Polycystic Ovary Syndrome (PCOS) is one of the most common conditions affecting women of reproductive age. It affects nearly one in ten women worldwide, but many go undiagnosed for years. PCOS is a complex condition that affects not only a woman’s reproductive health but also her metabolism, mental health, and long-term well-being
This article explains what PCOS is, its causes, symptoms, diagnosis, treatment options, diet, lifestyle tips, and ways to prevent complications, helping women make informed health decisions.
What is PCOS?
Polycystic ovarian syndrome (PCOS) is a condition caused by hormonal changes, occurring when ovaries (reproductive organs in females that produce eggs) release excess levels of hormones called androgens (male hormones), creating an imbalance that disrupts the menstrual cycle, affecting regular ovulation.
How does PCOS affect women?
Women with this condition may have
- Missed or irregular periods
- Polycystic ovaries (enlarged ovaries with multiple small follicles, often visible on an ultrasound)
- Increased androgen levels may cause acne, hair loss, and facial hair.
Note: PCOS is also associated with lifestyle-related conditions such as insulin resistance, obesity, type 2 diabetes, infertility, and heart disease, making it more than just a reproductive issue.
What are the different types of PCOS?
PCOS can be classified into 4 types. Depending upon the lifestyle and environmental factors, these include
1. Insulin-Resistant PCOS
This is the most common form of PCOS. It occurs when the body develops insulin resistance due to factors such as smoking, excessive sugar consumption, pollution, and trans fats. High insulin levels disrupt ovulation and cause the ovaries to produce excessive testosterone.
2. Pill-Induced PCOS
This is the second most common type and occurs after long-term use of birth control pills that suppress ovulation. Many women experience normal ovulation once they stop taking the pill. However, in some cases, ovulation does not occur for months or even years. However, this is a controversial concept that is frequently viewed as a temporary hormonal disruption rather than true PCOS.
3. Inflammatory PCOS
Inflammatory PCOS develops when chronic inflammation disrupts ovulation, resulting in hormonal imbalance and excess androgen production. Stress, environmental toxins, food sensitivities, and gluten intolerance are all potential causes of inflammation.
Common symptoms include frequent headaches, skin allergies, infections, vitamin D deficiency, abnormal blood counts, and thyroid irregularities.
4. Secondary PCOS
Hidden PCOS is often caused by underlying conditions and usually resolves within 3–4 months once the root issue is treated. Contributing factors may include thyroid disease, iodine deficiency (especially in women on a vegetarian diet), zinc deficiency, or consumption of artificial sweeteners.
When to suspect a different PCOS condition
- If periods stay irregular even with a healthy lifestyle, see your doctor.
- Irregular cycles after stopping birth control may indicate pill-induced PCOS.
- Being overweight with high insulin or abnormal glucose tests may indicate insulin-resistant PCOS.
Early diagnosis is key—treatment works best when customized to the type of PCOS.
What are the common symptoms of Polycystic Ovarian Syndrome?
Depending on the lifestyle and health condition, PCOS symptoms vary from woman to woman. The most common signs include
- Menstrual irregularities: Often related to missed periods and irregular cycles that sometimes involve heavy periods and bleeding.
- Excess hair growth (hirsutism): Often linked with PCOS, heavy hair growth can be observed in the arms, chest, face, and abdomen, affecting about 5-10% of women during reproductive age.
- Acne and Oily skin: Due to excessive androgen levels, acne can appear on your face and may continue throughout your puberty, and may be difficult to treat.
- Weight gain and obesity: approximately 50% of women with overweight are found to have PCOS, especially women, making it difficult to manage their weight.
- Dark patches around skin: you may have darkening of skin, especially in the region around the armpit, neck, and groin (between the legs). This condition is also known as acanthosis nigricans.
- Infertility: PCOS is one of the common causes of female infertility. This can be caused by irregular ovulation, which can make a female unable to conceive.
- Hair thinning: Usually associated with abnormal androgen levels, females may lose their hair or have male pattern baldness.
What are the Causes of PCOS?
While the exact cause of PCOS is not fully known, it can be due to several factors that can contribute to the increased risk of PCOS; these are:
- Hormonal Imbalance: Ovaries may produce an excess of androgen, which can affect ovulation, leading to missed and late periods, and may even cause infertility, resulting in PCOS.
