Women have a common problem of unwanted hairs over chin, upper lip, chest lower abdomen
i.e where they never wanted to have. Young girls with increasing waist, rising weight and greasy black neck and dark 
armpits are common these days. Trauma begets trauma , pain begets pain and on the top of it, they have irregular periods. The pain continues and when they visit their doctor they are told regarding the hormonal angle of illness and the problems they may face after marriage, getting pregnant. Some doctors advise them to marry at an earlier age and some on the contrary, starts oral contraceptives. These patients are now made victims of misinformation and they have a terrifying hormonal illness coming. The word PCOS starts haunting them and they are very prompt in labelling every problem of theirs to this illness. 

How much hormonal is this illness? 

The social and economic fabric has changed like never before, in last 25 years and there is a dramatic change for women. Women are economically independent, there is less physical work,  late marriages and less number of children and to the top of its abundant availability of food and other resources. Some 50 years back they had to go fetch water, had to work in fields, make food and had to grind flour and many more various responsibilities and the number of pregnancies were on  an annual basis.The food used to come after the male members had finished and literally they used to be on leftovers. This has gone deep in our genes. Now the tables have turned and is now making them fat. 

Is it all hormonal? 

The moment you increase your weight, there is an  increase in insulin resistance, especially when you have a diabetis running in the family. The increase in insulin levels makes your neck and armpits black and also drives your ovary to make more of  the male hormone testosterone. Testosterome has got an  effect on your ovarian follicles and leads to polycystic ovaries and also makes your periods, irregular. On routine the doctor sees your neck, armpits weight and immediately advices for the ultrasongraphy where he finds multiple cysts and he jumps to a conclusion of PCOS. 

What should be done? 

Going back to  the roots is the I give in my routine practice. Eat less, exercise more to lose more weight and keep a positive framework of  the mind. Unwanted hairs should be removed by waxing, threading and laser treatment . Medical management lies with drugs causing weight loss and drugs to suppress testosterone levels. Keep yourself fit , keep yourself well adjusted in diet, take proper medical advice from a dermatologist and an endocrinologist.