Polycystic ovary syndrome (PCOS) affects about one in every ten women of reproductive age, making it one of the most common hormonal conditions today. Recognising its symptoms and understanding management strategies are essential for women navigating the challenges associated with this condition. Here’s an updated look at PCOS symptoms, types, and effective management approaches that women can consider in 2025.
What is PCOS?
PCOS is a hormonal imbalance involving excess production of androgens, commonly known as male hormones, which can disrupt the menstrual cycle and make it harder for women to conceive. The ovaries may develop multiple small fluid-filled sacs or cysts, although not everyone with PCOS has these cysts. The hormonal imbalance often causes missed or irregular periods, one of the primary indicators of PCOS.
Key PCOS symptoms
While PCOS and PCOD symptoms can vary widely from person to person, there are several common indicators that may signal the presence of the condition:
- Irregular periods: One of the hallmark symptoms of both PCOS and PCOD is missed or irregular menstrual cycles. Many women with PCOS have fewer periods, prolonged cycles, or unpredictable menstrual flow.
- Hirsutism: This refers to excessive hair growth in areas where women typically have minimal hair, such as the face, chest, and back. Hirsutism is one of the more visible PCOS and PCOD symptoms and is caused by elevated levels of androgens.
- Acne and oily skin: Hormonal imbalance leads to increased oil production, resulting in acne on the face, chest, or back.
- Hair thinning or hair loss: Although PCOS may cause excess body hair, it can also result in thinning hair or hair loss on the scalp.
- Weight gain and “PCOS belly”: Many women with PCOS gain weight around the midsection, often due to insulin resistance, a common feature of the condition.
- Mood swings and fatigue: Hormonal fluctuations in PCOS can affect mood, potentially leading to symptoms like fatigue, anxiety, or depression.
These symptoms, especially in combination, can be indicative of PCOS, though they are not exclusive to the condition. The symptoms may worsen with weight gain, adding complexity to effective diagnosis and management.
Types of PCOS
Understanding the different types of PCOS can help women identify the most appropriate treatment options. Researchers often categorise PCOS based on hormone levels and symptoms:
- Non-hyperandrogenic PCOS: Characterised by irregular periods and ovarian cysts without elevated androgens.
- Ovulatory PCOS: Features both increased androgens and cysts but with regular ovulation.
- Non-PCO PCOS: High androgen levels and ovulation problems without visible ovarian cysts.
- Full-blown PCOS: Involves elevated androgens, cysts, and irregular ovulation.
Additionally, types such as insulin-resistant PCOS and inflammatory PCOS focus on underlying issues, with insulin resistance or inflammation playing a prominent role in symptom development.
Hormonal Imbalances in PCOS
PCOS disrupts multiple hormones that regulate essential body functions, contributing to the array of PCOS and PCOD symptoms:
- Androgens: Elevated androgen levels can interfere with regular ovulation, leading to acne, excess hair growth, and hair loss.
- Insulin: Insulin resistance is prevalent in PCOS, resulting in high insulin levels that may contribute to weight gain and increased androgen production.
- Luteinising hormone and follicle-stimulating hormone: These hormones regulate the menstrual cycle and ovulation but may be imbalanced in PCOS.
Management strategies for PCOS symptoms
Although PCOS has no cure, several treatment options can help manage symptoms. The choice of treatment often depends on whether the woman wishes to conceive.
- Lifestyle changes: Weight management is crucial for reducing PCOS symptoms, as even a small weight loss can help regulate the menstrual cycle. A balanced diet, low in refined carbs and sugars, can aid in managing insulin levels.
- Hormonal birth control: Birth control pills, patches, or injections can help regulate menstrual cycles, reduce excess hair growth, and manage acne. For women not planning pregnancy, hormonal contraceptives can also lower the risk of endometrial cancer associated with irregular cycles.
- Anti-androgen medications: Drugs like spironolactone may help reduce symptoms of excess hair and acne. However, they are not suitable for women who may become pregnant.
- Insulin-sensitising medications: Metformin, a diabetes medication, can help manage insulin resistance and improve ovulation. While not approved explicitly for PCOS, it is commonly prescribed to alleviate metabolic symptoms.
- Fertility treatments: For women struggling with fertility, medications like clomiphene, letrozole, or injections of gonadotropins can stimulate ovulation. Advanced treatments such as in vitro fertilisation (IVF) may also be considered.
- Cosmetic treatments for excessive hair growth: Laser therapy and electrolysis can reduce hair growth, though multiple sessions are often required for lasting effects.
Diet and exercise for PCOS management
A balanced diet and regular exercise are cornerstones of PCOS management:
- Diet: A diet low in refined carbohydrates can help regulate blood sugar and insulin levels. Whole grains, lean proteins, and high-fibre vegetables support balanced nutrition. Some women benefit from a low-glycaemic index diet, which reduces blood sugar spikes.
- Exercise: Regular physical activity helps reduce insulin resistance and lowers androgen levels. Exercise is also beneficial for weight management and mental health, helping alleviate mood swings and stress.
PCOS and long-term health risks
PCOS is associated with an increased risk of several health conditions, including type 2 diabetes, metabolic syndrome, and cardiovascular disease. Regular monitoring of blood sugar, blood pressure, and cholesterol levels is essential for women with PCOS. Mental health support may also be beneficial, as anxiety and depression rates are higher in those with PCOS due to both hormonal fluctuations and the stress of managing a chronic condition.
The importance of early diagnosis
PCOS and PCOD symptoms can be subtle, making diagnosis challenging. Many women are not diagnosed until they encounter reproductive issues, such as difficulty conceiving. Early detection through routine check-ups can help manage symptoms and prevent complications.
Conclusion
Understanding PCOS symptoms and management strategies empowers women to take control of their health and lifestyle. By recognising the symptoms early and exploring treatment options, women can navigate this complex condition more effectively. While PCOS is a lifelong condition, it can be managed with a combination of lifestyle adjustments, medication, and professional support, allowing women to lead fulfilling, healthy lives.
