lean pcos
Shifa Fathima's photo

By Shifa Fatima, MSc.,

Medically Reviewed by Dr. Apoorva T, MHM.

Reviewed: November 27, 2022

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What Is Lean PCOS?

A hormonal condition known as polycystic ovarian syndrome (PCOS) is brought on by an overproduction of androgens, or hormones like DHEA and testosterone, in either the ovaries or the adrenal glands. Up to 1 in 5 women who are of reproductive age are considered to be affected with PCOS globally.

People who are diagnosed with PCOS are generally overweight and have a higher body mass index (BMI). Although, it is possible to have a healthy BMI and a lean body and have PCOS at the same time. Just because a person may have “lean PCOS” does not necessarily mean it is a good thing; in fact, having lean PCOS may make it more difficult to get a diagnosis, even if it results in many of the same long-term health issues as other varieties of PCOS. If you have lean PCOS symptoms but have a BMI that is within a healthy range, consult a doctor and get a proper diagnosis.

What Is Considered Lean?

When a person has PCOS, the condition generally affects their weight wherein they tend to gain weight and have trouble shedding fat. Due to hormonal imbalances and weight gain, a person who has PCOS may develop insulin resistance which may eventually lead to type 2 diabetes, making it harder to lose weight. In that case, they fall under a category called ‘overweight’ or ‘obese’. These categories fall under what is known as body mass index.

Category           BMI range - kg/m2
Severe Thinness   < 16              
Moderate Thinness 16 - 17          
Mild Thinness     17 - 18.5        
Normal             18.5 - 25        
Overweight         25 - 30          
Obese Class I     30 - 35          
Obese Class II     35 - 40          
Obese Class III   > 40              

The body mass index is a way to determine if your current body weight is healthy or not by factoring in weight and height. The BMI is further divided into healthy and unhealthy categories which helps encourage people to lose weight in order to avoid any health issues for example, PCOS. 

In this context, "lean" refers to a healthy body mass index (BMI). Your weight in relation to your height is calculated using this ratio. For most women, a healthy BMI falls between 18 to 24.9. Women with PCOS who are "lean" struggle to burn calories as effectively as women of the same size who do not have the disorder. This implies that the majority of slim PCOS women must monitor their food and calorie intake extremely carefully and consult a doctor for lean PCOS treatment.

What Are The Symptoms Of Lean PCOS?

While lean PCOS and regular PCOS have similar symptoms, there are certain ways to differentiate between the two conditions. The general symptoms of PCOS are as follows:

  • Irregular menstrual cycle, skipped periods or heavy periods. 
  • Facial acne and facial and body hair growth
  • An increase in male hormones such as androgens.
  • Infertility 
  • Weight gain
  • Insulin resistance

The symptoms of lean PCOS are pretty much the same except for a few like weight gain and insulin resistance. Some of the most common symptoms of lean PCOS are:

  • Irregular periods and menstrual cycle
  • Underactive thyroid
  • Polycystic ovaries
  • Infertility

How is it different from regular PCOS?

Anybody, regardless of weight, may suffer a variety of symptoms related to PCOS. For instance, one individual could have irregular periods and excessive hair growth, while another person might have diabetes and reproductive problems. Two individuals with very different BMIs might have the same symptoms simultaneously. For this reason, PCOS may often go undiagnosed, and this risk increases if you are slim.

But there is a bright side. Lean PCOS may still cause the same health issues as other varieties of PCOS, but the effects of diabetes and insulin resistance are often less severe. Additionally, ovulation and fertility therapies often provide better outcomes.

However, just because lean PCOS may not be as bad as non-lean PCOS does not imply you are safe. It's critical that PCOS be addressed seriously by everyone since you still have a higher chance of developing conditions like cardiovascular disease. 

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How to treat lean PCOS?

Regardless of weight, the strategy for treating PCOS is decided by the symptoms a person encounters. Here are a few instances:

  • Maintaining a healthy weight is made easier by eating well and working out often. A person's PCOS symptoms may worsen as their body fat percentage increases.
  • In order to address reproductive concerns, fertility therapies like clomifene, surgery, or in vitro fertilization (IVF) may be used.
  • Menstrual cycle irregularities may be treated with birth control tablets.
  • Treatments for acne include topical drugs (benzoyl peroxide, topical antibiotics, retinoids) as well as tablets (isotretinoin, oral antibiotics, birth control pills).
  • Excessive hair growth may be controlled with hair removal methods including shaving, electrolysis, and laser hair removal.
  • Insulin resistance and high blood glucose levels may be controlled by exercise, metformin, and myoinositol.

With the help of your doctor, you can decide which course of action is appropriate for your case and make regular visits to your healthcare provider.

Also read about uses and side effects of sugar tablet


PCOS, also known as polycystic ovary syndrome, is brought on by an overproduction of androgens, which are hormones like DHEA and testosterone, in either the ovaries or the adrenal glands of a woman's body. Just because someone has "lean PCOS" does not imply it is a positive thing. Women with lean PCOS symptoms had a pregnancy success rate of 52%. Lean PCOS is a condition that may be considerably improved by adopting specific lifestyle adjustments. Except for a few exceptions like weight gain and insulin resistance, the symptoms of lean PCOS are almost identical. The best way to manage the condition known as lean PCOS is to consult a specialist doctor and understand the degree to which one may have this disorder. With the right medication and lifestyle changes, this condition can be manageable. Also know about blood sugar normal level chart.


Can I Get Pregnant If I Have Lean PCOS?

Yes, it is completely possible to conceive even if a person has lean PCOS symptoms. In certain cases, depending on the severity of the condition, a person may face challenges while conceiving but overall, there is a 52% pregnancy success rate among women with lean PCOS symptoms.

How do you treat lean PCOS without birth control?

Lean PCOS treatment can be done without taking birth control medication by making some significant lifestyle changes. Eating a healthy and nutritious diet, exercising regularly to maintain healthy blood sugar levels, maintaining a healthy routine and managing stress are all ways in which you can treat lean PCOS without taking medication for birth control. With the help of a doctor and a nutritionist, you can make the transition to these lifestyle changes easier.

Can lean PCOS be cured?

Lean PCOS is a condition that can be greatly managed by making certain changes to one’s lifestyle but PCOS is a health disorder that does not yet have a permanent cure. PCOS is a lifestyle disorder that can be managed with the help of medication and routine checkups.

Should lean PCOS gain weight?

No, people with lean PCOS must not gain weight as it will only worsen their condition and health in the long run. Generally, people with PCOS tend to gain weight and have a hard time losing it so people with lean PCOS are at a slight advantage considering their BMI is healthy.


  • https://www.goodrx.com/conditions/pcos/lean-pcos
  • https://flo.health/pcos/lean-pcos


This website's content is provided only for educational reasons and is not meant to be a replacement for professional medical advice. Due to individual differences, the reader should contact their physician to decide whether the material is applicable to their case.