What is Polycystic Ovarian Syndrome (PCOS)?

Polycystic Ovarian Syndrome (PCOS) is one of the most common hormonal disorders, affecting up to 10% of women of childbearing age. Despite its prevalence, PCOS often goes undiagnosed, leading to significant physical and emotional distress. As a doctor, I emphasise the importance of early recognition and comprehensive management to improve long-term health and quality of life.

PCOS Symptoms: What to Look For

PCOS disrupts the normal menstrual cycle and ovulation. Common symptoms include:

Irregular, heavy, or painful periods
Irregular or absent ovulation
Signs of high androgen levels (male hormones), such as:
- Hirsutism (excess facial or body hair)
- Acne
- Thinning hair or hair loss
Weight gain, especially around the abdomen
Insulin resistance (a precursor to type 2 diabetes)
Mood changes, including anxiety and depression
Difficulty conceiving (infertility)

Many women with PCOS report feeling consistently unwell, with low energy and emotional fatigue. If you experience these symptoms, it’s important to seek medical advice.

How is PCOS Diagnosed?

Diagnosis is based on clinical evaluation, symptom assessment, and targeted testing. The Rotterdam Criteria are commonly used, requiring at least two of the following:

Irregular or absent ovulation
Clinical or biochemical signs of hyperandrogenism
Polycystic ovaries on ultrasound

Recommended Diagnostic Tests:

HbA1c– screens for insulin resistance and diabetes risk
Hormone panel– measures testosterone, LH, FSH, and AMH
Thyroid function tests– rules out thyroid disorders
Vitamin D levels– often low in PCOS patients
Pelvic ultrasound– assesses ovarian morphology

For more details, refer to the Endocrine Society PCOS Guidelines.

PCOS Treatment: A Multimodal Approach

Effective PCOS management requires a combination of lifestyle changes, medical treatment, and ongoing monitoring.

Lifestyle Modifications :Lifestyle changes are the first-line treatment for PCOS:
- Anti-inflammatory diet: Focus on whole foods, lean protein, healthy fats, and low-glycemic carbohydrates. Resources like the Harvard Healthy Eating Plate can help guide your choices.
- Regular exercise:Aim for at least 150 minutes of moderate activity per week to improve insulin sensitivity.
- Weight management:Even a 5–10% reduction in body weight can restore ovulation and improve metabolic health.
Nutritional Supplements: Certain supplements may support hormonal balance, and always consult your doctor before starting supplements

- Inositol– improves insulin sensitivity and ovarian function, and
- Vitamin D3– often deficient in PCOS
- Omega-3 fatty acids– reduce inflammation
- Chromium & Magnesium– support glucose metabolism

Medical Treatments: Depending on your goals (regulating cycles, improving fertility, or managing symptoms), your doctor may recommend:

- Metformin– improves insulin resistance
- Oral contraceptives– regulate periods and reduce androgens
- Anti-androgen medications– for hirsutism and acne
- Ovulation induction agents(e.g., letrozole) – for fertility

For detailed treatment protocols, see the 2018 International PCOS Guideline.

Long-Term Health Risks of PCOS

Without proper management, PCOS increases the risk of:

Type 2 diabetes
Cardiovascular disease
Endometrial hyperplasia (due to unopposed estrogen)
Mood disorders
Sleep apnea

Regular screenings for glucose tolerance, lipid profiles, and blood pressure are essential.

Patient Empowerment: Taking Control of Your Health

Managing PCOS is a lifelong journey. Here’s how you can take an active role:

Educate yourselfusing trusted resources like the S. Office on Women’s Health – PCOS.
Track your symptoms– use apps or journals to monitor cycles, mood, and diet.
Build a support team– including an endocrinologist, gynecologist, dietitian, and mental health professional.
Advocate for yourself– ensure your concerns are heard and addressed.

Conclusion: You’re Not Alone

PCOS is a common but manageable condition. With the right diagnosis, lifestyle adjustments, and medical support, you can regulate your hormones, reduce symptoms, and lower long-term health risks. If you suspect you have PCOS, don’t wait—schedule an appointment with a healthcare provider experienced in hormonal health.