PCOS (Polycystic Ovary Syndrome) – Symptoms and Signs, Causes, Treatment

Polycystic Ovary Syndrome (PCOS) is a hormone-related condition that commonly affects women during their reproductive years. Despite its high prevalence, PCOS often goes unnoticed or misdiagnosed. Worldwide, it is estimated to impact around 6% to 13% of women. In India, the numbers are even more concerning, with studies indicating that up to 20% of women of reproductive age may be affected, especially in urban areas where lifestyle-related factors play a significant role.

PCOS is primarily caused by an imbalance in reproductive hormones, which interferes with normal ovarian function. This can result in several symptoms such as irregular menstrual cycles, skin issues like acne, increased facial or body hair, weight gain, and in many cases, difficulty in conceiving.

However, PCOS is far from a life sentence. With early diagnosis, proper medical care, and supportive lifestyle changes, the condition can be well managed. At Imprimis IVF, our team offers tailored solutions and fertility support to help women reclaim control over their health and reproductive goals.

This guide will walk you through PCOS in depth—its symptoms, causes, effects on fertility, and available treatments—to help you better understand and address this condition.

What is PCOS (Polycystic Ovary Syndrome )?

Polycystic Ovary Syndrome (PCOS) is a hormone-related condition that affects how the ovaries function. Despite the name, women with PCOS don’t always have actual cysts on their ovaries. Instead, the condition is diagnosed based on a combination of hormonal and reproductive symptoms.

The widely used Rotterdam Criteria helps doctors identify PCOS if a woman has at least two of the following:

• Rare or absent ovulation (which can lead to irregular periods)
• The body makes more male hormones than usual, like testosterone.
• Ovaries with many small, underdeveloped follicles visible on ultrasound

Important Indian Insights:

• Nearly 1 in 5 Indian women of childbearing age may exhibit PCOS symptoms (Source: Journal of Human Reproductive Sciences)
• Women in urban settings are at greater risk, with prevalence reported at 5%, compared to 11.9% in rural areas
• Over 70% of PCOS cases in India go undiagnosed until fertility or metabolic issues surface
• If untreated, PCOS may increase the long-term risk for type 2 diabetes, hypertension, and cardiovascular conditions

Signs and Symptoms of PCOS (Polycystic Ovary Syndrome)

PCOS manifests differently in every woman. Some may face noticeable menstrual or skin issues from adolescence, while others only become aware of the condition when they experience trouble conceiving. This variation makes timely diagnosis challenging but crucial.

According to the Indian Journal of Endocrinology and Metabolism, over 50% of women with PCOS in India are diagnosed only after they consult a doctor for irregular cycles or infertility.

Here’s a detailed overview of common symptoms:

1. Menstrual Disturbances

Women with PCOS may experience:

• Less than 8 periods per year
• Very long cycles (more than 35 days)
• Abnormal flow—either too light or too heavy

Such irregularities usually stem from disrupted ovulation due to hormonal imbalance.

Stat Fact: Around 80% of women with chronic irregular periods are found to have PCOS as a contributing factor.

2. High Androgen Levels

Elevated androgens (male hormones) may lead to:

• Hirsutism: Excessive hair more than normal on the face and other body parts.
• Acne or excessively oily skin
• Hair thinning or scalp baldness

A study in the Journal of Clinical Endocrinology found that nearly 70% of PCOS patients report symptoms linked to androgen excess.

3. Weight Issues and Metabolic Resistance

Due to insulin resistance, many women with PCOS:

• Often put on fat around the stomach region
• Find it hard to lose weight, even when eating healthy and staying active.

4. Skin Changes

Indicators of insulin resistance often appear on the skin:

• Acanthosis nigricans: Dark, thick skin that feels soft, usually appearing on the neck, underarms, or other body folds.
• Skin tags and pigmentation changes in body folds

These signs are early clues to metabolic disruption and should not be ignored.

5. Fertility Struggles

PCOS can make it harder for the ovaries to release eggs regularly, which may cause problems with getting pregnant.

• Irregular egg release, reducing natural conception chances
• Poor egg quality due to hormone imbalance
• Increased miscarriage risk without medical support

Data Insight: According to the American Society for Reproductive Medicine, up to 80% of women who do not ovulate regularly due to PCOS encounter fertility difficulties.

6. Mental and Emotional Health Effects

PCOS can also affect how you feel emotionally and mentally:

• Frequent mood changes or irritability
• High levels of anxiety or depression
  
• Reduced self-esteem is linked to physical symptoms

7. Other Noticeable Symptoms

• Persistent fatigue and low energy levels
• Sugar cravings or unstable blood sugar
• Difficulty sleeping or poor sleep quality

When Should You See a Specialist?

If you’re facing more than one of the symptoms listed above—particularly irregular periods, excess body hair, or difficulty conceiving—consult a fertility expert.

At Imprimis IVF, our specialists take a holistic approach to PCOS, offering personalised diagnosis, metabolic screening, hormone balance therapy, and assisted reproductive support, all under one roof.

What Causes PCOS (Polycystic Ovary Syndrome)?

Polycystic Ovary Syndrome (PCOS) is a multifactorial condition, meaning it doesn’t have a single, clear cause. Instead, it arises from a combination of genetic, hormonal, and lifestyle-related factors. While the exact cause is still being researched, several contributing triggers have been identified that influence how the condition develops and progresses.

Understanding these root causes can empower women to manage symptoms more effectively—and in many cases, prevent complications such as infertility, diabetes, and cardiovascular issues.

1. Genetic Predisposition

PCOS tends to run in families. If your mother or sister has PCOS, your risk of developing it increases significantly.

