Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome is the most common endocrine disorder in reproductive-age women, affecting 6–12%. It is characterized by androgen excess, ovulatory dysfunction, and/or polycystic ovarian morphology on ultrasound. Beyond menstrual irregularity and fertility impact, PCOS carries long-term metabolic risks including type 2 diabetes, dyslipidemia, and cardiovascular disease.
When to Book
Book a visit if symptoms are new, persistent, getting worse, or affecting daily life. Early evaluation often prevents complications.
Symptoms
Irregular or absent periods, excess facial or body hair (hirsutism), acne, scalp hair thinning, weight gain especially in the abdomen, skin tags, darkened skin in body folds, difficulty conceiving, and mood changes.
Causes & Risk Factors
The exact cause is multifactorial — insulin resistance amplifies androgen production from the ovaries, disrupting follicle development and ovulation. Genetic predisposition, low birth weight, and early puberty are additional risk factors. Approximately 70% of women with PCOS have insulin resistance.
How We Evaluate
Rotterdam criteria require two of three features: oligo/anovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology on ultrasound. We measure total and free testosterone, DHEAS, LH, FSH, estradiol, and rule out thyroid disease, hyperprolactinemia, and non-classic congenital adrenal hyperplasia.
Treatment Options
Lifestyle modification is first-line: a 5–10% weight reduction significantly improves ovulatory function and metabolic markers. Combined oral contraceptives regulate cycles and reduce androgens. Metformin improves insulin sensitivity and cycle regularity. Letrozole is first-line for ovulation induction in women seeking conception. Spironolactone addresses hirsutism and acne.
When It Is Urgent
PCOS is rarely an emergency. Seek prompt care for sudden severe pelvic pain (which could indicate ovarian torsion) or if you develop symptoms of ovarian hyperstimulation syndrome during fertility treatment.
Frequently Asked Questions
Can I get pregnant with PCOS?
Yes. Most women with PCOS can conceive with appropriate management. Letrozole achieves ovulation in the majority of cases, and metformin improves the response. Referral to reproductive endocrinology is available for more complex situations.
Does PCOS go away after menopause?
Androgen levels decline and menstrual irregularity resolves after menopause, but the metabolic risks — insulin resistance, cardiovascular risk — persist and may require continued management.
Get a Clear Plan for Polycystic Ovary Syndrome (PCOS)
Our endocrinology team evaluates you as an individual and builds a treatment plan that fits your life — not a template.