Is PCOD Possible for Thin Women? Gynaecologist Explains Symptoms Like Oily Skin and Acne

Polycystic Ovarian Disease (PCOD) is usually associated with weight gain or obesity, but that’s not the full picture and even women who are thin or of normal weight can have PCOD but however, because many people think PCOD only affects those who are overweight, it often goes undiagnosed, especially in women who don’t fit the typical stereotype. And according to a recent report from the World Health Organization (WHO), 6-13% of women of reproductive age have PCOS, but up to 70% are unaware they have it. Dr. Tejal Kanwar, a consultant gynaecologist, explains how lean PCOD is different from the typical form and outlines the key symptoms to be aware of.

What is PCOD?

PCOD is a hormonal disorder that impacts the ovaries as it’s often linked to irregular periods, high levels of male hormones (androgens), and cysts on the ovaries. PCOD is one of the leading causes of infertility, and it’s typically associated with symptoms like weight gain, oily skin, acne, and unwanted hair growth. However, PCOD doesn’t always look the same for every woman, and it can affect those with a lean body type just as much as those with a higher BMI.

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What is Lean PCOD?

Lean PCOD is simply a variation of the usual PCOD, but with one key difference: the person is not overweight. Instead of being linked to excess body fat, lean PCOD is driven by hormonal and metabolic issues. Dr. Kanwar explains that genetics play a big role in this type of PCOD. Even if you’re thin, you can still have insulin resistance or other hormonal imbalances that trigger the symptoms of PCOD but so, just because you’re not overweight doesn’t mean you’re immune to it.

Key Symptoms of Lean PCOD

While weight gain isn’t a common symptom in lean PCOD, there are still several telltale signs that women should watch out for and some of the most common symptoms include:

• Missed or Irregular Periods: You may have cycles that are longer than 35 days, or you might miss periods altogether.
• Oily Skin and Acne: Acne, especially around the jawline, is a classic sign of PCOD, even if you're not dealing with excess weight.
• Hirsutism: This refers to excess hair growth on the chin, upper lip, chest, or abdomen.
• Scalp Thinning: If you notice your hairline is widening or experiencing diffuse hair loss, it could be a sign of PCOD.
• Infertility: Even if you’re at a healthy weight, irregular ovulation can affect fertility.
• Dark Skin Patches: Some women develop darkened skin patches, known as acanthosis nigricans, which is often linked to insulin resistance.

How to Manage Lean PCOD?

Managing lean PCOD doesn’t focus on weight loss. Instead, the key is to manage hormonal and metabolic imbalances and here are some strategies to help:

1. Frequent Monitoring: It’s important to regularly check your hormone levels, insulin, thyroid, and androgen levels also keep track of your menstrual cycle as well, since irregular cycles are often the first sign of a hormonal imbalance.
2. Balanced, Low-GI Diet: Focus on eating whole grains, lean proteins like legumes and chicken, fiber-rich vegetables, and healthy fats. Avoid extreme diets or skipping meals, as these can make hormonal imbalances worse.
3. Regular Exercise: Aim for 150-300 minutes of exercise each week. A combination of strength training and cardio is ideal. While cardio helps with metabolism, strength training boosts insulin sensitivity.
4. Stress and Sleep Management: Practices like yoga, meditation, and improving your sleep routine can help lower cortisol levels and support healthier ovulation.

If you’re dealing with more severe symptoms like infertility or hirsutism, Dr. Kanwar recommends seeing a gynaecologist or endocrinologist, but they may suggest treatments like insulin-sensitizing drugs (such as metformin), ovulation-inducing medications, or specialized skincare for acne and unwanted hair growth.

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Understanding Lean PCOD: A Complex Condition

PCOD isn’t just about weight gain as it’s a complex condition that involves hormones, genetics, and metabolism. For women with lean PCOD, the condition may look different from the traditional form, but it’s just as important to recognize and treat it and getting an early diagnosis and taking steps to manage the symptoms can help with fertility planning and improve long-term health.