Polycystic ovary syndrome (PCOS) is a common hormonal disorder affecting 5–13% of women of reproductive age, characterized by irregular periods, excess androgen levels, and/or small, immature follicles (cysts) on the ovaries. It causes infertility, acne, excessive hair growth, and weight gain, often linked to insulin resistance. Treatment includes lifestyle changes (diet, exercise) and medications like birth control pills to manage symptoms.
World Health Organization (WHO)
Symptoms of PCOS
Symptoms often begin around puberty or in the 20s-30s and can include:
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- Irregular periods: Infrequent, missed, or very heavy periods (oligomenorrhea or amenorrhea).
- Hyperandrogenism: High levels of male hormones causing acne, hirsutism (excessive facial/body hair), and male-pattern baldness.
- Polycystic ovaries: Ovaries containing numerous small, immature follicles, often appearing on ultrasound as a "string of pearls".
Weight gain: Difficulty losing weight, particularly around the abdomen.
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Causes of PCOS
While the exact cause is unknown, it is considered a complex endocrine, metabolic, and reproductive disorder involving:
- Insulin resistance: High insulin levels prompt the ovaries to produce more androgens.
- Hormonal imbalance: Excess androgens (like testosterone) interfere with egg development and ovulation.
Genetics: It often runs in families.
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Long-Term Effects and Risks
If left unmanaged, PCOS increases the risk of:
- Type 2 diabetes.
- Infertility and pregnancy complications.
- Heart and blood vessel problems (high blood pressure, high cholesterol).
- Endometrial cancer (due to long-term lack of ovulation).
Diagnosis and Treatment
Diagnosis is typically made if a person has at least two of the following: irregular/no ovulation, high androgens, and/or polycystic ovaries on ultrasound. Treatment focuses on managing symptoms and improving long-term health:
- Lifestyle changes: Losing 5–7% of body weight can restore ovulation and improve symptoms.
- Medications: Combined hormonal contraceptives (pills, patches, rings) to regulate cycles, and Metformin for insulin resistance.
- Fertility treatments: Clomiphene or letrozole to induce ovulation for those trying to conceive.
- Hair Removal/Skin Treatments: Medications like spironolactone or procedures like laser hair removal for hirsutism/acne