Polycystic Ovarian Syndrome (PCOS): Most misunderstood and under-diagnosed - Part 1

Posted by Dr.Tanushree (PT) on Mar 10, 2019 9:42:48 AM

Globally, one in 10 women suffer from PCOS. Polycystic Ovarian Syndrome (PCOS) is one of the most common causes of female infertility, affecting an estimated 5 million women.


Women with PCOS have a hormonal imbalance and metabolism problems that may affect their overall health and appearance. PCOS is also a common and treatable cause of infertility.

Prevalence: In one study, up to 70 percent of women with PCOS hadn’t been diagnosed. PCOS is one of the most common endocrine disorders in women.

Causes: Sadly, the exact cause of PCOS is not known. Several factors including genetics play a role:

  • High levels of androgens: Androgens are sometimes called male hormone. Women with PCOS have more androgens than normal. This higher than normal prevents the ovaries from releasing an egg (ovulation) during each menstrual cycle causing extra hair growth and acne.
  • High levels of insulin: Insulin is a hormone that controls how the food you eat is changed into energy. Insulin resistance is when the body's cells do not respond normally to insulin. Many women with PCOS have insulin resistance, especially those are obese, have unhealthy eating habits and lack of physical activity.


  • Irregular periods: A lack of ovulation prevents the uterine lining from shedding every month. Some women with PCOS get fewer than eight periods a year.
  • Heavy bleeding: The uterine lining builds up for a longer period, so the periods you do get can be heavier than normal.
  • Hair growth: More than 70 percent of women with this condition grow hair on their face and body. Excess hair growth is called hirsutism.
  • Acne: Male hormones can make the skin oilier than usual and cause breakouts on areas like the face, chest, and upper back.
  • Weight gain: Up to 80 percent of women with PCOS are overweight.
  • Male-pattern baldness: Hair on the scalp gets thinner and fall out.
  • Darkening of the skin: Dark patches of skin can form in body creases like those on the neck, in the groin, and under the breast.
  • Headaches: Hormone changes can trigger headaches in some women.

Ways to diagnose PCOS:

PCOS often have many small cysts in their ovaries. But, contrary to the implication of “polycystic,” not everyone with PCOS has cysts.

There’s no single test that, by itself that shows whether you have PCOS.

  • Physical exam: Measure your blood pressure, body mass index (BMI), waist size, hair loss, extra hair on your face , skin discoloration, acne etc.
  • Pelvic ultrasound: To examine your ovaries from Cysts. It can show ovary changes in about 90% of women who have PCOS.
  • Blood test: Can be done to check for other health problems that can be mistaken for PCOS.

Remember not all women with PCOS are obese. Between 20–50% of women with PCOS are normal weight or thin.

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