What Is PCOS and Why It Matters Today
Polycystic Ovary Syndrome (PCOS) is no longer a rare or misunderstood condition—it is now one of the most common endocrine disorders affecting women of reproductive age. In India alone, approximately 20–25% of women are currently estimated to suffer from PCOS. That’s 1 in every 4 women, and the numbers are rising rapidly, especially in urban areas.
PCOS disrupts the normal functioning of the ovaries due to an imbalance in reproductive hormones. Women with PCOS may not ovulate regularly, may have irregular periods, and often produce higher-than-normal levels of androgens (male hormones). The condition can also cause multiple cysts to form in the ovaries—hence the name.
But PCOS is not just a reproductive disorder. It’s a full-body hormonal and metabolic syndrome that increases the risk of diabetes, cardiovascular disease, infertility, depression, and even endometrial cancer if left untreated.
India’s Urban Women at High Risk
According to a comprehensive study by the Indian Journal of Endocrinology and Metabolism, over 22.5% of women in urban India suffer from PCOS, compared to about 11.2% in rural areas. This stark urban-rural divide can be linked to sedentary lifestyles, high sugar and carb intake, pollution, stress, and reduced physical activity in cities.
In metropolitan cities like Mumbai, Delhi, and Bangalore, gynaecologists report that every third young woman walking into their clinic is either diagnosed with PCOS or displays early symptoms.
Symptoms You Should Not Ignore
PCOS is a condition with a wide spectrum of symptoms. Some women may show severe signs, while others may not even realize they have it until they face complications with fertility.
The most common symptoms include:
Irregular or missed menstrual cycles (over 80% of PCOS patients experience this) Excess facial and body hair due to elevated androgens (hirsutism affects nearly 70%) Acne and oily skin, especially on the face and back Thinning of scalp hair or male-pattern baldness Sudden or unexplained weight gain, often centered around the abdomen Dark patches on the skin, especially on the neck and armpits (a sign of insulin resistance) Difficulty in conceiving—PCOS is the leading cause of infertility among women Mood swings, anxiety, and depression, often triggered by hormonal imbalance
Insulin Resistance: The Invisible Culprit
A defining feature of PCOS in most cases is insulin resistance. Nearly 70% of women with PCOS have insulin resistance, meaning their cells do not respond properly to insulin—a hormone responsible for regulating blood sugar.
To compensate, the body produces more insulin, which in turn:
Stimulates the ovaries to produce more androgens Leads to weight gain, especially belly fat Disrupts ovulation and menstrual regularity Increases the risk of type 2 diabetes, metabolic syndrome, and heart disease
This is why even slim or “lean PCOS” women may still have internal insulin resistance and must not ignore symptoms just because they appear physically fit.
The Fertility Connection
One of the most distressing effects of PCOS is its impact on fertility. PCOS causes anovulation, where the ovary fails to release an egg. This disrupts the menstrual cycle and makes conception difficult.
According to the Indian Society for Assisted Reproduction (ISAR), about 40% of women with infertility issues in India are diagnosed with PCOS. Many only realize they have the condition when they face problems getting pregnant.
Mental Health: The Silent Struggle
PCOS is not just a physical condition—it deeply affects emotional well-being. A study by the Indian Journal of Psychiatry found that over 60% of women with PCOS suffer from anxiety, and around 50% report symptoms of depression.
These psychological effects stem from hormonal fluctuations, poor body image, weight gain, infertility concerns, and the chronic nature of the condition. Unfortunately, the emotional impact is often dismissed, even by healthcare professionals.
How Is PCOS Diagnosed?
There is no single test to diagnose PCOS. Doctors rely on a combination of criteria known as the Rotterdam criteria, where at least two of the following three signs must be present:
Irregular or absent periods Signs of excess androgen (acne, hirsutism, blood tests) Polycystic ovaries on ultrasound
A woman may have PCOS even without visible cysts, making clinical history and blood tests essential for diagnosis.
Treatment: A Multi-Faceted Approach
PCOS cannot be cured, but it can be managed effectively with the right mix of treatment, lifestyle changes, and regular monitoring.
Medical treatments may include:
Hormonal contraceptives to regulate menstrual cycles and lower androgen levels Metformin, a diabetes drug, to improve insulin sensitivity Clomiphene or Letrozole for women trying to conceive Spironolactone or other anti-androgens to manage hirsutism and acne
Lifestyle modifications are the first line of defense:
Weight loss of just 5–10% of body weight can dramatically improve symptoms and restore regular ovulation A low-carb, high-protein diet helps regulate insulin and manage weight Daily physical activity, even 30 minutes of walking or yoga, improves hormonal balance Stress management through mindfulness, therapy, or relaxation techniques
Why Early Intervention Matters
Without treatment, PCOS increases the risk of several serious long-term complications:
Type 2 Diabetes: Women with PCOS are 4 to 7 times more likely to develop diabetes High Blood Pressure & Heart Disease: Due to chronic inflammation and obesity Endometrial Cancer: Due to prolonged unopposed estrogen in the absence of regular periods Sleep Apnea, particularly in obese women Pregnancy Complications: Such as gestational diabetes, preeclampsia, and miscarriage
Breaking the Silence Around PCOS in India
In a country where discussions around menstruation and reproductive health are still considered taboo, PCOS remains underdiagnosed and misunderstood. Early awareness campaigns in schools, open conversations within families, and mandatory screenings in clinics are crucial to addressing the epidemic.
Public health policies need to focus on:
Adolescent screening programs Health education in schools and colleges Training for general physicians and rural health workers Affordable access to gynaecologists and diagnostic tools
A Message to Every Woman
If you are facing irregular periods, unexplained weight gain, acne, or fertility issues, do not ignore the signs. PCOS is manageable, but only if identified early. There’s strength in understanding your body and taking proactive steps—through lifestyle, medical care, and emotional support.
You are not alone. Millions of women are navigating this hormonal maze, and together, with the right knowledge and tools, we can reclaim our health, fertility, and emotional well-being.