- Insulin resistance: Insulin helps regulate blood sugar levels and is released by the pancreas. When cells become resistant to insulin, it causes more and more insulin to build up, which can lead to the release of a male hormone called androgen, leading to disrupted ovulation and other conditions like diabetes.
- Genetics: According to several studies, having a family history of PCOS increases the risk of developing the condition in future generations. This means that if your mother or sister has it, your risk increases.
- Chronic low-grade Inflammation: Women with polycystic ovarian syndrome may have increased levels of inflammatory markers even in the absence of any injury; this may indicate the PCOS condition. And associated complications.
How is PCOS diagnosed?
Your doctor or gynecologist first starts with a physical examination by looking for facial hair and acne, and other related symptoms, and asks about your medical history as well as the family history if it runs in your family.
As there is no specific testing to diagnose PCOS, your doctor may perform several exams, such as
- Pelvic exam: To check for any mass, growth, or other changes in your reproductive organs
- Blood test: Based upon your symptoms, blood test like hormone level test(to check hormone level), glucose tolerance tests( to measure body response to sugar), and triglyceride and cholesterol tests( to check for good and bad cholesterol) is recommended.
- Imaging test: Ultrasound Pelvis is recommended to look for the polycystic ovary (multiple cysts in the ovaries) by analyzing the size and bulkiness of the ovaries, which can confirm Polycystic ovarian syndrome. An MRI pelvis may be done in case the Ultrasound remains unclear.
Note: Diagnosis requires clinical correlation; ask your doctor about the condition after diagnosis to better understand it.
What are the treatment options for Polycystic ovarian syndrome?
There is no permanent treatment for PCOS, and it can be controlled by managing lifestyle habits, certain medications, and supportive therapies.
Lifestyle tips to control PCOS
- Try to manage your weight through regular workouts. Losing even 5–10% of body weight improves symptoms.
- Include a Balanced diet, such as Low-glycemic, anti-inflammatory foods. Reduce sugar intake—as even small amounts of sugar can add up and worsen insulin resistance.
- Regular exercise improves insulin sensitivity and hormone balance.
- Avoid smoking and alcohol, and get proper sleep.
- Manage your stress through Yoga, meditation, and proper sleep to reduce symptoms.
- Magnesium supplements, which are known to have anti-inflammatory properties, can also be beneficial. It helps to gradually improve symptoms.
Medication for PCOS
Depending on the individual symptoms and goals, it includes
- Birth control pills: This will help regulate the menstrual cycle, which in turn helps control the androgen levels, reducing facial hair and acne.
- Metformin: helps treat diabetes by lowering insulin levels, resulting in a normal period cycle with improved PCOS symptoms.
- Anti-androgen medicines (spironolactone): They help control the level of the androgen hormone to reduce acne and excess hair.
Fertility Treatment
If women are not able to conceive, some of the options include:
- Fertility drugs (Clomiphene, Letrozole): If PCOS is causing infertility, this drug is given to stimulate ovulation.
- Gonadotropin Injection: Mimics natural hormones like follicle-stimulating hormone and luteinizing hormone. These are given to stimulate egg production in women.
- In vitro fertilization: If medications remain ineffective, the woman’s partner’s sperm is artificially fertilized under lab conditions and transferred into the uterus.
