Understanding PCOS: A beginner’s guide for Nigerian women

When Lara was 23, she thought her irregular periods and stubborn acne were just from stress, especially Lagos stress. 

But when she started spotting for weeks non-stop, noticing unusual hair growth on her chin and couldn’t lose weight no matter what diet or gym plan she tried, she sensed something was wrong.

After hopping from one clinic to another in Lagos, enduring confused looks, incomplete tests, and the typical “just try to lose weight” or “come back when you’re married” advice, Lara finally got a diagnosis that made sense: Polycystic Ovary Syndrome, or PCOS.

If you’re experiencing similar PCOS symptoms, you’re definitely not alone. And no, it’s not your fault. 

Many Nigerian women face the same struggles with PCOS, and understanding it is the first step to feeling better. 

What exactly is PCOS?

PCOS is a hormonal disorder that affects how your ovaries function. 

Despite the name “polycystic,” you don’t have to have cysts on your ovaries to have PCOS. The real issue is a hormonal imbalance that disrupts ovulation and causes symptoms like irregular or missed periods, unwanted hair growth, acne, and other symptoms.

How is PCOS diagnosed?

Doctors diagnose PCOS using the Rotterdam criteria. This means you need at least two of the following:

• Irregular or absent menstrual cycles

• Signs of high androgen levels (like excess hair growth or acne)

• Polycystic ovaries seen on an ultrasound scan

But diagnosis isn’t always straightforward. Other conditions, like thyroid problems or hormonal imbalances, must be ruled out first. 

Don’t hesitate to ask your doctor if other causes for your symptoms have been ruled out. You 'll need to advocate for yourself. 

Many women in Nigeria with PCOS find that their symptoms are often overlooked, especially in busy clinics or general hospitals. That’s why understanding the diagnostic criteria is essential. It’s your right to get a thorough PCOS diagnosis.

What causes PCOS? 

Scientists haven’t identified a single cause for PCOS, but they know several key factors are involved:

• Insulin resistance and PCOS: Many women with PCOS have trouble processing insulin, a hormone that regulates blood sugar. Think of insulin like a key meant to open your cells to absorb sugar. In PCOS, the key doesn’t work well, so sugar builds up in the blood, and your body responds by making more keys (insulin), which causes more chaos. This affects ovarian function leading to symptoms like weight gain, acne, and irregular periods.

  
  

• Hormonal imbalances: High levels of luteinizing hormone (LH) and androgens which can interfere with ovulation, causing missed or irregular periods.

  
  

• Genetics: PCOS often runs in families, so if your mum or sister has it, your risk might be higher.

  
  

• Chronic low-grade inflammation: Low-grade inflammation might worsen hormone imbalances and insulin resistance.

  
  

What does PCOS look like in real life?

PCOS symptoms can vary widely, but many Nigerian women notice:

• Missing periods for months at a time

• Excess hair growth in places that is typical for a male like the chin, chest, or stomach

• Hair thinning on the scalp

• Painful acne that doesn’t go away

• Weight gain, especially around the belly (PCOS weight gain is common and frustrating). Not all women with PCOS are overweight, some present as lean type and might find it difficult to gain weight.

• Dark patches of skin on the neck or underarms

• Difficulty getting pregnant

  
  

You don’t need to have all of these symptoms to have PCOS, sometimes just a few can signal the condition.

Why PCOS is more than just a period problem

PCOS affects your whole body, not just your reproductive system. If left unmanaged, it increases the risk of:

• Type 2 diabetes

• High blood pressure and cholesterol

• Fatty liver disease

• Sleep apnea and snoring

• Mental health issues like anxiety and depression

• Endometrial cancer due to irregular shedding of the uterine lining

This is why early diagnosis and care for PCOS  matter, not just for fertility but for overall health.

Practical tips to manage PCOS

While there’s no one-size-fits-all cure, many women find relief by combining lifestyle changes and medical care.

Lifestyle Tweaks

• Whether you're overweight or lean, adding more movement to stimulate your muscle would help improve insulin sensitivity and ease PCOS symptoms. Move your body daily by walking or dancing. You can start with at home exercises found on YouTube. The key is to be consistent. 

  
  

• For a healthy PCOS diet, focus on eating  fibre-rich foods like okra, beans, lean proteins like titus fish, plus healthy fats from foods like avocado. Swap processed foods like white rice, white bread, and semo for whole options like ofada rice, sweet potatoes, and oats.

  
  

• Fast intermittently by spacing out your meals to allow your body enough time to digest food and move on to healing. Eating at time intervals less than 4 - 5 hours might keep insulin levels elevated in the body and worsen PCOS symptoms. 

  
  

• Drinks lots of water, it helps flush out toxins from the body. General recommendations for women are 2-3 liters per day but listen to your body. Look at the color of your pee, aim for light colored. If it's too dark, you know you need more water.

Medications

Depending on your symptoms, doctors might suggest:

• Birth control pills to regulate periods and reduce acne/hair growth

• Metformin to improve insulin resistance

• Anti-androgens (with monitoring)

• Fertility drugs if pregnancy is your goal

• Supplements if tests show you're lacking in certain vitamins and minerals. 

Mental Health Matters

This is a lot less talked about in Nigeria for PCOS women. PCOS can affect your mood and self-esteem. If you’re struggling with anxiety or depression related to PCOS, you’re not alone. 

Mental health and PCOS are closely linked, but often overlooked in African conversations.

Don’t hesitate to seek counseling, try journaling to manage stress and anxiety or join support groups. 

Being part of a support group like the PCOS Conquerors WhatsApp community gives you a safe space to vent, ask questions, and feel seen, something that can make a big difference in your emotional wellbeing. 

Now that you have a better understanding of PCOS, you're equipped to make better decisions and thrive. So, what’s next?

• Watch this powerful documentary 'Where the Heck Is My Period' about 10 phenomenal African women, including PCOS Conquerors community members and founder, who share their unspoken challenges of living with PCOS. It's currently streaming on Amazon Prime Video.

Disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider regarding any medical concerns, symptoms, or conditions, including Polycystic Ovary Syndrome (PCOS). The experiences shared here are meant to reflect common realities faced by Nigerian women with PCOS, but every woman’s journey is different. Do not ignore or delay seeking professional help based on something you’ve read here.

If you suspect you have PCOS or any other health condition, please speak to your doctor or a licensed healthcare professional.

References

1. MedlinePlus. (2024). Polycystic Ovary Syndrome. U.S. National Library of Medicine. https://medlineplus.gov/polycysticovarysyndrome.html

2. Velissariou, M., Athanasiadou, C. R., Diamanti, A., Lykeridou, A., & Sarantaki, A. (2025). The impact of intermittent fasting on fertility: A focus on polycystic ovary syndrome and reproductive outcomes in women—A systematic review. Metabolism Open, 25, 100341. https://doi.org/10.1016/j.metop.2024.100341

3. Centers for Disease Control and Prevention (CDC). (2023). PCOS and Your Health. https://www.cdc.gov/diabetes/basics/pcos.html

4. Endocrine Reviews, Volume 37, Issue 5, 1 October 2016, Pages 467–520.  https://doi.org/10.1210/er.2015-1104

5. Dybciak, P., Raczkiewicz, D., Humeniuk, E., Powrózek, T., Gujski, M., Małecka-Massalska, T., Wdowiak, A., & Bojar, I. (2023). Depression in polycystic ovary syndrome: A systematic review and meta-analysis. Journal of Clinical Medicine, 12(20), 6446. https://doi.org/10.3390/jcm12206446