Knowledge | Irregular periods, acne, or excess hair? It may be PCOS

“I'm only 30, but I keep losing hair, developing acne, having irregular periods, and cannot get pregnant.”

—This is not uncommon and may indicate undiagnosed PCOS.

Polycystic ovary syndrome (PCOS) is a very common but frequently overlooked endocrine disorder. According to WebMD, about 1 in 10 women of reproductive age has PCOS, and up to 70% do not know it.

What is PCOS, and why “polycystic”?

PCOS is a hormonal disorder that disrupts ovulation, menstrual cycles, and fertility. Despite the name, not everyone with PCOS has ovarian cyst-like follicles; this is only one possible feature.

Typical signs include:

Irregular or absent periods

Acne, especially on the chin and back

Excess facial or body hair, including the upper lip, abdomen, or inner thighs

Hair loss or thinning

Difficulty conceiving

Abdominal obesity

Mood changes, anxiety, or depression

Acanthosis nigricans, such as dark, thickened skin on the neck or underarms

Metabolic problems such as abnormal liver function, sleep apnea, and insulin resistance

Symptoms may be subtle or severely affect quality of life.

What type of PCOS do you have?

WebMD notes that PCOS varies and may be grouped into:

Type A, full phenotype: hyperandrogenism, anovulation, and polycystic ovaries;

Type B, non-polycystic: hyperandrogenism and anovulation without polycystic morphology;

Type C, ovulatory: polycystic ovaries and elevated androgens with regular periods;

Type D, non-hyperandrogenic: polycystic ovaries and ovulatory dysfunction with normal androgen levels.

Informal labels such as insulin-resistant, inflammatory, or post-pill PCOS are also used to discuss possible mechanisms.

What triggers PCOS?

The exact cause is unknown. Genetics, environmental exposures, and lifestyle may interact.

Family history: risk is substantially higher when a mother or sister has PCOS;

Insulin resistance: about 30%–80% of patients respond poorly to insulin, promoting androgen production;

Rapid weight gain: obesity worsens endocrine imbalance;

Chronic low-grade inflammation may stimulate excess ovarian androgen production;

External hormones: contraceptives may mask or trigger symptoms.

You may have PCOS without knowing it

PCOS often remains unnoticed until ovulatory or hormonal problems emerge while trying to conceive. Diagnosis typically requires two of three criteria:

Irregular menstrual cycles, including infrequent, absent, or prolonged periods

Hyperandrogenism shown by excess hair, acne, or blood tests

Polycystic ovarian morphology, with multiple small follicles on ultrasound

Evaluation may also include blood tests, ultrasound, physical examination, psychological assessment, and sleep screening.

Potential complications

PCOS affects more than periods and appearance. Complications may include:

Infertility

Pregnancy complications such as gestational diabetes, preeclampsia, preterm birth, and miscarriage

Type 2 diabetes; more than half may develop diabetes before age 40

Metabolic syndrome, including high blood pressure, lipids, and glucose

Depression, anxiety, and low self-esteem

Endometrial cancer, sleep apnea, and fatty liver disease

These conditions may affect lifelong health.

Can PCOS be cured?

PCOS cannot be cured, but it can be managed.

Treatment depends on pregnancy plans:

If not trying to conceive:

Hormonal contraception to regulate cycles, reduce excess hair, and lower endometrial cancer risk

Antiandrogens for acne and excess hair, with required contraception

Metformin to improve insulin sensitivity and ovulation

Topical or oral acne treatment

Laser, light-based, or electrolysis treatment for excess hair

If trying to conceive:

Ovulation-induction drugs such as clomiphene, letrozole, or injectable gonadotropins

IVF

Laparoscopic ovarian drilling, now used less often

PCOS management starts with lifestyle

Lifestyle measures remain fundamental with or without medication:

Weight management: losing even 10% of body weight may improve cycles and ovulation;

Low-glycemic eating: reduce sugar, refined rice and flour, and processed foods; eat more whole grains, fruit, and vegetables;

Regular exercise to improve insulin resistance, confidence, and mood;

Adequate sleep: at least 7 hours nightly and less late-night screen use;

Psychological support and stress management.

Source:

Collected online