PCOS is a multi organ disorder which affects the reproductive, metabolic, hormonal, general well being and psychological aspects of a female. Common features are infrequent or prolonged periods, excessive hair growth on body (hirsutism), acne, obesity. Ultrasound examination shows enlarged ovaries with multiple follicles seen as a ‘string of pearls’ along the ovaries.

Health risks involve hormonal imbalance, insulin resistance, metabolic abnormalities, infertility, pregnancy complications, type 2 diabetes, cardiovascular disease, cancer. Women are also at risk of mood disorder, eating disorder and anxiety. Almost 10% women of child bearing age have PCOS.

The main aspects that help doctors diagnose PCOS clinically:  

• Irregular periods
• Hirsutism
• Acne
• Skin tags
• Enlarged ovaries

Investigations that are needed to diagnose PCOS:

• Hormonal profile
• Thyroid function tests
• Prolactin
• Fasting sugar
• Lipid profile
• FSH
• LH
• DHEAS

  Management of PCOS :

The management of PCOS includes lifestyle modifications and medication to ensure that all aspects are managed and the signs and symptoms that are being caused due to PCOS are controlled.  

Lifestyle Modification:

• Weight management- 5-10% weight loss reduces the risk of serious complications and improves the clinical symptoms
• Exercise helps a lot in improvement
• Folate supplements
• Cosmetic therapy for hirsutism

Medication:

• Metformin improves the ovulation and helps managing weight. It improves period regulation also
• Combined oral contraceptive pill is the mainstay of management
• Cyclical progestins like medroxyprogesterone acetate can also be given for 10-14 days every 2-3 months to have periods
• Anti androgen therapy like aldactone or cyproterone can also be given for increased male hormones
• Infertility needs treatment

In a nutshell, PCOS is a disorder which causes irregular periods and increased androgens which cause male features to increase. It causes infertility, pregnancy complications, diabetes, cardiovascular disease, cancer etc. A multidisciplinary team of gynaecologist, dermatologist, endocrinologist, psychiatrist and physiotherapist are necessary for management of this complex disease with a lot of counselling so that you are motivated to keep on exercising and fighting against all odds.