Polycystic Ovary Syndrome (PCOS) Explained by the Best Gynecologist in Delhi

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal disorders affecting women of reproductive age. Characterized by a range of symptoms, including irregular menstrual cycles, acne, weight gain, and excess hair growth, PCOS impacts not only physical health but also emotional well-being and fertility.

The best gynecologist in Delhi emphasizes that PCOS is not a one-size-fits-all condition. Its presentation can vary significantly from one individual to another, and effective management often requires a personalized, multi-disciplinary approach. Early diagnosis and targeted lifestyle modifications can make a tremendous difference in improving quality of life and reducing long-term health risks.

This blog aims to unpack the causes, symptoms, diagnostic criteria, and treatment options for PCOS — helping you understand this condition and how to manage it effectively.

What Is PCOS?

Polycystic Ovary Syndrome is a complex endocrine disorder that affects how the ovaries function. In women with PCOS:

• The ovaries may develop multiple small cysts (fluid-filled sacs)
  
  

• Ovulation may be irregular or absent
  
  

• Hormonal imbalances disrupt menstrual cycles and other bodily functions
  
  

Despite the name, not all women with PCOS have ovarian cysts, and not all ovarian cysts indicate PCOS. The syndrome encompasses a broader hormonal disruption.

Causes and Risk Factors

The exact cause of PCOS remains unclear, but several contributing factors have been identified:

1. Insulin Resistance

Many women with PCOS have insulin resistance, where the body’s cells become less responsive to insulin. This leads to increased insulin levels, which in turn can stimulate excess androgen (male hormone) production in the ovaries.

2. Hormonal Imbalance

An excess of androgens (like testosterone) disrupts the normal development of follicles in the ovaries, interfering with ovulation and causing acne, hair growth, and irregular periods.

3. Genetics

PCOS tends to run in families. If your mother or sister has PCOS, your risk increases.

4. Low-Grade Inflammation

Chronic low-level inflammation is associated with PCOS and may contribute to androgen production and cardiovascular risk.

Common Symptoms of PCOS

PCOS can manifest in various ways, and not all women experience the same symptoms. Some of the most common include:

• Irregular periods or absence of menstruation (amenorrhea)
  
  

• Weight gain or difficulty losing weight
  
  

• Hirsutism (excess hair on the face, chest, or back)
  
  

• Acne and oily skin
  
  

• Hair thinning or male-pattern baldness
  
  

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

• Difficulty conceiving due to lack of ovulation
  
  

• Mood changes, anxiety, or depression
  
  

Many of these symptoms are subtle and can be mistaken for other conditions, which is why thorough evaluation is essential.

How Is PCOS Diagnosed?

There is no single test to confirm PCOS. Diagnosis is based on a combination of clinical signs, blood tests, and imaging studies.

The Rotterdam Criteria are commonly used and require two of the following three:

1. Irregular or absent ovulation (irregular or infrequent periods)
   
   

2. Clinical or biochemical signs of high androgens (acne, excess hair, elevated testosterone)
   
   

3. Polycystic ovaries on ultrasound (presence of 12+ follicles in each ovary or enlarged ovarian volume)
   
   

Other conditions like thyroid disorders, hyperprolactinemia, and congenital adrenal hyperplasia must be ruled out.

Diagnostic Workup May Include:

• Hormonal blood tests (LH, FSH, testosterone, prolactin, TSH)
  
  

• Pelvic ultrasound
  
  

• Glucose tolerance test
  
  

• Lipid profile
  
  

• Insulin and HbA1c testing
  
  

A holistic understanding of symptoms, labs, and medical history is key to an accurate diagnosis.

PCOS and Fertility

One of the most common concerns among women with PCOS is infertility. Due to irregular ovulation or anovulation, conceiving naturally may take longer. However, with the right interventions, most women with PCOS can achieve pregnancy.

Fertility Treatment Options Include:

• Lifestyle changes to improve ovulation
  
  

• Ovulation induction medications like Letrozole or Clomiphene
  
  

• Metformin for insulin resistance
  
  

• Assisted reproductive technologies (ART) like IUI or IVF in more complex cases
  
  

Early intervention and proper guidance increase the chances of successful conception.

Long-Term Health Risks of PCOS

PCOS is not limited to reproductive symptoms—it can have long-term implications if unmanaged:

• Type 2 Diabetes or Prediabetes
  
  

• High blood pressure
  
  

• Dyslipidemia (high cholesterol)
  
  

• Sleep apnea
  
  

• Depression and anxiety
  
  

• Endometrial hyperplasia or cancer (due to prolonged lack of ovulation)
  
  

• Heart disease risk later in life
  
  

Monitoring and managing PCOS from a young age helps prevent these complications.

Treatment: Managing PCOS Holistically

While PCOS cannot be "cured," it can be effectively managed through a combination of lifestyle changes, medications, and regular monitoring.

1. Lifestyle Modifications

This is the first and often most effective step:

• Weight loss (even 5–10% can restore ovulation)
  
  

• Balanced diet (low-GI foods, whole grains, lean protein, healthy fats)
  
  

• Regular exercise (a mix of cardio and strength training)
  
  

• Stress reduction through mindfulness, yoga, or therapy
  
  

• Adequate sleep to regulate hormones
  
  

These changes address insulin resistance and hormonal imbalances naturally.

2. Medications

• Combined oral contraceptives to regulate periods and reduce androgens
  
  

• Anti-androgens like Spironolactone to reduce hair growth and acne
  
  

• Metformin to improve insulin sensitivity
  
  

• Ovulation induction agents for women trying to conceive
  
  

Treatment is customized based on symptoms and goals—whether for cycle regulation, skin health, or fertility.

3. Skin and Hair Treatments

Topical creams, laser hair removal, and dermatologic therapies may be used alongside hormonal treatments to manage acne and hirsutism.

Adolescent PCOS: Special Considerations

Diagnosing PCOS in teenagers requires caution. Irregular periods and acne are normal during early puberty, making it difficult to distinguish from PCOS. However, if symptoms persist or worsen, medical evaluation is crucial.

Intervention in adolescence prevents complications and sets up lifelong healthy habits.

Emotional and Psychological Impact