Polycystic Ovary Syndrome: Understanding PCOS

Comprehensive guide to PCOS including symptoms, diagnosis, treatment options, and fertility considerations.

10 min readLast updated: 2026-02-17

Quick Facts

Prevalence
PCOS affects 6-20% of reproductive-age women
Hormonal
Characterized by elevated androgen levels
ICD-10
E28.2

Overview: What Is PCOS?

Polycystic ovary syndrome is a complex endocrine disorder characterized by hormonal imbalance and metabolic dysfunction. It's the most common endocrine disorder in reproductive-age women, affecting fertility, metabolism, and long-term health .

PCOS presents with irregular periods, elevated androgen levels (male hormones), and ovulatory dysfunction. While multiple small follicles may appear on ovaries, the name reflects an outdated understanding; many women without cysts have PCOS, and many with ovarian cysts don't have the syndrome.

Key Information
PCOS diagnosis requires two of three criteria: irregular ovulation, clinical or biochemical hyperandrogenism, and polycystic ovary appearance on ultrasound. Hyperinsulinemia and insulin resistance are common features.

Symptoms and Signs

Irregular or absent periods are hallmark symptoms. Women often experience excessive hair growth (hirsutism), acne, and male-pattern baldness. Many struggle with weight gain, particularly abdominal weight distribution. Some experience infertility or difficulty conceiving.

Diagnosis and Evaluation

Diagnosis involves blood tests measuring testosterone, DHEA-S, and LH/FSH ratios. Pelvic ultrasound visualizes ovarian structure. Metabolic assessment includes fasting glucose, insulin levels, and glucose tolerance testing.

Warning
PCOS increases risks for type 2 diabetes (5 times), metabolic syndrome, cardiovascular disease, and endometrial cancer. Regular screening and preventive care are essential.
Clinical Note
Treatment emphasizes lifestyle modifications: weight loss of 5-10% improves ovulation and metabolic parameters . Medications address specific concerns: oral contraceptives regulate cycles, metformin improves insulin sensitivity, and anti-androgens reduce excessive hair growth. Fertility treatment options exist for those desiring pregnancy.

Managing PCOS Long-Term

Maintenance requires ongoing monitoring, regular exercise, balanced nutrition focusing on lower glycemic index foods, and stress management. Annual screening for diabetes and cardiovascular disease is important.

Sources

  1. [1]Fauser BCJM et al.. "Polycystic ovary syndrome." Nature Reviews Disease Primers, 2018.
  2. [2]Lizneva D et al.. "PCOS: Clinical and molecular pathogenesis." Endocrine Reviews, 2019.

Medically reviewed by

Medical Review Team, Obstetrics and Gynecology

Last updated: 2026-02-17Sources: 2

The content on Medical Atlas is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider.