For context I am a trans man. I've been aware I have PCOS since my puberty started at the age of 11 (I'm almost 23), the most obvious symptom was that I literally never had regular periods in my life. They used to last 3 weeks with a crazy blood flow (and came with a huge amount of pain) and I would have them every other month. As time went on, I had them less and less often but they would still last almost a month. The last year before I went on HRT, I think I only had them once.
But every doctor (including a few endocrinologists) I saw when I was a teen failed to identify the problem. So I was only diagnosed with PCOS by my current endocrinologist when I had my first blood-test results checkup with her, 3 months after I started testosterone. She was like "yeah, you definitely have PCOS, it's crazy no other doctor came to that conclusion earlier, but it shouldn't bother you too much now that you're on T. You don't have to worry about it anymore".
I've been on HRT for 3 years now and I'm still thinking about this conversation every few months.
These past 3 years, I've been doing a lot of research on PCOS to understand better what my body went through during my first puberty, how it still affects my body as an adult and what my body might still go through now. And I'm pretty sure HRT has not fixed my PCOS. It has stopped the absolute chaos that was my period, but that's pretty much it. I still have brain fog (I have ADHD too, but I take meds for that so I know it's not an ADHD-related brainfog, it's something else), I'm still constantly tired and barely ever feel rested no matter how much I sleep, and I still have most PCOS symptoms I used to have pre-T. If 3 years of research to understand my PCOS better have taught me, it's that I still relate to most symptoms.
But I've heard mixed opinions on the internet on how HRT affects PCOS. I also know that 1. Going on HRT is safe for trans people with PCOS, and 2. T is sometimes prescribed to menopausal people (esp. with PCOS) to help with symptoms. And the bodies of trans men on T basically go through menopause and experience all its symptoms (while simultaneously going through male puberty).
So is it possible that HRT is not enough in my case? Is there anything I can do about it? I've recently come across discussions about a link between PCOS and insulin resistance, is it possible that my issues are related to IR? It will be easier to know what to tell/ask my doctor next time I see her if I understand this mess a little better