POLYCYSTIC OVARIAN SYNDROME (PCOS)
Your Journey to Restore Fertility
PCOS can affect more than just fertility; it also influences overall health, appearance, and well-being. About 1 in 5 women are affected, but many do not realise they have PCOS until they try to conceive.
What is PCOS?
Polycystic Ovarian Syndrome (PCOS) is a common hormonal condition that affects women of reproductive age.
It is caused by a combination of hormonal imbalances and insulin resistance, which can disrupt ovulation.
Many women with PCOS develop small fluid-filled sacs (follicles) along the edge of their ovaries. These follicles contain immature eggs that do not mature or release regularly, leading to irregular or absent periods.
Causes and Contributing Factors
The exact cause is unknown, but both genetics and lifestyle play a role. A family history increases the likelihood, while factors such as diet, weight, and insulin resistance can worsen symptoms. Contributing mechanisms include:
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Insulin resistance, which raises insulin levels and triggers higher production of androgens (male hormones).
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Hormonal imbalance, where elevated androgens and luteinizing hormone (LH), combined with low follicle-stimulating hormone (FSH), disrupt ovulation.
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Low-grade inflammation, which is linked to higher androgen levels and more severe symptoms.
Signs and Symptoms
PCOS looks different for every woman. Symptoms may appear at puberty or later, often after weight gain. Common features include irregular or absent periods, difficulty falling pregnant, acne or excess hair growth, scalp hair thinning, weight gain (especially around the waist), darkened skin patches or skin tags, and polycystic ovaries visible on ultrasound. Women with PCOS are also at higher risk of metabolic problems such as high cholesterol, high blood pressure, and type 2 diabetes.
Treatment options
Although PCOS cannot be cured, symptoms and fertility challenges can be effectively managed:
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Lifestyle changes such as weight management, a balanced diet, and regular exercise often improve insulin resistance, regulate cycles, and ease symptoms.
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Medication may include birth control pills to regulate cycles and manage acne or excess hair, metformin to improve insulin sensitivity, or anti-androgen medication.
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Fertility treatments such as ovulation induction with clomiphene or letrozole are first-line approaches, while IVF may be considered if other methods are unsuccessful.
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Surgery, in selected cases, may involve laparoscopic ovarian drilling to stimulate ovulation.
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When to Seek Help
Medical advice is recommended if you have irregular or missed periods, difficulty conceiving after regular unprotected intercourse, signs of high androgen levels (such as acne or excess hair growth), unexplained weight gain, or symptoms of insulin resistance. Early diagnosis helps manage symptoms and reduce long-term health risks.
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Long-Term Risks and Complications
If unmanaged, PCOS can increase the risk of diabetes, metabolic syndrome, obesity, high cholesterol, and high blood pressure. Irregular ovulation can also cause thickening of the uterine lining, raising the risk of endometrial cancer. Women may experience depression, anxiety, and pregnancy complications such as gestational diabetes, hypertension, or pre-eclampsia.