PCOS (Polycystic Ovary Syndrome) is a common endocrine disorder that affects about one in ten women of childbearing age. It is characterized by a hormonal imbalance leading to excessive androgen production, irregular menstrual cycles, and often the presence of small ovarian follicles visible on an ultrasound. Its symptoms are varied— acne, hair loss, abdominal weight gain, hirsutism—which often leads to a delayed diagnosis.
The exact causes of PCOS are not fully understood, but three main factors have been identified. Genetic predisposition plays a role: a family history of the condition significantly increases the risk.Insulin resistance affects nearly 70% of women with the condition and stimulates excessive androgen production by the ovaries. Finally, an unbalanced diet, a sedentary lifestyle, and chronic stress worsen symptoms and accelerate the progression of the syndrome.
PCOS manifests differently in different women. Menstrual irregularities—infrequent, irregular, or absent periods—are the most common sign. Hyperandrogenism manifests as excessive hair growth (hirsutism), persistent acne, and androgenetic hair loss. Many patients experience difficulty conceiving due to the absence of regular ovulation. Some women also suffer from anxiety or episodes of depression, which are exacerbated by the syndrome’s impact on body image and quality of life.
The diagnosis is based on the Rotterdam criteria: meeting at least two of the following three conditions is sufficient to confirm PCOS. The first is the absence or irregularity of menstrual cycles (oligo-anovulation). The second is clinical hyperandrogenism—excessive body hair, acne—or biological hyperandrogenism, with elevated androgen levels in the blood. The third is the presence of ovarian cysts on ultrasound. Comprehensive hormone testing helps rule out other associated endocrine disorders.
Yes, PCOS is one of the leading causes offemale infertility. The absence of regular ovulation prevents the monthly release of an egg, making conception difficult—though not impossible. Lifestyle changes alone are sometimes enough to restore ovulation. If these fail, medications such as clomiphene or letrozole can stimulate ovulation. In complex cases, fertility treatment may also involve IVF.
PCOS management is tailored to the patient’s symptoms and goals. Lifestyle changes are the first line of treatment: a low-glycemic-index diet, regular physical activity, and stress management improve insulin sensitivity. The combined oral contraceptive pill regulates cycles and reduces hyperandrogenism. Metformin improves insulin resistance. Omega-3s and magnesium can supplement the nutritional approach under medical supervision.
It is not possible to completely prevent PCOS, especially when there is a genetic predisposition. However, adopting a healthy lifestyle starting in adolescence reduces the risk of the condition worsening and of complications. A diet rich in fiber and low in refined sugars, maintaining a stable weight—even a moderate weight loss of 5 to 10% significantly improves symptoms—and daily physical activity are the most effective long-term strategies.
If left untreated or poorly managed, PCOS increases the risk of several long-term complications. Insulin resistance can progress to type 2 diabetes, which is particularly common in this population. The risk of high blood pressure and cardiovascular disorders is also increased. Persistent menstrual irregularities can, over time, lead to endometrial hyperplasia. Regular medical follow-up helps detect and prevent these risks before they develop.
