Polycystic Ovarian Syndrome (PCOS) affects millions of women of reproductive age, and what makes it challenging in clinical practice is the way metabolic and hormonal pathways overlap.
The hormonal shifts associated with PCOS shape everything from cycle regularity to androgen activity. For providers, understanding these patterns helps make sense of why symptoms persist even when patients make thoughtful lifestyle changes.
Pellecome, founded by board-certified OB-GYN Dr. Enrique Jacome in Gladstone, NJ, has long been involved in advancing hormone science for providers nationwide. His background in BHRT informs many conversations about how hormonal physiology influences complex conditions like PCOS.
What Causes Hormonal Imbalance in PCOS
Insulin resistance plays a central role for many women. Even at a normal BMI, elevated insulin can push the ovaries to produce more androgens, which interferes with follicle maturation and ovulation.1
This imbalance contributes to irregular cycles, acne, and changes in hair growth. At the same time, communication between the brain and ovaries becomes disrupted. Faster GnRH pulsatility leads to higher LH levels, increasing androgen production further while FSH activity remains too low to support balanced estrogen and progesterone.
Because many women with PCOS do not ovulate regularly, progesterone often stays low, and estrogen can remain elevated for longer stretches than intended.1
Without the normal rise and fall of these hormones, cycles become unpredictable, and symptoms can intensify.
What Emerging Research Is Exploring
Although hormone therapy is not currently an established treatment for PCOS, some early exploratory work has looked at how modulating progesterone might influence symptoms in carefully selected cases.
A six-month pilot case using cyclic oral micronized progesterone showed shorter, more regular cycles and reductions in breast tenderness, cervical mucus, and fluid retention.2 Another small pilot combining progesterone with an anti-androgen reported patient-noted improvements in several hormone-linked symptoms.3 Broader research continues to highlight the role that hormonal rhythms play in metabolic and reproductive function, prompting interest in how future studies may expand this conversation.4
Hormone-related nutrients may also play a supportive role. Vitamin D has become a particular area of interest, as several reviews note an association between low vitamin D levels, insulin resistance, menstrual irregularity, and disrupted follicular development in women with PCOS.⁵ Some studies suggest supplementation may influence cycle patterns, AMH levels, and metabolic markers.5
Supporting Patients Through Informed, Hormone-Aware Care
PCOS will always require individualized management, and understanding the hormonal disruptions behind it helps guide clearer clinical decisions.
Pellecome is committed to supporting providers who engage deeply with hormone science, as reflected in our advancements in BHRT, our specialized supplements, and our work to streamline safe hormone delivery. From the Re3 Advanced Delivery System to comprehensive provider training and practice resources, our team helps clinicians expand their hormone-related services.
For more information about working with Pellecome, contact the team online or call 888-773-9969.
- Shukla A, Rasquin LI, Anastasopoulou C. Polycystic ovarian syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
- Shirin S, Murray F, Goshtasebi A, Kalidasan D, Prior JC. Cyclic progesterone therapy in androgenic Polycystic Ovary Syndrome (PCOS)-A 6-month pilot study of a single woman’s experience changes. Medicina (Kaunas) [Internet]. 2021;57(10):1024. Available from: http://dx.doi.org/10.3390/medicina57101024
- Cyclic progesterone and spironolactone treatment for polycystic ovarian syndrome (PCOS) [Internet]. Health Research BC. 2024 [cited 2025 Nov 26]. Available from: https://healthresearchbc.ca/award/cyclic-progesterone-and-spironolactone-treatment-for-polycystic-ovarian-syndrome-pcos
- Bo Y, Zhao J, Liu C, Yu T. Comparative efficacy of pharmacological interventions on metabolic and hormonal outcomes in polycystic ovary syndrome: a Network Meta-Analysis of Randomized controlled trials. BMC Womens Health [Internet]. 2025;25(1):64. Available from: http://dx.doi.org/10.1186/s12905-025-03594-6
- Mohan A, Haider R, Fakhor H, Hina F, Kumar V, Jawed A, et al. Vitamin D and polycystic ovary syndrome (PCOS): a review. Ann Med Surg (Lond) [Internet]. 2023;85(7):3506–11. Available from: http://dx.doi.org/10.1097/MS9.0000000000000879
