Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) affects 10-13% of women of reproductive age, often undiagnosed in up to 70% of cases worldwide. It stems from hormonal imbalances, particularly elevated androgens, disrupting ovulation and leading to small ovarian cysts visible on ultrasound—though cysts aren't required for diagnosis. Women experience irregular or absent menstrual cycles, anovulation, and metabolic issues like insulin resistance, increasing risks for obesity, type 2 diabetes, and cardiovascular disease.

This image illustrates polycystic ovaries with multiple small cysts, contrasting normal ovarian structure in PCOS pathology.

Symptoms and Complications

Common signs include hirsutism (excess facial/body hair), acne, alopecia, weight gain, and fertility challenges due to infrequent ovulation. Psychological effects like anxiety, depression, and mood swings are prevalent, alongside skin tags and acanthosis nigricans from insulin issues. Long-term, PCOS raises endometrial cancer risk from unopposed estrogen.

Diagnosis and Management

Diagnosis uses Rotterdam criteria: two of three features—oligo/anovulation, hyperandrogenism, polycystic ovaries—after excluding other conditions. Management focuses on lifestyle: weight loss (5-10% reduces symptoms), balanced diet, and exercise. Medications include combined oral contraceptives for cycle regulation and hirsutism, metformin for insulin sensitivity, and ovulation inducers like clomiphene for fertility. Anti-androgens, acne treatments, or laser hair removal address symptoms; IVF or surgery for refractory infertility. Early intervention improves outcomes.