What is Polycystic Ovary Syndrome (PCOS)? How is it Treated?

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal disorders affecting women of reproductive age. It is a complex endocrine condition that can impact menstrual cycles, ovulation, fertility, metabolism, and long-term health.

Many women first hear about PCOS after experiencing irregular periods, difficulty getting pregnant, acne, or unexpected weight gain. On ultrasound, the ovaries may appear with multiple small follicles aligned along the outer edge — often described as a “pearl necklace” appearance.

What is Polycystic Ovary Syndrome (PCOS)?

Polycystic Ovary Syndrome (PCOS) is a hormonal and metabolic disorder characterized by:

• Irregular or absent ovulation
• Elevated androgen (male hormone) levels
• Polycystic ovarian appearance on ultrasound

PCOS is not just a gynecological condition — it is also closely linked to insulin resistance and metabolic dysfunction.

In many women with PCOS:

• Insulin levels are elevated (hyperinsulinemia)
• Ovaries produce higher levels of testosterone
• Ovulation becomes irregular or stops entirely

This hormonal imbalance disrupts the communication between the brain (hypothalamus and pituitary gland) and the ovaries, leading to menstrual irregularities and fertility challenges.

PCOS is diagnosed based on clinical findings, blood hormone levels, and ultrasound imaging — not solely on the presence of ovarian cysts.

Symptoms of Polycystic Ovary Syndrome

Symptoms of PCOS can vary significantly from one woman to another. Some women experience mild symptoms, while others may have more pronounced hormonal and metabolic effects.

Common Symptoms of PCOS

• Irregular menstrual cycles (cycles shorter than 21 days or longer than 35 days)
• Absence of menstruation (amenorrhea)
• Difficulty getting pregnant
• Excess facial or body hair (hirsutism)
• Acne and oily skin
• Hair thinning or male-pattern hair loss
• Weight gain, especially around the abdomen
• Insulin resistance
• Darkened skin patches (acanthosis nigricans)

Not all women with PCOS are overweight. Lean PCOS also exists.

What Causes Polycystic Ovary Syndrome?

The exact cause of PCOS is not fully understood, but several contributing factors are recognized:

1. Insulin Resistance

Insulin resistance plays a central role in many PCOS cases. Elevated insulin levels stimulate ovarian androgen production, which disrupts ovulation.

2. Hormonal Imbalance

Increased LH (luteinizing hormone) relative to FSH can interfere with follicle maturation.

3. Genetic Factors

PCOS tends to run in families.

4. Chronic Low-Grade Inflammation

Some studies suggest inflammation contributes to increased androgen production.

PCOS is therefore considered both a reproductive and metabolic syndrome.

Does Polycystic Ovary Syndrome Go Away?

One of the most common questions is:

“Can PCOS disappear completely?”

PCOS does not fully disappear. However, it can be effectively managed.

With:

• Weight loss
• Lifestyle changes
• Medical treatment
• Hormonal regulation

Symptoms can significantly improve, and ovulation may resume.

PCOS management is long-term, but many women successfully control symptoms and achieve pregnancy.

Does PCOS Cause Infertility?

PCOS is one of the leading causes of ovulatory infertility.

Because ovulation is irregular or absent, natural conception may be more difficult.

However, infertility due to PCOS is often treatable.

Many women with PCOS conceive successfully with:

• Lifestyle modification
• Ovulation induction medication
• Insulin-sensitizing therapy
• Assisted reproductive treatments when necessary

Even a modest weight loss of 3–5% can significantly increase ovulation and natural pregnancy rates.

Treatment for Polycystic Ovary Syndrome (PCOS)

Treatment depends on:

• Whether pregnancy is desired
• Symptom severity
• Metabolic risk factors
• Age and overall health

PCOS treatment focuses on symptom management and long-term health protection.

1. Lifestyle Changes and Nutrition

Diet and exercise are foundational in PCOS management.

Goals include:

• Improving insulin sensitivity
• Reducing androgen levels
• Restoring ovulation
• Lowering long-term metabolic risk

Recommended strategies:

• Reduce processed carbohydrates
• Avoid sugary drinks and refined flour products
• Increase fiber intake
• Choose whole grains and legumes
• Engage in regular physical activity
• Maintain healthy body weight

Herbal treatments have not been shown to provide permanent resolution of PCOS.

2. Medication Treatment

Medication depends on treatment goals.

For menstrual regulation:

• Combined oral contraceptives

For ovulation induction:

• Letrozole
• Clomiphene citrate

For insulin resistance:

• Metformin

For excessive hair growth or acne:

• Anti-androgen medications (under medical supervision)

Medication restores hormonal balance and improves ovulatory function.

3. Surgical Treatment (Laparoscopic Ovarian Drilling)

If ovulation induction medications fail, laparoscopic ovarian drilling may be considered.

This minimally invasive procedure:

• Creates small punctures in the ovarian surface
• Reduces androgen production
• May restore ovulation temporarily

Pregnancy rates may improve within 6 months after the procedure.

However, surgery is not first-line treatment.

Long-Term Health Risks of PCOS

PCOS is associated with increased risk of:

• Type 2 diabetes
• Metabolic syndrome
• Hypertension
• Cardiovascular disease
• Endometrial hyperplasia
• Endometrial cancer (due to chronic anovulation)

Regular follow-up is essential.

When Should You See a Doctor?

You should consult a doctor if you experience:

• Irregular or absent periods
• Difficulty getting pregnant
• Excess facial hair or severe acne
• Rapid weight gain
• Signs of insulin resistance

Early diagnosis allows better symptom control and fertility preservation.

Frequently Asked Questions (FAQ)

What is the main cause of PCOS?

The main underlying factor in many cases is insulin resistance, which increases androgen production and disrupts ovulation.

Can you get pregnant with PCOS?

Yes. Many women with PCOS conceive naturally or with treatment. Ovulation induction therapy is highly effective.

Does losing weight cure PCOS?

Weight loss does not cure PCOS but significantly improves symptoms and restores ovulation in many women.

Is PCOS dangerous?

PCOS itself is not life-threatening, but if untreated, it increases the risk of diabetes, heart disease, and endometrial cancer.

Does PCOS always show cysts on ultrasound?

No. Not all women with PCOS have visible cysts, and having ovarian cysts alone does not mean PCOS.

Can PCOS go away after pregnancy?

Pregnancy does not cure PCOS. However, symptoms may temporarily improve due to hormonal changes.