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PCOS (Polycystic Ovary Syndrome)

A metabolic and hormonal condition that touches many systems — one at a time.

Polycystic ovary syndrome affects up to 1 in 10 women of reproductive age. It combines irregular periods, excess androgens, and often insulin resistance. Treatment is personalised to the goal: regular cycles, clearer skin, fertility, or long-term metabolic health.

Causes & risk factors

  • Genetic predisposition
  • Insulin resistance
  • Hormonal imbalance (high LH, high androgens)

Symptoms

  • Irregular or absent periods
  • Acne, especially jawline and chin
  • Excess hair growth on face or body
  • Hair thinning on scalp
  • Weight gain
  • Difficulty conceiving

How it's diagnosed

  • Two of three Rotterdam criteria: irregular periods, clinical or biochemical hyperandrogenism, polycystic ovaries on ultrasound
  • Baseline labs: LH, FSH, testosterone, prolactin, TSH, HbA1c, lipids

Evidence-based treatment

  • Weight loss of 5% if overweight — dramatic improvements
  • Combined oral contraceptives for cycle regulation and skin
  • Metformin for insulin resistance
  • Letrozole or clomiphene for ovulation induction
  • Spironolactone for hirsutism
  • Topical eflornithine for facial hair

PCOS (Polycystic Ovary Syndrome) — FAQ

Can I still get pregnant with PCOS?

Yes. Most women with PCOS conceive, often with weight loss and ovulation induction. Early intervention improves outcomes.