Polycystic Ovary Syndrome
- Students vs. Pandemics
- 1 day ago
- 4 min read
By Gabriella IP
Introduction
Polycystic Ovary Syndrome, known as PCOS, is a hormonal condition that impacts 6-13% of reproductive-aged women and an estimated 70% of women remain undiagnosed according to the World Health Organization. It’s the most common cause of anovulation and infertility, and unfortunately it comes with long-term health problems.(1) PCOS is commonly associated with insulin resistance, since it contributes to the hormonal imbalances and exacerbates metabolic issues that further complicates reproductive health; this hormonal imbalance is what leads to infertility in women with this condition.
Causes of PCOS
There is no exact cause of PCOS, but there are multiple factors that could lead to this condition: insulin resistance, excess androgen, low-grade inflammation, and heredity. Insulin is a hormone the pancreas makes, which enables cells to use sugar as energy; however, insulin resistance means that these cells are resistant to insulin action, so blood sugar levels go up. As a response, the body makes more insulin to bring down the sugar level, which causes too much production of androgen, a male hormone. The production of androgen originates in the ovaries, which can interfere with ovulation–meaning eggs aren’t developed often or released. This is how women have a risk of infertility with PCOS. Low-grade inflammation is another cause of this condition, which refers to the response of white blood cells making substances after an infection or injury. Women with PCOS have a long-term, low-grade inflammation that leads to the ovaries producing androgens. Past research has shown that certain genes could also be linked to PCOS; someone is more likely to have the condition if their mother or sister has it. Lastly, researchers agree that there is a close link between PCOS and obesity, as 38-88% of women with PCOS are overweight or obese (1,2).
Diagnoses
There’s multiple tests to diagnose PCOS. There are transvaginal ultrasounds, blood tests, and pelvic exams. The ultrasound checks the appearance of the ovaries and lining of the uterus, which is done with a wandlike device called a transducer in the vagina. The transducer emits sound waves that are translated into images of blood, vessels, tissues, and organs. It’s also a way to observe for any cysts (1,3). Blood tests can help measure hormone levels, which can clear up any confusion for symptoms like menstrual problems that mimic PCOS; high levels of androgens, blood glucose levels, and cholesterol levels are checked (4). Pelvic exams allow providers to check if the reproductive organs have any masses, growths, or abnormalities (3).
Symptoms
PCOS usually starts during adolescence, but symptoms evolve over time (1). There are common symptoms such as irregular periods, polycystic ovaries (ovaries that are larger or have cysts), extra body hair, weight gain, acne, hair thinning, skin tags, and dark/thick skin patches (1, 2, 4). Irregular periods can look like periods that last for a while or that occur fewer than nine times in a year. The growth in facial hair is due to the high levels of androgen that leads to excess facial/body hair (2). Other health complications include fertility, type 2 diabetes, high blood pressure, and uterine cancer (4).
Treatment
Unfortunately, there is no cure for PCOS, but there are treatments known to improve symptoms. Options depend on whether one plans to become pregnant or not. If a patient plans pregnancy, treatments include a change in diet and activity or medications. This includes a healthy diet and exercise in order to use insulin more efficiently, lower blood glucose levels, and help ovulation. Medications can help the ovaries release eggs, but there are risks such as birthing twins and ovarian hyperstimulation, where the ovaries release too many hormones and cause pelvic pain. If a patient doesn’t plan to get pregnant, they may be prescribed birth control pills or diabetes medication. Birth control can help control menstrual cycles and lower androgen levels. Diabetes medicine can lower insulin resistance, which also helps ovulation to occur regularly (2,4).
Insulin Resistance
Insulin resistance is associated with PCOS and impacts a lot of women–about 50-90% manifest insulin resistance (5). Factors that contribute to insulin resistance include body fat and a lack of exercise. Insulin is essential for life and regulating sugar levels in bodies, since it helps move glucose from your blood into your cells for the body to use it as energy. When cells can’t efficiently use glucose, the glucose builds up in the blood. As a response, the body produces more insulin to compensate, which is a condition called hyperinsulinemia. The higher the insulin levels, the more risks women are affected with PCOS experience. This excess in insulin can interact with a hormone in the ovaries, called the luteinizing hormone; this then leads to the increased production of androgens, male hormones–a symptom of PCOS. Androgens are what causes the other symptoms of PCOS: hair growth, acne, and irregular periods. Insulin also affects the development of follicles in the ovaries, preventing them from maturing. Insulin resistance and PCOS also go hand in hand with an increased risk of type 2 diabetes, especially since insulin resistance leads to higher blood sugar levels. As a way to help alleviate PCOS symptoms, women can improve insulin sensitivity through weight loss, medication like metformin, and/or with a healthy diet to lessen the irregular periods and metabolic issues associated with the condition (6). The medication metformin has been demonstrated to be effective, as women in trials have experienced enhanced ovulation and reduced the negative impacts on reproduction and metabolic health (7).
Conclusion
Polycystic Ovary Syndrome (PCOS) is a complex hormonal condition that affects 6-13% of reproductive-aged women, leading to infertility and metabolic risks and issues. The condition is influenced by several factors such as insulin resistance, an increase in androgen hormone production, low-grade inflammation, and genetic predisposition. Unfortunately there is no cure for PCOS, but there are a variety of treatments available such as dietary changes, exercise, and medications such as birth control and diabetes medication that can help manage and improve symptoms. Addressing insulin resistance especially, through medications like metformin and lifestyle changes, are crucial for alleviating symptoms and reducing the long-term health risks with this condition. Therefore, early diagnosis and management are essential for improving the quality of life for women with PCOS.
References
https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome
https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439
https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443
https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos
https://www.sciencedirect.com/science/article/pii/S1470211824026848
https://my.clevelandclinic.org/health/diseases/22206-insulin-resistance
This post is not a substitute for professional advice. If you believe that you may be experiencing a medical emergency, please contact your primary care physician, or go to the nearest Emergency Room. Results from ongoing research is constantly evolving. This post contains information that was last updated on May 16, 2025.