Polycystic Ovary Syndrome

Polycystic Ovary Syndrome (PCOS) is a common hormonal condition affecting women of reproductive age. It involves irregular ovulation, raised androgen (male-type) hormone levels, and often a characteristic ultrasound appearance of the ovaries. Indian estimates suggest at least 1 in 5 women of reproductive age has PCOS — it is among the commonest reasons for irregular periods, infertility and unwanted facial hair in Indian women.

Features

• Irregular or missed periods.
• Difficulty becoming pregnant.
• Acne, oily skin, and facial/body hair (hirsutism), particularly on chin, upper lip, chest.
• Weight gain, particularly around the belly — though PCOS also occurs in lean women.
• Darkening of skin folds (acanthosis nigricans) — sign of insulin resistance.
• Mood changes, anxiety, depression.
• Male-pattern hair thinning on the scalp.

Why it matters long-term

PCOS raises the risk of type 2 diabetes (often earlier than expected in Indian women), gestational diabetes, non-alcoholic fatty liver disease, high blood pressure, sleep apnoea, cardiovascular disease, and endometrial cancer (because of infrequent periods). Weight control and cycle regulation substantially reduce these risks.

Diagnosis

• History and examination.
• Blood tests — LH, FSH, testosterone, prolactin, thyroid, fasting insulin, fasting sugar or HbA1c.
• Pelvic ultrasound — shows multiple small follicles.
• Two of three features — irregular ovulation, raised androgens, polycystic appearance — support diagnosis.

Treatment — depends on what matters most right now

• Lifestyle is the foundation — weight loss of 5-10% can restore regular cycles and ovulation. Diet with lower refined carbs and sugar, daily exercise, strength training.
• For acne, hirsutism — combined oral contraceptive pills, topical treatments, laser hair reduction.
• For infertility — weight loss, medicines to induce ovulation, insulin-sensitising medicines in selected cases; IUI/IVF if needed.
• For insulin resistance / prediabetes — insulin-sensitising medicines and lifestyle.
• Regular screening for diabetes, BP, lipids, fatty liver.

PCOS is not curable, but it is very manageable. Diagnosis in teenagers should be cautious — some PCOS features mimic normal puberty. Keep going back; treatment needs change as life does.