I don't think it hit me as hard as my adenomyosis diagnosis at 18 (as it makes getting pregnant harder and delivery more dangerous). I was diagnosed with PCOS at 20. Obviously not ovulating regularly makes getting pregnant harder, but there are medications to induce ovulation. I was diagnosed via regular and transvaginal ultrasound, same way as my adenomyosis. I didn't have (symptomatic) PCOS at 18. They didn't find any cysts at that time. At 19 I had GI issues, causing me to need abdominal imaging twice. Both times in my paperwork a cyst was noted. I didn't think anything of it because the doctors didn't say anything. Why would they? An occasional cyst is normal. At 20, I knew something was wrong when I had gone 3 months with a period. At that point I had been off birth control for a year, so my period should have been regulated. Yeah I had been having (and still have) lower abdominal pain, but I wrote it off as my adenomyosis because it's known to be a very painful condition. The gyno found numerous cysts, my fasting blood sugar was high, and I had put on a lot of weight recently.
Birth control didn't directly affect my mental health. Instead, it killed my sex drive and gave me periods that lasted for over a month. When I had a partner, it made intimate time very difficult and caused tension. I wanted to want sex, but the drive just wasn't there. I went from being borderline hypersexual to very rarely wanting anything. It was a hard adjustment and ultimately I decided birth control wasn't for me.
I am down 36 lbs in 3.5 months. I have days where I mess up and eat too much, but overall weight loss has been going pretty damn well. People who use PCOS as an excuse saying its "near impossible" to lose weight simply aren't devoted to the process. Yes, dieting sucks, so make it a sustainable lifestyle. I eat whatever I want and just stay mindful of calories. Generally, I eat very healthy, but if I want something sweet I'll eat something sweet. Denying yourself just makes you prone to binging or having too many cheat days. All of this weight loss isn't even from working out. I'm losing the bulk of weight before I hit the gym because I have really bad joints. I don't want to put them through the additional stress of working out while overweight. Once I have a healthy BMI again, I'll build my strength.