What is PCOS?
Polycystic ovarian syndrome (PCOS) is a common hormonal disorder affecting women of reproductive age and one of the leading causes of infertility. It is marked by irregular or absent ovulation, higher levels of male hormones (androgens), and ovaries that may appear enlarged with multiple small follicles (often called “cysts”).
Causes
The exact cause is not fully understood, but several factors play a role:
- Genetics – family history increases risk.
- Insulin resistance – high insulin levels stimulate the ovaries to produce more androgens.
- Hormonal imbalance – excess androgens disrupt ovulation.
- Low-grade inflammation – may contribute to insulin resistance and cardiovascular risks.
Symptoms
PCOS symptoms vary but can include:
- Irregular or absent periods
- Difficulty getting pregnant
- Excess hair growth (face, chest, abdomen)
- Acne or oily skin
- Scalp hair thinning (male-pattern baldness)
- Weight gain, especially around the waist
- Dark patches of skin on the neck, armpits, or groin (acanthosis nigricans)
- Mood changes, anxiety, or sleep problems such as sleep apnea
Diagnosis
PCOS is usually diagnosed using a combination of:
- Medical history and physical exam
- Blood tests
- Ultrasound to check ovaries and uterine lining
Treatment
Treatment depends on symptoms and goals (such as improving fertility, regulating periods, or treating acne).
- Lifestyle changes: Healthy eating, exercise, and weight management can improve insulin resistance and hormone balance.
- Medications:
- Combined oral contraceptives regulate periods, lower androgens, and reduce acne and excess hair.
- Metformin can improve insulin resistance and menstrual cycles.
- Fertility treatments (such as letrozole, clomiphene, or gonadotropins) may help women trying to conceive.
- Procedures: Rarely, laparoscopic ovarian drilling may be considered if medications fail.
Long-Term Health Considerations
Women with PCOS have an increased risk of type 2 diabetes, high cholesterol, high blood pressure, sleep apnea, pregnancy complications, and endometrial (uterine) cancer. Ongoing monitoring and preventive care are important.
