Winter and PCOS — Why Symptoms Worsen for Some Individuals and What Actually Helps - Dr Akriti Gupta

Winter often brings relief to many – crisp air, cosy clothes, shorter days. But for some women with Polycystic Ovary Syndrome (PCOS), the colder months can feel like an unseen adversary, intensifying symptoms that may already feel overwhelming.

Why winter can worsen PCOS symptoms

PCOS is more than a reproductive-hormone disorder: it is fundamentally a metabolic and endocrine condition. Many affected women struggle with insulin resistance or compensatory hyperinsulinaemia, and as a result, have higher risks of obesity, type-2 diabetes, dyslipidaemia and chronic low-grade inflammation.

During winter, several environmental and behavioural factors converge that may aggravate this metabolic imbalance. Reduced daylight and colder temperatures commonly lead to decreased exposure to sunlight, which in turn often contributes to lower vitamin D levels. In fact, studies have observed that women with PCOS disproportionately exhibit vitamin D deficiency compared with healthy volunteers.

Low vitamin D is a significant factor and data links deficient 25-hydroxyvitamin D with worsened hyperandrogenism (excess male-type hormones), insulin resistance and ovulatory dysfunction.

Beyond that, winter tends to reduce physical activity, increase sedentary habits and encourage richer, heavier dietary patterns – all of which aggravate insulin resistance, weight gain and inflammatory responses.

Moreover, emerging research suggests cold exposure alone may trigger inflammatory changes in the uterus and ovaries. While human data remains limited, such findings lend biological plausibility to why colder climates or abrupt seasonal change could exacerbate reproductive and metabolic dysfunction in women predisposed to PCOS.

Implications for women considering fertility treatment

For women with PCOS contemplating fertility treatments or assisted reproduction, understanding these seasonal influences is especially relevant.

A recent study noted that risk of Ovarian Hyperstimulation Syndrome (OHSS) in PCOS patients undergoing oocyte retrieval was significantly higher during winter (and summer), compared with milder seasons. This underscores that hormonal, environmental and metabolic stresses in winter may influence not only symptom burden but also treatment risks and outcomes.

Therefore, doctors and patients should proactively adjust protocols, nutritional optimisation (especially vitamin D status), lifestyle planning and cycle scheduling – ensuring that fertility interventions account for the additional burden winter may impose.

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