PCOS: Signs, Complications & Treatment!

Polycystic ovary syndrome also known as PCOS is a condition presented with various symptoms, caused due to an elevated level of male hormones (androgens) in females.


  • Fewer than nine menstrual periods a year
  • No periods for three or more consecutive months
  • Infertility due to lack of ovulation
  • High amount of androgens
  • Acne
  • Hirustism, growth of hair on the chest or the chin
  • Heavy & prolonged menstrual periods
  • Increased hair thinning or diffuse hair loss
  • Obesity
  • Insulin resistance


  • Endometrial cancer
  • Type II Diabetes
  • High blood pressure
  • Cardiovascular disease
  • Depression
  • Dyslipidemia
  • Stroke
  • Miscarriage


  • Genetic & hereditary factors
  • Environmental factors like exposure to bisphenol A & some other drugs
  • Increasing rate of obesity
  • Hormonal & endocrine system dysfunction like;
  • Ovaries are stimulated to produce excess of androgens due to following factors:
    a) Release of excess luteinizing hormone (LH) by the anterior pituitary.
    b) High levels on insulin in the blood.
  • Increased GnRH pulse frequency
  • Excess of adipose tissue present in obese women
  • There is a relation between PCOS & increased oxidative stress.


  1. Careful noting of obvious symptoms that are present like hirustism, acne, change in menstrual pattern & obesity.
  2. Ultrasound of the ovaries done, looking for the presence of ovarian follicles (12 or more should be seen).
  3. Laparoscopic examination may reveal a thickened, smooth, pearl-white outer surface of the ovary.
  4. Elevated blood levels of androgens are found (androstenedione & testosterone).
  5. Higher level of anti-Müllerian hormone (AMH)
  6. Glucose tolerance test may indicate impaired glucose tolerance (insulin resistance).


  • Oral contraceptives: Increase sex hormone binding globulin which binds with free testosterone, therefore reducing symptoms of hirsutism & normalizing menstrual cycle.
  • Topical cream,  eflornithine to reduce facial hair
  • Medications like flutamide & spironolactone are used for their anti-androgen effect & reducing hirsutism.
  • 5-alpha reductase inhibitors (such as finasteride and dutasteride) block the conversion of testosterone to DHT.
  • Medications to induce ovulation in case of infertility (clomiphene, leuprorelin & letrozole).
  • Assisted reproductive technology procedures such as controlled ovarian hyperstimulation with follicle-stimulating hormone (FSH) injections followed by in vitro fertilisation (IVF).
  • Metformin is the anti-diabetic drug used to treat insulin resistance, associated with PCOS.
  • Metformin along with clomiphene increases the fertility index of the patient.
  • Statins in management of metabolic disorders & obesity.


  • Diet rich in fruits, vegetables & whole grains.
  • Low carbohydrate diet
  • Intake of Vitamin D supplements & treatment of the deficiency.
  • Increase in physical activity & exercise.
  • Weight loss & maintaining a healthy weight
  • Stress management.