PCOS is common in the reproductive age – from early teenage years to menopause.

It is most common in the twenties and thirties.

Symptoms of PCOS

Irregular Periods 

The commonest symptoms of PCOS is irregular periods.

Young girls come in with symptoms of irregular bleeding – the periods are usually delayed by days or sometimes even by months.

In some cases, some menstrual cycles may be short  but in most cases, they are long and delayed.

When periods do occur, there may be heavy bleeding.

The periods can be prolonged and last for 2-3 weeks.

Increased Hair Growth on Face, Body

Hair growth on the body, especially on the chin and along the sides of the face may occur.  This male pattern hair growth is called hirsutism. The hair grows thick along the chin. Hair growth on the upper lip is also common.

Increased hair growth may also be seen in other body parts – on the arms and legs  as well as on the abdomen and breasts.

Hair Fall

Another very common symptom of PCOS  is hair fall .  Girls complain of increasing hair fall   which is not controlled even by  taking supplements.

Increased Body Weight

A very common symptom is increase in the body weight.  A young girl may put on as much as 20 – 30 kgs in a few months , in spite of maintaining her diet.

Increase in body weight is generally due to a low metabolic rate caused by PCOS.

Other symptoms of PCOS:

•  Increased acne
• Lethargy
• Fatigue
• Mood swings
• Fertility problems ( difficulty in getting pregnancy is usually due to lack of ovulation in PCOS)

Examination:

A thorough medical history is important, especially with relation to a family history of diabetes.  Diabetes and PCOS are usually due to the same cause – insulin resistance.  And a woman with a family history of diabetes can develop PCOS at any age.

The patient needs to be examined – pulse rate, blood pressure, weight.

Also, an examination of the abdomen to check for any pain.

She needs to be examined for excessive hair growth on the body.

A pelvic examination is also necessary .

Blood tests 

Some blood tests may be needed to diagnose PCOS:

• Fasting insulin level.
• Testosterone level
• DHEAS level.

Some tests are also necessary to rule out other causes of irregular periods –

• Thyroid profile.
• Prolactin hormone levels.

Ultrasound

An ultrasound of the  abdomen is necessary to check the ovaries – the ovaries may show a series of small cysts on the periphery – called the necklace pattern – very typical of PCOS.

Treatment 

The main treatment is by improving the lifestyle.

• Increase exercises
• Cut down on carbohydrates like rice and maida
• Stop sugar, junk food.
• Regular meal times and no snacks in between.

Medical Treatment of PCOS

• Inositol – Medicines like inositol help to improve the insulin fasting level and need to be prescribed for at least 6 months.
• Birth control pills – can help to regulate the periods and can  be prescribed for 3 months. 
• Tranexemic Acid pills – Excessive bleeding is controlled by medicines like tranexemic acid.

The main treatment of PCOS is lifestyle changes with improved diet, regular exercise, adequate sleep and water.

PCOS is a condition  which can recur  on and off through the reproductive life.