The Rising Awareness of PCOS and Overlapping Conditions
“Go see a gynecologist now,” she repeated. I had health scientist and dietician Charlotte Adema on the phone for an interview and, as often happens, found myself outlining my own case to her within ten minutes. My weight, the binge eating and the changes I’ve noticed since starting medication for diabetes. One surprising side effect is that I’m menstruating again for the first time in years. And consistently around the 14th of the month, which is also a first.
Menstruation had been, for years, a mass discharge of unused reproductive material. An abundance of blood, with days where it wasn’t even worth leaving the toilet. Anemia, fainting, and more of those obstacles led me to start taking the pill at age twelve and faithfully use a coil for years afterward.
PCOS: A Potential Underlying Factor
“Everything you’re telling me now also occurs with PCOS,” Charlotte interrupted my stream of consciousness. “Your binge eating, your weight, excessive hair growth, your irregular cycle. One can’t create a diagnosis based on this conversation, but it could be a reason to discuss this with your doctor and investigate further. The medication you’re taking for diabetes is sometimes used in PCOS, so it could be influencing your cycle.”
Naturally, I’ve already considered it and extensively Googled PCOS (Polycystic Ovary Syndrome). I know it’s a hormonal condition where follicles in the ovaries don’t mature properly, leading to irregular or absent menstruation, reduced fertility, and often increased male hormones. The result? Acne, hirsutism, and weight gain.
But what would a diagnosis even add at this point? Perhaps a bit simplistic, but I’ve already had children, my weight seems under control now, and I’m slowly entering menopause. “Precisely!” Charlotte emphasizes. According to her, I should investigate whether a diagnosis is possible given that my symptoms could worsen during menopause.
The Delay in Diagnosis and the Impact of Weight Stigma
The truth is, I already requested a referral from my doctor in 2018. I had a suspicion then, but had to push for it, as my doctor wanted to know what my specific request was. Did I seek to lose weight? Had I kept a food diary? My ADHD led me to leave the referral on my desk, and I delayed making an appointment for so long that shame overtook initiative. I didn’t know what to inquire or what I wanted, and I knew I just needed to eat less and exercise more.
“Not entirely,” says Charlotte. “Not because that basic advice isn’t correct, but because PCOS can make it more complicated. Many women find they hit a wall faster with the same ‘eat less and exercise more’ due to fluctuations in hunger, energy, sleep, or mood. They often need more than general advice.”
Research shows women are increasingly delaying seeking help, continuing to struggle, or believing they should solve it themselves. Delaying care ultimately leads to more complaints, more shame, or worsening conditions through experimenting with diet. We’re even seeing women in their twenties burning out whereas thinking it’s a matter of discipline.
ADHD and the Complexities of Weight Management
There’s that R-word again. Because not seeking specialist help is also about taking up space. There’s already little attention for women in healthcare, and if you’re also a larger woman, you can expect a deduction. First, lose weight. A survey by the Dikke Vinger foundation, which advocates for equality for larger people, found that 76 percent of respondents have experienced weight discrimination in healthcare. 80 percent also report postponing care for that reason.
This postponement also happens unconsciously. Now that I weigh less, I’ve noticed some complaints have disappeared that I never even recognized as such. The pain in my foot, for example, is gone, but it didn’t occur to me to consider the throbbing in my toes a complaint. I thought I just needed different shoes. The swelling in my ankle is gone, but I never really had trouble with it.
I already knew that being overweight wasn’t my favorite thing, even though I kept trying to relate to it. Now I’m only just realizing how much trouble it actually caused. Physically, but also from the struggle. ADHD contributes significantly to binge eating, due to the greater need for dopamine to even take action or regulate an overwhelming flood of impressions and emotions.
The impulsivity associated with ADHD makes it even easier to convince myself that a stroopwafel is a good idea. Add to that the hormonal challenges of PCOS and a blood sugar level like a wave pool, and I immediately understand why I’ve been so tired for years. Tired of trying, learning, getting up, and continuing. In that respect, I deserved to know earlier in life that my body could have used some help.
Beyond Discipline: Recognizing Medical and Mental Health Challenges
Discipline is just one of the flavorings in the menu of my healthy self, and not the main ingredient. This insight could have saved me so much self-hatred.
So, for the disguised insults (“You look good! Have you finally started exercising?”), the healthcare providers who dwell on your BMI (“Lose five percent first”), the know-it-alls in the comments (“You just need to stop stuffing your face, girl!”), and especially for the people in the back: extra weight can be a consequence of various medical and mental health challenges, and you should be able to ask for help with that. Always.
Did you know?
Charlotte Adema is an Obstetrics & Gynecology specialist practicing in Maywood, IL, with 2 years of experience (as of February 6, 2026).
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