Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a common hormonal disorder affecting women of reproductive age, causing irregular periods, elevated levels of male hormones, and, in many cases, small cysts on the ovaries. It is a leading cause of infertility but can be managed effectively.

• Irregular, infrequent, or absent menstrual periods
• Excess hair growth on the face or body (hirsutism)
• Acne or oily skin
• Weight gain or difficulty losing weight
• Thinning hair on the scalp
• Difficulty conceiving, related to irregular or absent ovulation

• The exact cause is not fully understood, but PCOS involves a combination of hormonal imbalance, insulin resistance, and genetic factors.
• Family history of PCOS increases risk.
• Insulin resistance is common in PCOS and can contribute to both the hormonal imbalance and weight-related symptoms.

• Diagnosed using a combination of clinical features (such as irregular periods and signs of excess male hormone activity), blood tests for hormone levels, and, where available, pelvic ultrasound to assess the ovaries — typically requiring at least two of these three types of findings, after excluding other causes of similar symptoms.
• Testing for insulin resistance and blood lipid levels is often included, given the associated metabolic risk.

Lifestyle measures — a balanced diet and regular physical activity — are a foundation of management, particularly as modest weight loss can improve symptoms and hormonal balance in those who are overweight.

Hormonal contraception (such as the combined oral contraceptive pill) is commonly used to regulate periods and reduce excess hair growth and acne in women not currently trying to conceive.

Metformin may be used to help address insulin resistance, particularly in women with associated metabolic features.

For women trying to conceive, specific fertility medicines may be used under specialist guidance to support ovulation.

Regular monitoring for associated conditions, such as type 2 diabetes and abnormal blood lipids, is recommended given the increased long-term metabolic risk associated with PCOS.

• Maintain a balanced diet and regular physical activity to support a healthy weight and insulin sensitivity.
• Seek early assessment for irregular periods rather than assuming they are simply normal variation.
• Attend regular follow-up for monitoring of metabolic risk factors, such as blood sugar and cholesterol.
• Discuss family planning goals with a health worker, since management differs depending on whether pregnancy is currently desired.