MS (Obstetrics & Gynaecology)

Senior Consultant HEC PARAS HOSPITAL, Ranchi

Ex. Senior Resident Safdarjung Hospital, Delhi

Laparoscopy & InfertilitySpecialist



A Guide for the Patients:

PCOS is one of the most common hormonal problem affecting one in ten women of  child bearing age.

In a normal monthly cycle,  multiple follicles develop and one egg is matured and released into fallopian tube during ovulation.

In women with PCOS , hormones required for full maturation of egg are not present. So ovulation does not happen and small cysts are formed in ovaries.

Females who are targets of this disease are from adolescents (teenagers) to Perimenopausal females.

How the Diagnosis of PCOS is made:

Many a times the symptoms can be vague, so the disease remain silent/undiagnosed.

Disease is diagnosed, when there is atleast two out of three criterias are fulfilled:

1.Irregular, heavy or missed periods due to absence of ovulation (means no realease of egg from ovaries). It also causes difficulty in being pregnant (infertility).

2. Hyperandrogenemia: Normally women also have some male hormones but higher levels of these hormones is called Hyperandrogenemia. It can cause excess of hair growth (Hirsutism),on your face, chest, upper lip, chin, back other areas. This hormone can be detected in blood test.

3. POLYCYSTIC Ovaries: That means there may be twelve or more follicles/cysts in ovaries. This is an important feature of PCOS and that's why the name of the disease is PCOS, but some women may not be having POLYCYSTIC Ovaries in PCOS. Polycystic Ovaries can be detected on doing Ultrasonography.

Other Symptoms of PCOS are:


2. Weight gain, specially over abdomen and hips

3. Acanthosis Nigricans: Means darkening and thickening of skin creases of armpit and back of neck

4. Hyperinsulinemia: Means increase levels of Insulin, when secretion of Insulin is normal but it can't be used by the body.

What are the causes of PCOS:

Their is no definite cause. Genetics and Environmental factors together on separately may play a role in causing PCOS.

Obesity: This is not a cause but it may worsen PCOS.

How PCOS causes difficulty in being Pregnant:

  All women with PCOS does not have difficulty in being pregnant.

  Common cause of Infertility is anovulation.

If you are not having menstruation regularly each month, it is better to consult a specialist, medications are given to induce regular ovulation along with lifestyle changes - which improves the chances of conception.

How PCOS can be treated:

We can't cure PCOS but we have to manage the symptoms. These symptoms are different in different phases of life. But mainstay of treatment remains life style changes and treatment of symptoms.

1. By the word LIFESTYLE change I mean exercise at least 30 min daily for 5 to 6 days per week.

2.Dietary Advice:

Diet with less carbohydrate and more     protein.

        As women with PCOS can't easily process the carbohydrate, which lead to more weight gain.

Average normal BMI- should be 20-25. BMI is calculated as : weight/ Height square in meters.

If the BMI is more than 30, every possible effort should be done to improve it. Even 5% of reduction in body weight can improve chances of being pregnant.

Dietary tips are:

  •  Drink water at least 2-3 liters daily .
  • Avoid Sugar rich drinks.
  • Choose whole grains in place of Refined food(Junk food).
  • Have more unsaturated fats e.g walnuts, Avocado, Brocoli, Green vegetables, 100gms of sprouts daily.

3. If one is having irregular periods, certain medications are given,  otherwise endometrium (inner lining of the uterus) overgrows and may cause endometrial cancer (Uterine Cancer) later.

4. Abormal hair growth: Treatment for this is essential,  as this affects your quality of life. It can be done with medicines or if resistant to medication then Laser therapy may be required.

5. INFERTILITY: Their are fertility medications which helps. In some cases procedures like IUI or OI can improve pregnancy rates. If it doesn't work injectable hormones may be given.

What can be future complications:

1. Increased chances of heart diseases

2. Hypertension: Increased blood Pressure

3. High Cholesterol

4. Stroke

5. Type 2 Diabetes

That's why Life Style Modifications is of prime importance.  By proper Diet and Regular exercises there may be help in reducing the risk of heart disease,  Hypertension and Diabetes.