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Health and fitness expert Jillian Michaels is opening up about struggling with the hormonal disorder PCOS (polycystic ovary syndrome) as a teenager. Michaels learned she had PCOS at 15 years old in an “incredibly painful” way. “I discovered it because I had a cyst burst on one of my ovaries,” Michaels shares with Yahoo Lifestyle. She was in so much pain that her mother thought Michael’s appendix was bursting. Michaels was rushed to the emergency room where doctors discovered it was a cyst that had burst. Her doctor suggested she go on birth control pills — a common treatment for PCOS that helps regulate periods and lower androgen levels. But Michaels didn’t want to take the medication. She found out that PCOS is linked to insulin resistance. In fact, according to the Cleveland Clinic, “insulin resistance is one of the root physiological imbalances in most, if not all, PCOS.” By changing her diet, Michaels thought she could “sensitize” her body to insulin. “No fake sugars, no processed sugars, no processed grains — things that drive insulin to the roof,” she says. “And over time, I pretty much had the situation under control.” Her lifestyle changes had a dramatic impact on her health. “I haven’t had an issue in about 20 years,” she says. “It’s about eating right, working out, and eating clean. A lot of chemicals that are in our food wreak havoc on your endocrine system.” However, Michaels clarifies one thing about her choice not to take birth control pills to help her PCOS back when she was a teenager: “I’m not saying if your doctor puts you on a birth control pill, say no,” she says. “I’m just saying for me personally, I was able to manage the situation with lifestyle.”