Polycystic Ovary Syndrome, commonly known as PCOS, is one of the most common hormonal disorders affecting individuals with ovaries, especially during their reproductive years. Characterized by irregular menstrual cycles, hormonal imbalance, and small fluid-filled sacs (cysts) on the ovaries, PCOS can significantly affect fertility and overall health if left unmanaged.

This guide explores what PCOS is, what causes it, its key symptoms, associated health risks, and the available treatment options. It also provides insight into how PCOS impacts pregnancy and menopause.

What Is PCOS?

PCOS is a condition that disrupts normal ovarian function. In individuals with PCOS, the ovaries may develop multiple immature follicles that fail to release eggs regularly, leading to irregular or absent ovulation.

Along with ovarian cysts, PCOS is marked by increased levels of androgens (male hormones), which can cause physical symptoms like acne, excess facial and body hair, and thinning hair on the scalp. It also interferes with insulin usage in the body, increasing the risk of insulin resistance and related metabolic issues.

PCOS is a leading cause of ovulatory infertility. It’s also associated with long-term health risks such as type 2 diabetes, heart disease, and high blood pressure.

 

Quick Facts About PCOS

  • PCOS affects an estimated 8–20% of individuals of reproductive age.

  • More than half of people with PCOS may develop type 2 diabetes before the age of 40.

  • PCOS contributes to approximately 70% of ovulation-related infertility.

  • Despite its prevalence, many people remain undiagnosed due to its wide range of symptoms and varying severity.

Causes and Risk Factors

While the exact cause of PCOS remains unknown, several contributing factors are believed to influence its development:

1. Genetic Predisposition

PCOS often runs in families. If a parent or sibling has the condition, the risk increases significantly.

2. Insulin Resistance

Many individuals with PCOS have difficulty using insulin effectively. This leads to higher insulin levels, which can trigger the ovaries to produce more androgens, disrupting the normal menstrual cycle and leading to symptoms like weight gain and acne.

3. Low-Grade Inflammation

Ongoing low-level inflammation may contribute to higher androgen production in the ovaries and plays a role in insulin resistance.

Health Risks Linked to PCOS

The hormonal imbalance and insulin resistance seen in PCOS can increase the likelihood of several medical conditions, including:

  • Type 2 diabetes

  • Infertility and miscarriage

  • Metabolic syndrome

  • High cholesterol and triglycerides

  • Sleep apnea

  • Liver inflammation (nonalcoholic fatty liver disease)

  • High blood pressure

  • Endometrial cancer

  • Depression and anxiety

  • Obesity and weight management issues

Because of these risks, early diagnosis and appropriate treatment are essential to prevent complications.

Common Symptoms of PCOS

PCOS symptoms can vary from person to person, and not everyone will experience the same combination or intensity. Common signs include:

  • Irregular or missed periods

  • Heavy or prolonged menstrual bleeding

  • Excess hair on the face, chest, or abdomen (hirsutism)

  • Acne or oily skin

  • Thinning hair or hair loss on the scalp

  • Unexplained weight gain or difficulty losing weight

  • Dark patches of skin (acanthosis nigricans), especially on the neck or underarms

  • Skin tags

  • Pelvic pain

  • Low libido

  • Fatigue

  • Infertility or difficulty getting pregnant

  • Mood changes, anxiety, or depression

If left unaddressed, some of these symptoms may worsen over time, especially around menopause.

How PCOS Is Diagnosed

There is no single test to definitively diagnose PCOS. Healthcare providers use a combination of the following methods:

  • Medical history review, including symptoms and menstrual patterns

  • Physical exam, which may include a pelvic exam

  • Blood tests to measure hormone, glucose, and cholesterol levels

  • Ultrasound to examine the appearance of the ovaries and endometrial lining

A diagnosis is typically confirmed if at least two of the following criteria are met:

  • Irregular or absent ovulation

  • Signs of excess androgens (through symptoms or bloodwork)

  • Multiple small follicles on the ovaries as seen on ultrasound

Treatment Options for PCOS

There is no cure for PCOS, but several treatments are available to help manage symptoms and reduce the risk of long-term complications. The approach often depends on whether or not the individual is trying to conceive.

For Managing Hormonal Imbalance and Menstrual Irregularities:

  • Birth control pills (combined estrogen and progestin) help regulate the menstrual cycle and reduce androgen levels.

  • Progestin-only therapy may also be used periodically to prevent endometrial hyperplasia.

For Fertility Support:

  • Clomiphene citrate (Clomid) to stimulate ovulation

  • Letrozole (Femara), which may be more effective for some patients

  • Metformin, especially if insulin resistance is present

  • Gonadotropin injections (FSH and LH) to trigger ovulation

  • In vitro fertilization (IVF) or intrauterine insemination (IUI) for advanced fertility support

For Excessive Hair Growth and Acne:

  • Spironolactone, an anti-androgen medication

  • Eflornithine cream to slow facial hair growth

  • Laser hair removal or electrolysis for permanent results

  • Finasteride, though not suitable for use during pregnancy

Surgical Interventions:

  • Ovarian drilling, a minimally invasive procedure to restore ovulation

  • Oophorectomy, the removal of one or both ovaries in severe cases

  • Hysterectomy, in cases where childbearing is no longer desired and symptoms are severe

  • Cyst aspiration, to remove fluid from enlarged cysts

Home Remedies and Lifestyle Support

Many individuals with PCOS find that certain lifestyle changes can help improve symptoms and hormonal balance:

  • Adopt a nutrient-rich diet with whole grains, lean proteins, fruits, and vegetables

  • Maintain a healthy weight to reduce insulin resistance and regulate hormone production

  • Exercise regularly, including both aerobic activity and strength training

  • Quit smoking, as it increases androgen levels and cardiovascular risk

  • Manage stress through mindfulness, sleep hygiene, or therapy

Even modest weight loss—around 5–10% of body weight—can significantly improve PCOS symptoms and fertility outcomes.

PCOS and Its Impact on Pregnancy and Menopause

During Pregnancy

Women with PCOS may still conceive, but they have a higher risk of:

  • Miscarriage

  • Gestational diabetes

  • Pregnancy-induced hypertension

  • Preterm birth

  • Complications requiring neonatal intensive care

Proper medical support and blood sugar monitoring are essential during pregnancy for individuals with PCOS.

After Menopause

While menstrual irregularities often resolve post-menopause, other symptoms—such as excess hair growth, scalp hair thinning, and metabolic risks—can persist or worsen. PCOS also increases the risk of developing cardiovascular disease and type 2 diabetes in older age.

Conclusion

Polycystic Ovary Syndrome is a complex, lifelong condition with implications that go far beyond fertility. While the root cause remains unknown, early detection and consistent management can help reduce symptoms, improve quality of life, and prevent long-term complications.

If you suspect you may have PCOS—or experience irregular periods, excessive hair growth, or unexplained weight changes—consider speaking with a healthcare provider for a full evaluation and guidance on treatment options.