10 Signs of Hormonal Imbalance with PCOS That Could Be Stalling Your Weight

If you're living with PCOS and feel like your body is working against you when it comes to weight, you're not imagining it.

Hormones play a central role in how your body stores fat, builds muscle, manages cravings, and burns energy. When they’re out of balance, which is common in PCOS, progress can feel painfully slow, even if you're doing everything right on paper.

Many women I support are eating well, moving more, and still not seeing changes on the scales or in how they feel. This isn’t about willpower, it's often about underlying hormone imbalances linked to insulin, cortisol, androgens, oestrogen and progesterone.

Understanding the signs of hormone disruption in PCOS can help you make sense of your symptoms, and take practical, effective steps to support your health and weight.

My free 7-day PCOS Sugar Reset is a great place to start.

10 Signs Your Hormones Might Be Out of Sync with PCOS

1. Persistent Fatigue, Even After Rest

If you feel drained despite a full night’s sleep, it may point to cortisol disruption or blood sugar instability. These are common in PCOS and can affect your energy, motivation and metabolism. When your body’s running on empty, it’s more likely to crave sugar and store fat.

2. Strong Sugar or Carb Cravings

Cravings aren’t a lack of discipline, they’re often linked to insulin resistance, a core driver in PCOS. When cells become less responsive to insulin, blood sugar rises, fat storage increases and hunger signals get thrown off. Learn more about how to reverse insulin resistance naturally in this post.

3. Belly Fat That Won’t Budge

Excess weight around the middle is often driven by insulin resistance, high cortisol, and low-grade inflammation, all of which are common in PCOS. It’s more than cosmetic, it’s a hormonal red flag that your metabolism may be under pressure. I have written more about inflammation root causes and triggers here.

4. Mood Swings, Anxiety or Low Mood

Low progesterone, high androgens and fluctuating blood sugar can all affect your mood and emotional resilience. If you're feeling wired, overwhelmed or flat, it becomes harder to stay consistent with food and movement.

5. Irregular or Missing Periods

PCOS often means long or absent cycles, these are signs that ovulation isn't happening regularly. This can affect progesterone production, which is important not only for fertility but also for metabolic health and weight regulation. If you are preparing your body for pregnancy, find out the signs of ovulation in this post.

6. Sleep Issues

Struggling to fall asleep, waking in the night or feeling unrefreshed can all make PCOS symptoms worse. Poor sleep increases cortisol, worsens insulin resistance and can heighten hunger hormones like ghrelin, making it harder to manage appetite and energy. Read more about how sleep disrupts hormone balance here.

7. Thinning Hair or Hair Loss

Hair loss at the crown or temples is often driven by excess androgens in PCOS. It's also a sign of inflammation and possible nutrient imbalances, which can interfere with both metabolic function and hormone balance.

8. Acne or Oily Skin

Breakouts around the jawline, chin or back often point to high testosterone or DHEAS. These skin symptoms are outward signs of deeper hormonal imbalance and inflammation.

9. Brain Fog and Poor Focus

Feeling mentally sluggish or easily distracted can be linked to blood sugar instability, low oestrogen, or chronic inflammation, all known to affect women with PCOS. If brain fog is stopping you from thinking clearly or making good food choices, hormones could be playing a role.

10. Weight Plateau Despite Doing 'Everything Right'

This is one of the most frustrating signs I hear from clients. You’re eating balanced meals, exercising regularly, and nothing is shifting. It’s a common experience in PCOS, and often reflects hidden issues with insulin, low progesterone, or stress-related cortisol patterns. This post explains more about why stress is bad for hormone balance.

Why These Symptoms Matter

These aren’t just random frustrations. They’re signals from your body that your hormones may be imbalanced. And with PCOS, it’s rarely just one hormone, it’s the complex interaction between insulin, cortisol, androgens, oestrogen and progesterone that often drives symptoms like stubborn weight gain.

By recognising these signs early, you can take targeted steps to support your metabolism, rebalance hormones, and work with your body - not against it.

How to Start Supporting Your Hormones and Weight with PCOS

You don’t need to overhaul everything at once. Start with small, consistent steps:

• Eat regular, balanced meals with quality protein, fibre, and healthy fats to steady blood sugar. 30g protein meal ideas here.

• Prioritise sleep – aim for 7–9 hours of restorative sleep to support cortisol and hunger regulation

• Reduce stress where you can – even simple changes like walking outside or a 5-minute breathing break can help

• Focus on anti-inflammatory foods – oily fish, berries, olive oil, leafy greens and colourful veg. Learn more about foods in the anti-inflammatory diet here.

• Move in a way that feels good – resistance training, walking or yoga all support metabolic health

• Consider targeted supplements if needed – omega-3s, magnesium or inositol may be helpful (always seek guidance)

• Work with a practitioner who understands PCOS to explore personalised support and testing, if appropriate

Final Thoughts

If you recognise several of these signs, it’s not about doing more or trying harder, it’s about understanding your hormones and shifting your approach.

With the right support, it’s possible to feel more in control of your weight, energy and mood, even with PCOS.

If you’re ready to take the first step, my 12-week programme is designed to help you do just that, with clear weekly guidance, nutrition strategies that work for PCOS, and real-life support every step of the way.

Next Step: Rebalance Your Hormones and Support Your Weight

Hi I'm Lisa, a BANT registered nutritionist, my online nutrition programmes are designed for PCOS weight gain and fertility. I work online with women locally in Manchester and across the UK.

If you have PCOS and are moving into your late 30s or 40s, my PCOS and perimenopause guide explains how hormone changes at this stage can affect symptoms, weight, and overall health, plus practical ways to support your body during the transition.

My 12-week PCOS Hormone Shift Method is designed for women struggling with PCOS weight gain, hormone symptoms and post-pill imbalances.

Not ready for a full programme? Try my mini programmes here.

If you're ready to take the next step with food-first, evidence-based support book a FREE no-obligation call today.

Updated in July 2025 to reflect new PCOS research and nutrition strategies.

DISCLAIMER: The content on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.