Understanding PCOS: It Is More Than Just Irregular Periods

The Core Features of PCOS: A diagnosis of PCOS typically requires two of the following three criteria (the Rotterdam criteria): 1. Irregular or absent periods (oligo/anovulation) 2. Signs of high androgens (male hormones) — such as excess facial/body hair, acne, or male-pattern hair loss 3. Polycystic ovaries seen on ultrasound (multiple small follicles, giving a 'pearl necklace' appearance) The Hidden Symptoms: Beyond the diagnostic criteria, many women with PCOS struggle with symptoms that impact their daily lives: - Weight gain or severe difficulty losing weight - Fatigue and low energy - Skin tags or dark patches of skin (acanthosis nigricans), especially on the neck or armpits (signs of insulin resistance) - Mood changes, depression, and anxiety - Sleep apnea The Role of Insulin Resistance: Up to 70-80% of women with PCOS have insulin resistance, meaning their bodies produce insulin but cannot use it effectively. To compensate, the pancreas pumps out more insulin. High insulin levels trigger the ovaries to produce more androgens (testosterone), which then disrupts ovulation and worsens symptoms like weight gain and hair growth. This creates a vicious cycle. How PCOS Affects Fertility: The primary fertility issue is anovulation. Since you are not releasing an egg every month (or at all), conception naturally becomes very difficult. The hormonal imbalances can also affect egg quality and the uterine lining. Management is Ongoing: PCOS cannot be 'cured', but it can be highly managed. The foundation of management is lifestyle: targeted diet (low glycemic index), regular exercise, and maintaining a healthy weight. Medical treatments range from Metformin (for insulin resistance) to Letrozole (to induce ovulation) and, in some cases, IVF.