Note: Consult with your doctor before taking any medications or following any treatment plan
7-day PCOS diet Plan
| Day | Breakfast | Lunch | Snack | Dinner |
| Day 1 | Greek yogurt with berries and almonds | Spinach salad with grilled chicken, avocado & vinaigrette | Apple with 1 tbsp of peanut butter | Baked salmon with roasted asparagus & quinoa |
| Day 2 | Spinach, banana & protein smoothie (almond milk) | Turkey wrap with whole wheat tortilla, lettuce, tomato & hummus | Baby carrots with hummus | Tofu stir-fry with broccoli, bell peppers & brown rice |
| Day 3 | Oatmeal with banana slices & cinnamon | Tuna salad with greens, cherry tomatoes & a handful of balsamic vinegar | a handful of mixed nuts | Grilled lean steak with steamed broccoli & sweet potato |
| Day 4 | Scrambled eggs with spinach, mushrooms & feta | Quinoa salad with black beans, corn, peppers & lime | Cucumber slices with Greek yogurt tzatziki | Chicken curry with cauliflower rice |
| Day 5 | Whole-grain toast with mashed avocado & tomatoes | Greek salad with cucumber, olives, feta & grilled shrimp | Piece of dark chocolate | Zucchini noodles with marinara & lean ground turkey |
| Day 6 | Kale, pineapple & protein smoothie (coconut water) | Turkey & avocado wrap with lettuce, tomato & mustard | Celery sticks with almond butter | Grilled shrimp skewers with peppers, onions & quinoa |
| Day 7 | Veggie omelet with tomatoes, onions, spinach & feta | Salmon salad with greens, cucumber & lemon vinaigrette, | a handful of cherry tomatoes | Veggie stir-fry with tofu, broccoli, carrots & brown rice |
Disclaimer: It is a sample diet plan and should be discussed with your dietitian or nutritionist before following
Tips to Follow a PCOS Diet
- Instead of refined carbs, opt for low-GI options like whole grains, quinoa, oats, and sweet potatoes.
- Eating high-fiber foods such as vegetables, fruits, beans, and lentils can help control blood sugar and improve digestion.
- To maintain stable blood sugar levels, combine protein, healthy fats, and complex carbohydrates.
- Reduce your intake of sugary drinks, fruit juices, and processed foods that cause insulin spikes.
- Drink at least 2-3 liters of water per day to aid metabolism and hormone balance.
- For better hormone health, consume healthy fats such as nuts, seeds, avocado, olive oil, and fatty fish.
- Avoid packaged snacks, fried foods, and fast food.
- Consume small, balanced meals throughout the day rather than large, heavy meals.
- Meal prepping allows you to avoid eating unhealthy foods when you’re hungry.
- Eat slowly, avoid distractions, and listen to your body’s hunger signals.
Health Risks & Complications of PCOS
Untreated PCOS can lead to conditions like the following:
- Infertility – Due to a lack of ovulation, resulting in an irregular period cycle.
- Type 2 diabetes – Linked to insulin resistance
- High blood pressure and heart disease are associated with metabolic syndrome.
- Endometrial cancer – Caused by irregular periods and thickened uterine lining.
- Depression and anxiety: caused by hormonal imbalances and body image issues.
- Obesity—associated with lifestyle changes—can worsen symptoms.
Conclusion
Polycystic Ovary Syndrome (PCOS) is a complex condition affecting reproductive health, metabolism, and mental health. While there is no cure, women can manage their PCOS through healthy lifestyle choices, proper diet, regular exercise, stress management, and medical care as needed.
The earlier PCOS is diagnosed, the greater the chance of avoiding long-term complications such as diabetes, heart disease, and infertility. Women with PCOS can live healthy, balanced, and fulfilling lives if they are aware and manage their condition consistently.
FAQs
Is PCOS the same as having ovarian cysts?
No. Despite the name, not all women with PCOS develop ovarian cysts. PCOS is primarily a hormonal imbalance, not simply cyst formation.
Can PCOS result in infertility?
Yes, PCOS is a major cause of infertility due to irregular ovulation. However, with treatment, many women can conceive naturally or with medical assistance.
Is it possible to reverse PCOS naturally?
PCOS cannot be “cured,” but symptoms can be alleviated by losing weight, eating healthier, exercising regularly, and managing stress.
Can I get pregnant if I have PCOS?
Yes. Many women with PCOS can conceive naturally, but it may take longer. Additionally, treatments like IVF or medication can increase your chances.
At what age does PCOS usually begin?
PCOS typically begins in adolescence, following a girl’s first period, but it can develop later.
What foods are good for PCOS?
Whole grains, lean meats, fresh fruits, vegetables, nuts, and seeds are all part of a PCOS-friendly diet. These foods boost insulin sensitivity and help in hormone balance.
Can I eat sugar if I have PCOS?
Refined sugar, sweets, and sugary beverages should be avoided. Choose natural fruit sugars and a little honey or jaggery instead.
Does every woman with PCOS require medication?
No, not always. Some women manage their symptoms through lifestyle changes alone, while others may require medication.
