Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting approximately 10–20% of women of reproductive age globally (Teede et al., 2018). Characterised by hormonal imbalances, irregular menstrual cycles, and metabolic complications, PCOS can significantly impact a woman’s physical and mental health. Despite its prevalence, the condition is often underdiagnosed, leading to delayed treatment and management. This article explores the causes, symptoms, diagnosis, and treatment of PCOS, offering evidence-based insights for those affected.

Keywords: Polycystic Ovary Syndrome (PCOS), What is PCOS?, Symptoms of PCOS, Causes of PCOS, PCOS diagnosis criteria, Managing PCOS symptoms, PCOS treatment options, PCOS and fertility, Lifestyle changes for PCOS

PCOS is a complex hormonal disorder involving the ovaries, which produce higher-than-normal levels of androgens (male hormones). This hormonal imbalance interferes with ovulation, resulting in irregular or absent menstrual cycles. While the term “polycystic” refers to the presence of multiple small cysts on the ovaries, not all women with PCOS exhibit this characteristic (Azziz et al., 2016).

The condition is associated with several health risks, including infertility, insulin resistance, type 2 diabetes, obesity, and cardiovascular disease. PCOS also has psychological implications, such as increased rates of anxiety and depression (Dokras et al., 2018).

The exact cause of PCOS is unknown, but several factors contribute to its development:

1. Genetic Predisposition

A family history of PCOS or type 2 diabetes increases the likelihood of developing the condition. Genetic factors influence hormone regulation and insulin sensitivity (Goodarzi et al., 2011).

2. Insulin Resistance

Insulin resistance is a key feature of PCOS, affecting approximately 70% of women with the condition (Moran et al., 2010). High levels of insulin stimulate the ovaries to produce excess androgens, disrupting the normal menstrual cycle.

3. Hormonal Imbalances

Elevated levels of luteinising hormone (LH) and low levels of sex hormone-binding globulin (SHBG) contribute to the hormonal dysregulation observed in PCOS.

The symptoms of PCOS vary widely among individuals and can include:

• Menstrual Irregularities: Infrequent, prolonged, or absent periods.
• Excess Androgen: Symptoms include hirsutism (excessive hair growth), acne, and male-pattern baldness.
• Polycystic Ovaries: Enlarged ovaries with multiple small cysts visible on ultrasound.
• Weight Gain: Difficulty managing weight, particularly around the abdomen.
• Fertility Issues: Difficulty conceiving due to irregular ovulation.
• Mental Health Challenges: Higher prevalence of anxiety and depression.

Tip: Early recognition of symptoms can improve long-term outcomes through timely intervention.

The diagnosis of PCOS is based on the Rotterdam Criteria, which require two of the following three features (Teede et al., 2018):

1. Irregular or absent ovulation.
2. Clinical or biochemical signs of hyperandrogenism.
3. Polycystic ovaries on ultrasound.

Other conditions with similar symptoms, such as thyroid disorders or hyperprolactinaemia, must be ruled out before confirming a diagnosis.

Tip: Consult a healthcare professional if you experience symptoms associated with PCOS for accurate diagnosis and management.

While there is no cure for PCOS, various strategies can effectively manage symptoms and reduce health risks:

1. Lifestyle Modifications

Lifestyle changes, including a balanced diet, regular exercise, and weight management, are the cornerstone of PCOS management. Studies show that even a 5–10% reduction in body weight can improve hormonal balance and menstrual regularity (Moran et al., 2011).

2. Medication

• Oral Contraceptives: Help regulate menstrual cycles and reduce androgen levels.
• Metformin: Improves insulin sensitivity and reduces insulin levels.
• Anti-Androgens: Address symptoms such as hirsutism and acne.

3. Fertility Treatments

For women trying to conceive, fertility medications such as clomiphene or letrozole may be prescribed to induce ovulation. In some cases, assisted reproductive technologies like in-vitro fertilisation (IVF) are considered.

4. Psychological Support

Managing mental health through therapy or support groups can address the emotional impact of PCOS.

Tip: A multidisciplinary approach involving gynaecologists, endocrinologists, and mental health professionals is ideal for comprehensive care.

Women with PCOS face an increased risk of developing metabolic and cardiovascular complications. Regular monitoring of blood glucose, cholesterol, and blood pressure is essential. Early intervention and consistent management can mitigate these risks.

PCOS is a complex condition that affects many aspects of a woman’s health, from reproductive function to emotional well-being. While the challenges of living with PCOS can be significant, effective management strategies, including lifestyle modifications, medication, and psychological support, can greatly improve quality of life. Increased awareness and timely diagnosis are key to empowering women with PCOS to take control of their health and lead fulfilling lives.

• Azziz, R., Carmina, E., & Chen, Z. (2016). Polycystic ovary syndrome. Nature Reviews Disease Primers, 2, p.16057.
• Dokras, A., Clifton, S., Futterweit, W., & Wild, R. (2018). Increased risk for abnormal depression scores in women with polycystic ovary syndrome: A systematic review and meta-analysis. Obstetrics & Gynecology, 121(1), pp. 51-59.
• Goodarzi, M. O., Dumesic, D. A., Chazenbalk, G., & Azziz, R. (2011). Polycystic ovary syndrome: Etiology, pathogenesis and diagnosis. Nature Reviews Endocrinology, 7(4), pp. 219-231.
• Moran, L. J., Hutchison, S. K., Norman, R. J., & Teede, H. J. (2011). Lifestyle changes in women with polycystic ovary syndrome. The Cochrane Database of Systematic Reviews, (2), CD007506.
• Teede, H. J., Misso, M. L., Costello, M. F., Dokras, A., Laven, J., & Moran, L. (2018). Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Human Reproduction, 33(9), pp. 1602-1618.

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