Doç. Dr. Emre BaşerObstetrics & Gynecology
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Polycystic Ovary Syndrome (PCOS): Symptoms, Diagnosis and Treatment

PCOS affects 10% of women in their reproductive years. This article covers everything from symptoms to treatment.

May 3, 20262 min read

Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. It presents with hormonal imbalance, irregular periods, increased hair growth, and infertility.

PCOS Symptoms

While they vary between patients, common symptoms include:

  • Menstrual irregularity — infrequent, late or absent periods
  • Excessive hair growth (hirsutism) on face, chin, chest, abdomen
  • Acne and oily skin
  • Hair loss (especially frontal scalp)
  • Weight gain, particularly around the waist
  • Difficulty getting pregnant
  • Skin darkening (acanthosis nigricans)

How is it Diagnosed?

Rotterdam criteria are used. At least two of the following three findings must be present:

  1. Ovulatory dysfunction — irregular periods
  2. Clinical and/or laboratory hyperandrogenism
  3. Polycystic ovary appearance on ultrasound

Tests Ordered

  • Hormonal panel: FSH, LH, estradiol, total/free testosterone, DHEA-S, prolactin, TSH
  • Fasting glucose and insulin (HOMA-IR)
  • HbA1c, lipid panel
  • Pelvic ultrasound

Treatment Approach

Treatment is personalized to age, symptoms and fertility goals.

1. Lifestyle Modification

The cornerstone of treatment. Even 5–10% weight loss can restore menstrual regularity, reduce insulin resistance and improve fertility.

  • Low-glycemic, balanced diet
  • At least 150 minutes/week of moderate exercise
  • Stress management and adequate sleep

2. Medical Treatment

  • Combined oral contraceptives: for cycle regulation, acne, hirsutism
  • Metformin: for insulin resistance
  • Anti-androgens: for hirsutism
  • Clomiphene citrate / letrozole: for ovulation induction in those seeking pregnancy

3. Advanced Treatment

Patients not responding to first-line treatment may require gonadotropin-based ovulation induction, IUI or IVF.

Long-term Risks

Untreated PCOS can lead to:

  • Type 2 diabetes
  • Cardiovascular disease
  • Endometrial cancer
  • Sleep apnea
  • Depression and anxiety

Properly managed, PCOS allows a high quality of life. Early evaluation is recommended for any woman with relevant symptoms.