Research Insight: A study published in the Journal of Clinical Endocrinology and Metabolism found that women with a first-degree relative with PCOS are 5–8 times more likely to be diagnosed themselves.

This genetic component doesn’t guarantee you’ll develop PCOS, but it can increase your susceptibility, especially when combined with environmental or lifestyle triggers.

2. Hormonal Imbalance

One of the hallmarks of PCOS is an imbalance of reproductive hormones, particularly:

• Excess androgens (male hormones): These interfere with the development of ovarian follicles, leading to irregular ovulation.
• Increased luteinizing hormone (LH): High LH can trigger abnormal androgen production.
• When FSH levels are too low or not balanced, it can affect the growth and development of eggs in the ovaries.
• Elevated estrogen levels without the balancing effect of progesterone contribute to irregular menstruation and a thickened uterine lining.

Medical Finding: Up to 60%–80 % of PCOS patients show elevated androgen levels, according to data from the American College of Obstetricians and Gynaecologists.

3. Insulin Resistance and High Insulin Levels

Insulin resistance plays a major role in PCOS, especially among Indian women. When the body’s cells stop responding properly to insulin, it starts making extra insulin to make up for it. This excess insulin can:

• Stimulate the ovaries to produce more androgens
• Disrupt ovulation
• Contribute to weight gain and fatigue

Stat Alert: Over 65%–70 % of Indian women with PCOS exhibit insulin resistance—even those who are lean.

This link is especially crucial, as insulin resistance also raises the risk for type 2 diabetes, gestational diabetes, and cardiovascular disease.

4. Low-Grade Inflammation

Many women with PCOS have chronic low-grade inflammation, which can stimulate the ovaries to produce androgens and contribute to cyst formation.

• Inflammatory markers like C-reactive protein (CRP) are often elevated in PCOS patients.
• This constant low-level inflammation can raise the chances of developing blocked arteries and heart problems in the long run.

Health Fact: A 2022 study from AIIMS found that inflammatory biomarkers were significantly higher in Indian women with PCOS, compared to those without it.

5. Lifestyle and Environmental Triggers

Modern lifestyle changes have intensified the prevalence and severity of PCOS across Indian metros:

• Sedentary habits: Limited physical activity reduces insulin sensitivity.
• Poor dietary patterns: High sugar, refined carbs, and processed foods spike insulin.
• Stress: Chronic stress disrupts cortisol balance and indirectly affects sex hormones.
• Exposure to endocrine-disrupting chemicals: Found in plastics, cosmetics, and food packaging, these can interfere with hormonal balance.

Urban India Insight: According to a study published in the Indian Journal of Endocrinology, PCOS prevalence in Indian urban women has increased by threefold over the last decade, largely attributed to changing lifestyle and diet.

Is PCOS Your Fault? Not.

It’s important to remember that PCOS is not something you caused. It’s a medical condition rooted in biological and genetic factors. But with the right knowledge and proactive management, it can be controlled, and fertility can be restored.

PCOS and Fertility: What You Should Know

One of the most emotionally challenging effects of PCOS is its impact on a woman’s ability to conceive. PCOS is not only one of the leading causes of infertility worldwide, but also the most common cause of anovulatory infertility—infertility resulting from a lack of ovulation.

How PCOS Affects Fertility

PCOS disrupts the normal hormonal signals that stimulate ovulation each month. Women with PCOS typically have:

• Irregular or absent ovulation
  
• Unpredictable menstrual cycles
  
• Hormonal imbalances that impair egg quality or cause premature follicle arrest (when eggs stop maturing)
• High levels of insulin and male hormones can disrupt how the ovaries work, making it harder for them to release eggs regularly.

Data Insight: According to the World Health Organisation (WHO), about 70% of women with PCOS experience infertility due to ovulatory dysfunction.

Fertility Challenges Faced by Women with Polycystic Ovary Syndrome

A study published in the Indian Journal of Endocrinology found that PCOS women undergoing fertility treatment have nearly double the miscarriage rate if insulin resistance is not managed.

The Good News: You Can Still Conceive with Polycystic Ovary Syndrome

While PCOS can make conception more difficult, it does not mean infertility is permanent. Many women with PCOS go on to have healthy pregnancies, naturally or with the support of fertility treatment.

Lifestyle changes, weight management, and timely medical support dramatically improve fertility outcomes. According to a study from AIIMS, even a 5–10% reduction in body weight can restore ovulation in over 60% of women with PCOS.

Conclusion – Polycystic Ovary Syndrome

Polycystic Ovary Syndrome (PCOS) may be a lifelong condition, but it does not define your womanhood, your health, or your ability to conceive. With early diagnosis, lifestyle changes, and the right medical support, PCOS is entirely manageable, and fertility can be successfully restored.

What’s most important is awareness. As we’ve seen, 1 in 5 Indian women may be silently battling PCOS, often without a diagnosis. If you or someone you love is experiencing irregular periods, sudden weight gain, excessive hair growth, or struggling to conceive, don’t ignore the signs. It’s very important to seek timely help.

At Imprimis IVF, we understand the unique hormonal, emotional, and fertility challenges that come with PCOS. Our team is committed to offering personalised, evidence-based care—from diagnosis and lifestyle management to advanced fertility treatments like IUI and IVF.

Let PCOS be a turning point, not a stopping point.
With the right guidance, a healthy pregnancy and a balanced life are not just possible—they’re within reach.

If you’re ready to take the first step toward understanding and managing your PCOS (Polycystic Ovary Syndrome), we’re here to help. Book a consultation with Imprimis IVF today.

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