What is PCOS?

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder affecting people with ovaries, typically diagnosed during reproductive years. It's one of the most common endocrine disorders in women of reproductive age.

What causes PCOS?

The exact cause is unknown, but factors include:

• Insulin Resistance: The body doesn't use insulin efficiently, leading to higher blood sugar and increased insulin levels, which stimulate androgen production.
• Hormonal Imbalance: Elevated androgens (male hormones) interfere with ovulation.
• Genetics: PCOS often runs in families.
• Low-Grade Inflammation: May stimulate polycystic ovaries to produce androgens.

Symptoms (The PCOS Triad):

• Irregular Periods: Infrequent, prolonged, or absent menstruation.
• Hyperandrogenism: Excess facial/body hair (hirsutism), severe acne, male-pattern baldness.
• Polycystic Ovaries: Enlarged ovaries with multiple small cysts (seen on ultrasound).
• Weight Gain: Particularly around the abdomen.
• Skin Changes: Dark patches (acanthosis nigricans), skin tags.
• Fertility Issues: Difficulty conceiving due to irregular ovulation.

Diagnosis (Rotterdam Criteria - Need 2 of 3):

• Irregular ovulation (oligo/anovulation)
• Clinical or biochemical signs of hyperandrogenism
• Polycystic ovaries on ultrasound

Labs: Testosterone, LH/FSH ratio, fasting insulin, glucose tolerance test.

Treatment:

Lifestyle Modifications:

• Weight Loss: Even 5-10% can restore ovulation and improve symptoms.
• Diet: Low glycemic index, balanced nutrition.
• Exercise: Regular physical activity improves insulin sensitivity.

Medications:

• Birth Control Pills: Regulate periods, reduce androgens.
• Metformin: Improves insulin resistance, may restore ovulation.
• Anti-Androgens: Spironolactone for hirsutism/acne.
• Fertility Treatment: Letrozole or Clomiphene to induce ovulation.

Long-Term Health Risks:

• Type 2 Diabetes (50% risk by age 40)
• Metabolic Syndrome and heart disease
• Endometrial cancer (from prolonged unopposed estrogen)
• Sleep apnea
• Depression and anxiety

Living with PCOS:

PCOS is lifelong but manageable. Regular monitoring, healthy lifestyle, and appropriate medical treatment can significantly improve quality of life and reduce long-term complications.