Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age, occurring in approximately 5-10% of this population. Despite its name, PCOS is not primarily a condition of the ovaries but rather a complex hormonal disorder characterized by irregular ovulation, elevated androgen levels, and metabolic abnormalities. The "polycystic" appearance of the ovaries on ultrasound is actually due to multiple small follicles that have failed to mature and ovulate properly.

The diagnosis of PCOS is based on the Rotterdam criteria, which require the presence of at least two of the following three features: irregular or absent ovulation, clinical or biochemical signs of elevated androgens (such as hirsutism, acne, or male-pattern baldness), and polycystic appearing ovaries on ultrasound. Common symptoms include irregular menstrual periods, weight gain or difficulty losing weight, excessive hair growth on the face and body, acne, and hair thinning or male-pattern baldness. Many women also experience insulin resistance, which can lead to diabetes and cardiovascular disease if left untreated.

PCOS significantly impacts fertility due to irregular or absent ovulation, making it one of the leading causes of female infertility. Women with PCOS are also at increased risk for several long-term health complications including type 2 diabetes, cardiovascular disease, endometrial cancer (due to unopposed estrogen from lack of ovulation), sleep apnea, and mood disorders such as depression and anxiety. Early diagnosis and treatment are crucial for managing symptoms and preventing these complications.

Treatment for PCOS is individualized based on the patient's symptoms, goals, and desire for pregnancy. For women not trying to conceive, hormonal contraceptives are often used to regulate menstrual cycles and reduce androgen levels. Metformin may be prescribed to improve insulin sensitivity and help with weight management. For women trying to conceive, ovulation induction medications such as clomiphene citrate or letrozole may be used. Lifestyle modifications including weight loss, regular exercise, and dietary changes are fundamental aspects of PCOS management for all patients. Our comprehensive approach addresses both the immediate symptoms and long-term health implications of PCOS.