What is PCOS?
PCOS is a hormonal disorder affecting 1 in 10 women of reproductive age. It causes irregular periods, excess androgens (male hormones), and sometimes cysts on the ovaries. Early diagnosis and treatment can help manage symptoms and reduce long-term complications.
Common PCOS Symptoms
Menstrual Irregularities
- • Infrequent periods: Fewer than 9 periods per year
- • Absent periods: No period for 3+ months (amenorrhea)
- • Heavy bleeding: When periods do occur
- • Unpredictable cycles: Can't track ovulation
Excess Androgen Signs
- • Hirsutism: Excess facial and body hair (face, chest, back, abdomen)
- • Acne: Persistent acne, especially on face, chest, upper back
- • Male-pattern baldness: Thinning hair on scalp
- • Oily skin: Increased sebum production
Metabolic Symptoms
- • Weight gain: Especially around abdomen, difficulty losing weight
- • Insulin resistance: Prediabetes or type 2 diabetes
- • Darkened skin: Acanthosis nigricans (neck, armpits, groin)
- • Skin tags: Small excess flaps of skin
Fertility & Reproductive Issues
- • Infertility: PCOS is leading cause of female infertility
- • Miscarriage risk: Slightly higher risk
- • Complications in pregnancy: Gestational diabetes, preeclampsia
Diagnosis Criteria
Rotterdam Criteria (2 of 3 needed):
- 1. Irregular ovulation: Infrequent or absent periods
- 2. Elevated androgens: Blood tests or physical signs (hirsutism, acne)
- 3. Polycystic ovaries: On ultrasound (12+ follicles per ovary)
Note: Other conditions must be ruled out (thyroid disorders, high prolactin, Cushing's)
Treatment & Management
Lifestyle Modifications
- • Weight loss: 5-10% reduction can restore ovulation
- • Low-glycemic diet: Reduce insulin resistance
- • Regular exercise: 150 minutes/week moderate activity
- • Strength training: Improves insulin sensitivity
Medications
- • Birth control pills: Regulate periods, reduce androgens
- • Metformin: Improve insulin sensitivity, may restore ovulation
- • Anti-androgens: Spironolactone for hirsutism
- • Clomid/letrozole: For fertility treatment
- • Hair removal: Laser, electrolysis for hirsutism
Long-Term Health Risks
Women with PCOS have increased risk for:
- • Type 2 diabetes: 50% develop diabetes by age 40
- • Heart disease: Higher rates of high blood pressure, cholesterol
- • Endometrial cancer: From years of unopposed estrogen
- • Sleep apnea: Especially with obesity
- • Depression/anxiety: 2-3x higher rates
Regular monitoring and treatment can significantly reduce these risks
Medical Review
Reviewed by: Ricardo Hamilton, MD
Last Updated: November 26, 2025
Sources: American College of Obstetricians and Gynecologists (ACOG), Endocrine Society, NIH