PCOS (Polycystic Ovary Syndrome): Symptoms and Treatment

7 min read · Conditions · By the Asthra Health Care team

What is PCOS?

Polycystic ovary syndrome, or PCOS, is a common hormone condition in women of reproductive age. The ovaries make more male-type hormones (androgens) than usual, and eggs may not be released every month. This leads to irregular or missed periods. On an ultrasound, the ovaries may show many small fluid-filled follicles, which is where the name comes from, though these are not true cysts.

PCOS is seen very often in young Indian women, including college students. It is closely linked to insulin resistance, where the body does not respond well to insulin. This is why PCOS raises the risk of prediabetes, type 2 diabetes, high cholesterol and fatty liver later in life.

Causes

The exact cause is not fully known. PCOS tends to run in families, so genes play a part. Insulin resistance causes the body to make more insulin, and high insulin pushes the ovaries to make more androgens. Weight gain, especially around the belly, makes insulin resistance worse, which in turn worsens symptoms. However, PCOS also occurs in slim women, so it is not only about weight. Low-grade inflammation in the body may also play a part.

Signs and symptoms

Symptoms vary a lot from one woman to another. Some have only irregular periods, while others have several problems together. Symptoms often begin in the late teens or early twenties, but some women notice them only when they try to become pregnant. Common signs include:

• Irregular, infrequent or missed periods, or sometimes very heavy periods
• Extra hair on the face, chin, chest or belly
• Acne that does not settle, and oily skin
• Thinning of scalp hair
• Weight gain, especially around the waist, and difficulty losing it
• Dark, velvety skin patches on the neck or underarms
• Difficulty getting pregnant

How PCOS is diagnosed

There is no single test for PCOS. A doctor, usually a gynaecologist, makes the diagnosis based on your periods, signs of high androgens such as extra hair or acne, and ultrasound findings. Generally two of these three features are needed, after ruling out other causes such as thyroid problems or high prolactin.

Blood tests may include thyroid function, prolactin, sometimes testosterone and other hormones, along with sugar and cholesterol tests to check for related problems. In teenagers, doctors are careful, because irregular periods and acne are common in the first few years after periods start, and ultrasound is less useful at this age.

Lifestyle: the foundation of treatment

For women who are overweight, losing even a small amount of weight can make periods more regular, improve skin and increase the chance of pregnancy. Focus on steady habits rather than crash diets. Choose home-cooked meals with vegetables, dal, pulses, curd, eggs or lean meat, and whole grains or millets. Cut down on sweets, bakery items, fried snacks and sugary drinks.

Regular activity helps the body use insulin better, even without weight loss. Aim for brisk walking, cycling, dancing, yoga or sports on most days, plus some strength exercises. Good sleep and stress control also help hormones settle. Avoid long hours of sitting, and try to go to bed and wake up at regular times.

Medicines your doctor may use

Treatment depends on your main concern: irregular periods, skin and hair problems, or pregnancy. Hormonal pills may be used to regulate periods and reduce acne and hair growth. Metformin may be used to improve insulin resistance. Fertility medicines help release an egg when pregnancy is desired. All of these are taken only on a doctor's prescription.

Some medicines used for extra hair growth must not be taken in pregnancy, so reliable contraception is needed while on them. Hormonal pills are not suitable for everyone, for example those with a history of blood clots or migraine with aura. Your doctor will choose what is safe for you.

Long-term health and follow-up

PCOS is a long-term condition, so regular check-ups matter even when symptoms are controlled. Get your blood sugar, cholesterol and blood pressure checked as your doctor advises. Very infrequent periods over a long time can thicken the lining of the womb, so do not ignore months without periods. Women with PCOS who become pregnant need closer checks for sugar and blood pressure.

PCOS can also affect mood and self-confidence. Anxiety and low mood are common, and talking about them is part of good care. Speak with your doctor or pharmacist about any symptom or medicine concern, and ask for support early rather than waiting.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.