What is PCOS?

PCOS occurs in approximately 5 to 10 percent of women. The elevated androgen levels and insulin resistance is considered to be the main causes of PCOS. If you have PCOS you may be experiencing irregular periods, excessive facial hair growth, acne, and/or male-pattern scalp hair thinning. Most, but not all, women with PCOS are overweight or obese, and they are at higher-than-average risk of developing diabetes. Most women with PCOS are able to lead a normal life without significant complications.


Hormonal imbalance:- The cause of PCOS is not completely understood. With regards to the reproductive system, it is believed that abnormal levels of the hormones interfere with the normal function of the ovaries. An ultrasound of the ovaries often shows cysts that may or may not related to the PCOS. In women with PCOS, multiple small follicles (small cysts 4 to 9 mm in diameter) accumulate in the ovary, hence the term polycystic ovaries.

Metabolic syndrome:- The metabolic system controls the processing of carbohydrates, fats, and proteins. PCOS is associated with elevated levels of insulin in the blood. Insulin is a hormone that is produced by specialized cells within the pancreas; insulin regulates blood glucose levels. When blood glucose levels rise (after eating, for example), these cells produce insulin to help the body use glucose for energy.

If glucose levels do not respond to normal levels of insulin, the pancreas produces more insulin. Excess production of insulin is called hyperinsulinemia. Also the body doesn’t respond to the insulin to metabolise glucose is called insulin resistance.

Insulin resistance and hyperinsulinemia can occur in both normal-weight and overweight women with PCOS. Among women with PCOS, up to 35 percent of those who are obese develop impaired glucose tolerance ("prediabetes") by age 40 years, while up to 10 percent of obese women develop type 2 diabetes. The risk of these conditions is much higher in women with PCOS compared with women without PCOS.


Signs and symptoms of PCOS usually begin around the time of puberty, although some women do not develop symptoms until late adolescence or even into early adulthood. Because hormonal changes vary from one woman to another, patients with PCOS may have mild to severe acne, facial hair growth, or scalp hair loss.

Irregular Periods

Women with PCOS usually have fewer than six to eight menstrual periods per year. Some women have normal cycles during puberty, which may become irregular if the woman becomes overweight.

Weight Gain and Obesity

PCOS is associated with gradual weight gain and obesity in approximately one-half of women. For some women with PCOS, obesity develops at the time of puberty.

Male Pattern Hair Growth and Acne

Male-pattern hair growth (hirsutism) may be seen on the upper lip, chin, neck, sideburn area, chest, upper or lower abdomen, upper arm, and inner thigh. Acne is a skin condition that causes oily skin and blockages in hair follicles.


Many women with PCOS do not ovulate regularly, and it may take these women longer to become pregnant. An infertility evaluation is often recommended after 6 to 12 months of trying to become pregnant.

Heart Disease

Women who are obese and who also have insulin resistance or diabetes may increase the risk of cardiovascular diseases. Both weight loss and treatment of insulin abnormalities can decrease this risk.

Sleep Apnea

Sleep apnea is a condition that causes brief spells where breathing stops (apnea) during sleep. Sleep apnea may occur in up to 50 percent of women with PCOS. Patients with this problem often experience fatigue and daytime sleepiness.

Other Symptoms

Depression and anxiety, Sexual dysfunction, Eating disorders and anorexia.


There is no single test for diagnosing PCOS. You may be diagnosed with PCOS based upon your symptoms, blood tests, and a physical examination. Expert groups have determined that a woman must have two out of three of the following to be diagnosed with PCOS:

  • Irregular menstrual periods caused by anovulation or irregular ovulation.
  • Evidence of elevated androgen levels. The evidence can be based upon signs (excess hair growth, acne, or male-pattern balding) or blood tests (high androgen levels).
  • Polycystic ovaries on pelvic ultrasound examination

Blood tests are usually recommended to determine whether another condition is the cause of your signs and/or symptoms. Blood tests for pregnancy, prolactin level, thyroid-stimulating hormone (TSH), and follicle-stimulating hormone (FSH) may be recommended.

If PCOS is confirmed, blood glucose and cholesterol testing are usually performed. An oral glucose tolerance test is the best way to diagnose prediabetes and/or diabetes. A fasting glucose level is often normal even when prediabetes or diabetes is present. In women with moderate to severe hirsutism (excess hair growth), blood tests for testosterone and dehydroepiandrosterone sulfate (DHEAS) may be recommended. Symptoms of PCOS may seem minor and annoying, and treatment may seem unnecessary. However, untreated PCOS can increase a woman's risk of other health problems over time.

Preparing for the Doctor’s Visit

In today’s health-care environment, many physicians are crunched for time. Be sure to bring anything to the appointment that outlines your past medical history and specific concerns. Make a list of all the potentially important pieces of the puzzle for the PCOS expert to analyze. This greatly facilitates the gathering of information and helps the clinician develop a clear picture of what’s been happening and what your goals are. Gather the following information ahead of time:

Menstrual history: How old were you when you got your first period? What has your menstrual pattern been like? Are there any previous pregnancies, and if so, how many?

Weight history: If you are currently overweight, did your weight change significantly in a short period of time? Has your weight been a challenge all your life, or has managing it become more of a problem recently?

Family history: Are there diabetes, heart disease, cancer, history of fertility problems, or weight issues in your family?
Medications and/or dietary supplements. Include everything you are taking as well as the doses.

Previous tests: If available, bring along the results of previous blood tests, ultrasounds, and so on.

The first thing that will generally happen in the diagnosis process is that the doctor will look to rule out other explanations for your health complaints. These might include such disorders as hyperprolactinmeia, non-classic congenital adrenal hyperplasia, or Cushing’s syndrome, a hormonal disorder caused by prolonged exposure of the body’s tissues to high levels of the hormone cortisol. The doctor will weed through three different types of information: the symptoms and a physical examination, a variety of blood tests, and other test results. What exactly is he or she looking for?