What Is PCOS?
Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting people with ovaries of reproductive age. It is characterised by a combination of hormonal imbalances, irregular menstrual cycles, and often the presence of multiple small cysts on the ovaries. PCOS is also one of the leading causes of infertility.
How Common Is It?
Estimates vary, but PCOS affects roughly 520% of women worldwide, depending on diagnostic criteria and population studied. It is one of the most common hormonal disorders in the reproductiveage group.
Key Symptoms
- Irregular periods missed periods, very light or very heavy bleeding.
- Excess androgen levels hirsutism (unwanted facial or body hair), acne, and occasional malepattern hair loss.
- Polycystic ovaries multiple small follicles visible on ultrasound.
- Weight gain especially around the abdomen, and difficulty losing weight.
- Insulin resistance leading to higher blood sugar and increased risk of type2 diabetes.
- Fertility challenges due to anovulation or irregular ovulation.
- Mood changes anxiety, depression, and reduced quality of life are reported more often in people with PCOS.
Causes & Risk Factors
The exact cause of PCOS is unknown, but several factors are thought to contribute:
- Genetics the condition often runs in families, suggesting a hereditary component.
- Insulin resistance high insulin levels can increase ovarian androgen production.
- Inflammation lowgrade inflammation may stimulate the ovaries to produce excess hormones.
- Hormonal imbalance an overproduction of luteinising hormone (LH) relative to folliclestimulating hormone (FSH) can disrupt normal ovulation.
Diagnosis
Diagnosing PCOS typically involves a combination of:
- Medical history and symptom review.
- Physical exam (checking for signs of excess hair, acne, and bodymass index).
- Blood tests to measure hormone levels (androgens, LH, FSH, insulin, glucose).
- Pelvic ultrasound to visualise ovarian morphology.
Most clinicians use the Rotterdam criteria, which require at least two of the following three features: oligo or anovulation, clinical/biochemical hyperandrogenism, and polycystic ovaries on ultrasound.
Health Implications
Beyond reproductive concerns, PCOS can increase the risk of:
- Type2 diabetes and prediabetes.
- Metabolic syndrome (a cluster of high blood pressure, high blood sugar, excess abdominal fat, and abnormal cholesterol).
- Cardiovascular disease.
- Endometrial hyperplasia or cancer due to prolonged unopposed estrogen exposure.
Management Strategies
While there is no cure, a combination of lifestyle changes and medical treatments can control symptoms and lower longterm risks.
1. Lifestyle Modification
- Weight management modest weight loss (510% of body weight) can improve insulin sensitivity and restore regular cycles.
- Balanced diet lowglycemic, highfiber foods help stabilise blood sugar.
- Regular exercise a mix of aerobic and resistance training improves insulin response.
2. Medication
- Hormonal contraceptives combined oral contraceptives regulate periods and reduce androgen levels.
- Metformin improves insulin sensitivity and may help with weight and menstrual regularity.
- Antiandrogens (e.g., spironolactone) reduce hirsutism and acne.
- Fertility agents clomiphene citrate, letrozole, or gonadotropins stimulate ovulation for those trying to conceive.
- Inositol supplements emerging evidence suggests benefits for insulin resistance and ovulation.
3. Cosmetic & Dermatologic Options
- Laser hair removal or electrolysis for hirsutism.
- Topical or oral acne treatments (benzoyl peroxide, retinoids, antibiotics).
4. Psychological Support
Because PCOS can affect selfesteem and mood, counseling, support groups, or cognitivebehavioral therapy are valuable adjuncts.
Living With PCOS
People with PCOS often benefit from a proactive, multidisciplinary approach:
- Regular checkups with a primary care physician, endocrinologist, or gynecologist.
- Monitoring of blood glucose and lipid profiles at least annually.
- Open communication with a fertility specialist if pregnancy is desired.
- Education about symptom triggers and selfcare strategies.
With proper management, most individuals lead healthy, productive lives and can achieve successful pregnancies.
