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    Lean PCOS: A Comprehensive Guide on Causes, Symptoms and Treatment


    Lean PCOS: A Comprehensive Guide on Causes, Symptoms and Treatment

    Updated on 21 December 2023

    Medically Reviewed by

    Dr. Shruti Tanwar

    C-section & gynae problems - MBBS| MS (OBS & Gynae)

    View Profile

    Polycystic ovary syndrome (PCOS) is a condition that affects millions of women worldwide. It is a hormonal disorder that causes enlarged ovaries with small cysts on the outer edges. While most people associate PCOS with weight gain and obesity, a significant percentage of women with PCOS are lean. In fact, up to 30% of women have lean PCOS.

    In this article, we will provide a comprehensive guide on PCOS in lean women, its symptoms, diagnosis, and lean PCOS treatment.

    What is lean PCOS?

    Lean PCOS is a subtype of PCOS that is not associated with obesity. Lean women with PCOS have a normal body mass index (BMI) but experience the same symptoms as those with PCOS. The exact cause is not yet fully understood, but it is believed to be related to insulin resistance.

    Insulin resistance is a condition in which the body's cells become less responsive to insulin, leading to higher insulin levels in the blood. This can cause the ovaries to produce more androgen hormones, leading to symptoms of PCOS.

    Women with lean PCOD or PCOS may also have higher levels of luteinizing hormone (LH) than normal, which can cause the ovaries to produce more androgens.

    You may also like: PCOS with Regular Periods: Understanding the Symptoms and Implications

    Lean PCOS Symptoms

    Here are seven common symptoms of lean PCOS:

    1. Irregular periods

    Women with this condition may have irregular periods or no periods at all because of the lack of ovulation.

    2. Acne

    Increased production of androgen hormones can cause acne in women.

    3. Hirsutism

    Women may also experience excessive hair growth on the face, chest, and back.

    4. Hair loss

    Androgen hormones can cause hair loss or thinning hair in women with this type of PCOS.

    5. Difficulty getting pregnant

    Lean PCOD or PCOS can also cause infertility due to the lack of ovulation.

    6. Mood swings

    Women may also experience mood swings due to hormonal imbalances.

    7. High cholesterol levels

    Women with this condition may have higher levels of LDL (bad) cholesterol and lower levels of HDL (good) cholesterol.

    Difference Between Lean PCOS and PCOS

    While lean PCOS and PCOS share many similarities, there are some key differences between the two conditions. Here are three differences between lean PCOS and PCOS:

    1. Body weight

    Women with PCOS are typically overweight or obese, while women with lean PCOS have a normal BMI.

    2. Insulin resistance

    Insulin resistance is more common in women with PCOS than in those with lean PCOS.

    3. Treatment

    Women with lean PCOS may respond differently to treatment than those with PCOS.

    How is Lean PCOD or PCOS Diagnosed?

    Diagnosing lean women with PCOD or PCOS involves a physical exam and a series of tests. The doctor will ask about the patient's medical history and symptoms, including menstrual history, acne, and hirsutism. They may also perform a pelvic exam to check for enlarged ovaries or cysts.

    Blood tests may also be performed to check hormone levels, including testosterone, LH, and follicle-stimulating hormone (FSH). An ultrasound may also be used to check for cysts on the ovaries.

    Lean PCOS Treatment

    While there is no cure for lean PCOS, there are several treatment options to manage symptoms and improve fertility, including:

    1. Lifestyle changes

    Eating a healthy diet and exercising regularly can help improve insulin resistance and reduce symptoms.

    2. Medications

    Birth control pills can regulate menstrual cycles and reduce lean PCOS symptoms. Metformin, a medication used to treat type 2 diabetes, can also help improve insulin resistance.

    3. Fertility treatments

    Women with lean PCOD who are trying to conceive may benefit from fertility treatments such as ovulation induction or in vitro fertilization (IVF).

    4. Surgery

    In rare cases, surgery may be recommended to remove cysts on the ovaries.

    5. Alternative therapies

    Some women may also benefit from acupuncture, yoga, or other alternative therapies to help manage symptoms.

    Foods to Include and Avoid in Lean PCOS Diet

    Here are five foods to include in a diet for lean women with PCOS:

    1. Whole grains

    Whole grains are a great source of fiber and can help improve insulin resistance.

    2. Lean protein

    Lean protein sources such as chicken, fish, and tofu can help regulate blood sugar levels.

    3. Fruits and vegetables

    Fruits and vegetables are rich in vitamins and minerals and can help improve overall health.

    4. Nuts and seeds

    Nuts and seeds are a good source of healthy fats and can help improve insulin resistance.

    5. Water

    Drinking plenty of water can help flush toxins from the body and improve overall health.

    You may also like: PCOD Diet: How the Right Diet Can Transform Your Life

    Here are five foods to avoid in a lean PCOS diet:

    1. Sugar

    Sugary foods and drinks can cause a spike in blood sugar levels and worsen insulin resistance.

    2. Processed foods

    Processed foods are often high in sugar and unhealthy fats and can worsen insulin resistance.

    3. Trans fats

    Trans fats are found in many processed foods and can contribute to inflammation and insulin resistance.

    4. Red meat

    Red meat is high in saturated fats and can worsen insulin resistance.

    5. Dairy products

    Some women with lean PCOS may be sensitive to dairy products, which can worsen symptoms.

    Final Thoughts

    Lean PCOS is a subtype of PCOS that affects women with a normal BMI. Understanding what is lean PCOS, its symptoms and treatment options can help women regain control of their hormonal balance and improve their overall health. While it may present unique challenges and symptoms compared to traditional PCOS, it is important to remember that it can still be managed effectively.


    1. Toosy S, Sodi R, Pappachan JM. (2018). Lean polycystic ovary syndrome (PCOS): an evidence-based practical approach. J Diabetes Metab Disord.

    2. Goyal M, Dawood AS. (2017). Debates Regarding Lean Patients with Polycystic Ovary Syndrome: A Narrative Review. J Hum Reprod Sci.

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    Medically Reviewed by

    Dr. Shruti Tanwar

    C-section & gynae problems - MBBS| MS (OBS & Gynae)

    View Profile

    Written by

    Anandita Sharma

    Drawing on more than a decade of expertise in administration, Anandita Sharma currently serves as a content operations e

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