PCOS (Polycystic Ovary Syndrome)

PCOS is the most common hormonal disorder in women of reproductive age, and India has one of the highest prevalence rates globally. It is not just a reproductive condition but a metabolic one affecting multiple body systems.

Diagnosis (Rotterdam Criteria)

Requires 2 of 3 features: irregular or absent ovulation, clinical or biochemical hyperandrogenism (acne, hirsutism, elevated testosterone), and polycystic ovaries on ultrasound.

Why insulin resistance matters

70-80% of women with PCOS have insulin resistance, even at normal weight. This drives many PCOS symptoms (weight gain, acne, irregular periods) and increases long-term risk of type 2 diabetes.

Treatment approach

Lifestyle: A 5-10% weight loss can restore ovulation in many women. Medication depends on goals: Metformin for insulin resistance, oral contraceptives for period regularity, letrozole or clomiphene for fertility. Inositol supplementation has growing evidence.

Long-term management

PCOS is a lifelong condition but is well-manageable. Annual screening for diabetes, lipids, and blood pressure is recommended. Endometrial protection is important (periods at least every 3 months).