication inside our body changes, and those systems change along with it.

So when we talk about healing—or improving—PCOS, it’s rarely a perfectly straight line upward.

Understanding that ahead of time makes the process much less discouraging.

Here’s what’s usually happening.

Your body has spent years functioning in a particular physiological state—whether that’s insulin resistance, chronic stress, elevated cortisol, inflammation, or one of the other PCOS root causes.

Your body has become familiar with that environment.

Take cravings, for example.

Over time, those cravings don’t just stay cravings—they become habits.

Maybe every night after dinner you crave something sweet.

At first, that craving came from your physiology. But after responding to it over and over again, it also became a habit.

Now you have both a physiological craving and a psychological habit.

Your body expects that little blood sugar spike after dinner, and your brain expects the routine.

That can take a little while to change.

Understanding this helps explain why things can feel difficult for a while, even though your body is actually responding.

Your physiology may begin improving before your brain fully rewires the habit.

That’s not failure.

That’s simply understanding what genuine healing and environmental change actually look like.

Sustainable changes happen when we give our body time to adapt, rather than expecting dramatic results overnight.

 

So as we think about what it looks like to reverse PCOS, improve PCOS, or heal PCOS—whatever terminology resonates most with you—I want you to recognize that it’s really about creating an environment where your body is finally able to function the way it was designed to function.

Your body wants to heal.

Your body wants to ovulate.

Your body wants to have steady energy.

Your body wants to maintain a healthy weight.

Your body wants to have healthy skin and healthy hair.

These are all things that your body is naturally designed to do.

The challenge is that your body has adapted to an environment that it perceives isn’t safe enough or supportive enough to prioritize those things.

When we begin changing those signals, little by little, your body begins changing the way it responds.

That doesn’t mean everything changes overnight.

In fact, most of the time it doesn’t.

This is where I think women become discouraged because they’re looking for dramatic changes after a week or two. But hormones simply don’t work that quickly.

Remember, your body is constantly evaluating whether this new environment is actually going to stay this way.

Think about it from an evolutionary standpoint.

If food suddenly became plentiful for one week after months of famine, your body wouldn’t immediately assume the famine was over.

It would wait.

It would watch.

It would collect more information before deciding it was safe to change.

Your hormones work very similarly.

Your body wants consistency.

It wants repeated signals that say, “This environment is different now.”

That’s why creating consistent daily habits is so much more powerful than being perfect for a week.

This is also why I encourage women to stop looking at each individual day as either successful or unsuccessful.

Instead, start looking at weeks.

Then months.

Ask yourself questions like:

“Am I doing better this month than I was last month?”

“Are my meals more supportive overall?”

“Am I sleeping a little better?”

“Is my stress recovery improving?”

“Am I moving my body more consistently?”

Because those are the questions that actually predict whether your hormones are heading in the right direction.

One meal doesn’t create insulin resistance.

One workout doesn’t heal PCOS.

One stressful day doesn’t undo months of progress.

Your body is always looking at the overall pattern.

And that’s exactly what I want you to begin doing as well.

Sometimes women ask me, “How will I know if it’s working?”

There are actually a lot of little clues before your period ever becomes regular.

Maybe you notice you’re waking up with a little more energy.

Maybe your afternoon crash isn’t quite as severe.

Maybe your cravings aren’t quite as intense.

Maybe your sleep starts becoming deeper.

Maybe you’re noticing your mood is more stable throughout the day.

Those are all signs that your physiology is beginning to change.

Those are wins.

Don’t overlook them simply because your cycle hasn’t fully regulated yet.

Your body is giving you feedback every single day.

We just have to learn how to recognize it.

Then, over time, those smaller improvements start stacking together.

Energy improves.

Inflammation decreases.

Blood sugar becomes more stable.

Ovulation becomes stronger.

Progesterone improves.

Cycles become more predictable.

Symptoms begin fading.

Not because we forced them away, but because we changed the environment that was creating them.

That’s a completely different way of thinking about health.

Instead of asking, “How do I make this symptom disappear?”

We begin asking, “What environment do I need to create so my body no longer needs to produce this symptom?”

That question changes everything.

It moves us away from fighting our bodies and toward partnering with them.

And honestly, that’s one of the biggest mindset shifts I hope you take away from today’s episode.

Your body is not working against you.

It’s working for you based on the information it’s receiving.

Our job is simply to change the information.

We do that through nutrition.

We do that through movement.

We do that through improving sleep.

We do that through managing stress.

We do that through supporting our nutrient status.

We do that through understanding our root causes.

Each one of those sends little signals to your body that say, “Things are becoming safer.”

As those signals become stronger and more consistent, your hormones begin responding differently.

That’s why I always say PCOS isn’t just about balancing hormones.

It’s about creating an environment where hormone balance naturally becomes possible.

That’s a much more sustainable approach because it doesn’t rely on willpower forever.

It relies on creating habits and routines that become part of your everyday life.

Eventually, you stop feeling like you’re “on a PCOS plan.”

You’re simply living in a way that supports your body.

And that’s ultimately the goal.

Not perfection.

Not restriction.

Not constantly wondering if you’re doing enough.

Just creating a life where your body feels supported, nourished, and safe enough to function the way it was designed to.

As we wrap up today, I want you to remember this:

Healing PCOS isn’t about becoming perfect.

It’s not about finding the one magic supplement, the one perfect workout, or the one perfect meal plan.

It’s about learning to understand your body well enough that you begin giving it what it’s actually asking for.

When you do that consistently, your body starts responding differently.

Your symptoms begin changing because the environment that created those symptoms has changed.

And that’s the goal.

If you’re feeling like you’ve tried everything, I hope today’s episode gave you a little bit of hope. Maybe it helped you realize that it isn’t about trying harder. Maybe it’s about trying differently.

Maybe it’s about understanding your body more deeply instead of searching for the next quick fix.

Because once you understand your body’s patterns, your root causes, and the signals it’s sending you, your health journey becomes so much less frustrating.

Instead of constantly wondering, “Why isn’t this working?” you begin asking, “What is my body asking for next?”

That simple shift changes everything.

If you’re ready to better understand your own patterns, I encourage you to start with the free PCOS Root Cause Quiz. It’s designed to help you identify the primary driver behind your symptoms and give you a clearer direction instead of leaving you guessing. I’ll link it in the show notes below.

And if you’re ready to go even deeper, the PCOS Root Cause Bootcamp walks you step by step through understanding your root causes, creating your personalized healing plan, and learning exactly how to build an environment where your body can thrive.

Remember, this isn’t about doing everything perfectly.

It’s about making steady progress.

It’s about learning your body.

It’s about creating habits that become part of your lifestyle instead of something you have to force yourself to do.

Those small, consistent changes are what create lasting hormone balance.

Thank you so much for spending part of your day with me. I truly hope this episode helped you see your PCOS in a different light and gave you a little more confidence moving forward.

If you found today’s episode helpful, I would love it if you would hit that subscribe button on whatever podcast platform you’re listening on. That way you’ll be notified each and every week when a new episode becomes available to support you on your PCOS healing journey.

And if you know someone else who has PCOS and has been feeling stuck or discouraged, I hope you’ll share this episode with them. Sometimes one new perspective is all it takes to completely change the direction of someone’s health journey.

Until next time, bye for now.