Polycystic Ovary Syndrome (PCOS) is the most common hormonal disorder affecting women of reproductive age, affecting nearly 1 in 10 women worldwide. Despite its name, PCOS is not simply a condition of ovarian cysts. It is a complex hormonal and metabolic disorder that can affect menstrual cycles, fertility, skin, weight, and long-term health.

What causes PCOS?

The exact cause of PCOS is not fully understood. It results from a combination of genetic factors, insulin resistance, and hormonal imbalance. Many women with PCOS have insulin resistance, meaning their body's cells do not respond efficiently to insulin. As a result, insulin levels rise, stimulating the ovaries to produce excess male hormones (androgens), which interfere with normal ovulation.

Common symptoms

Symptoms vary from one woman to another and may include:

Irregular or absent menstrual periods

Difficulty conceiving due to irregular ovulation

Excess facial or body hair

Persistent acne and oily skin

Thinning hair over the scalp

Weight gain or difficulty losing weight

Dark, velvety skin over the neck or underarms (a sign of insulin resistance)

Importantly, not all women with PCOS are overweight. Many women have lean PCOS, where hormonal imbalance occurs despite having a normal body weight.

Why is early diagnosis important?

Untreated PCOS may increase the risk of:

Infertility

Type 2 diabetes

High blood pressure

High cholesterol

Fatty liver disease

Sleep apnoea

Anxiety and depression

Thickening of the uterine lining (endometrial hyperplasia), which can increase the risk of endometrial cancer if periods remain absent for prolonged periods.

Early diagnosis and treatment help reduce these risks and improve quality of life.

The role of diet in PCOS

Diet is one of the most effective treatments for PCOS. The goal is not crash dieting, but improving insulin sensitivity, reducing inflammation, maintaining a healthy weight, and restoring hormonal balance.

Choose foods that nourish your body

Fill half your plate with colourful vegetables.

Include good-quality protein at every meal, such as pulses, sprouts, eggs, paneer, tofu, fish, or lean chicken.

Choose whole grains like whole wheat, oats, brown rice, millets, quinoa, or jowar instead of refined flour and white rice.

Eat healthy fats from nuts, seeds, olive oil, groundnuts, and avocado.

Include high-fibre foods to help control blood sugar and keep you full for longer.

Limit foods that worsen insulin resistance

Try to reduce:

Sugary drinks and packaged fruit juices

Sweets, cakes, pastries, and desserts

Refined carbohydrates such as white bread, biscuits, and bakery products

Highly processed and fast foods

Frequent snacking on chips and sugary foods

Practical eating tips

Never skip breakfast.

Eat regular meals instead of long periods of fasting followed by overeating.

Drink plenty of water.

Practice portion control.

Aim for at least 150 minutes of moderate exercise each week, along with muscle-strengthening exercises two to three times weekly.

Even a 5–10% reduction in body weight can significantly improve menstrual regularity, ovulation, fertility, and insulin resistance in women who are overweight.

How is PCOS diagnosed?

There is no single test for PCOS. Your doctor will evaluate your symptoms, menstrual history, physical examination, hormone tests, blood sugar levels, and pelvic ultrasound. A diagnosis is usually made when at least two of the following are present:

Irregular or absent ovulation

Evidence of excess male hormones

Polycystic ovaries on ultrasound

Can PCOS be treated?

Although there is no permanent cure, PCOS can be successfully managed. 

Treatment is individualised depending on symptoms and future pregnancy plans. It may include lifestyle modification, medications to regulate menstrual cycles, medicines to improve insulin sensitivity, treatment for acne or excess hair growth, and fertility treatment when pregnancy is desired.

A positive outlook

PCOS is a lifelong condition, but it is highly manageable. Healthy eating, regular exercise, adequate sleep, stress management, and timely medical care can greatly improve symptoms and reduce long-term health risks.

If you have irregular periods, troublesome acne, unwanted hair growth, or difficulty conceiving, seek medical advice early. Early diagnosis and personalised treatment can help you take control of PCOS and lead a healthy, fulfilling life.

Dr Nupur Mital believes that every woman with PCOS deserves an individualised treatment plan that addresses not only hormonal balance and fertility but also long-term metabolic health and emotional well-being.