Polycystıc Ovary Syndrome
What Is Polycystic Ovary Syndrome? Symptoms and Treatment
Polycystic Ovary Syndrome, briefly known as PCOS, is a common hormonal and metabolic condition seen in women of reproductive age. PCOS may be associated with menstrual irregularity, ovulation problems, increased androgen hormones, excess hair growth, acne, hair loss, and insulin resistance in some patients (1).
According to the World Health Organization, PCOS may affect approximately 10-13% of women of reproductive age, and a significant proportion of women with PCOS worldwide may continue their lives without receiving a diagnosis (1). Therefore, gynecological evaluation is important when symptoms such as menstrual irregularity, excessive hair growth, weight gain, or difficulty conceiving are present.
“ Polycystic ovary syndrome is not only about cysts seen in the ovaries; it is a holistic health condition that can affect hormones, metabolism, menstrual regularity, and fertility together. ”
What Is Polycystic Ovary Syndrome?
Polycystic Ovary Syndrome is a hormonal imbalance that can affect the regular ovulation function of the ovaries. In people with PCOS, ovulation may become infrequent or irregular. This may cause delayed periods, infrequent menstruation, or absence of menstruation during some periods.
The term “polycystic” in PCOS refers to the appearance of many small follicles in the ovaries. However, not every PCOS patient must have a polycystic ovarian appearance on ultrasound. Similarly, seeing many follicles in the ovary alone is not enough to diagnose PCOS. Diagnosis is made by evaluating menstrual pattern, androgen-related findings, blood tests, and ultrasound findings together (2).
What Are the Symptoms of PCOS?
PCOS symptoms may vary from person to person. In some patients, the most prominent finding is menstrual irregularity, while in others, excess hair growth, acne, difficulty with weight control, or infertility may be more prominent. ACOG lists irregular periods, infertility, obesity, excess hair growth, acne, and hair loss among the common symptoms of PCOS (2).
The main symptoms that may be seen in polycystic ovary syndrome are:
- Menstrual Irregularity: Infrequent periods, long intervals between periods, or absence of menstruation.
- Ovulation Disorder: Difficulty conceiving due to lack of regular ovulation.
- Excessive Hair Growth: Male-pattern hair growth on the face, chin, chest, abdomen, or back.
- Acne and Oily Skin: Acne especially along the jawline, face, back, or chest area.
- Hair Loss: Male-pattern hair thinning or thinning on the crown area.
- Weight Gain: Fat accumulation especially around the waist or difficulty losing weight.
- Signs of Insulin Resistance: Sugar cravings, difficulty controlling weight, or darkening of the skin.
- Psychological Effects: Anxiety, depression, body image problems, or self-confidence issues.
What Causes PCOS?
PCOS does not have a single cause. Genetic predisposition, insulin resistance, hormonal imbalances, and environmental factors may play a role together. Mayo Clinic states that the exact cause of PCOS is unknown; however, insulin resistance, low-grade inflammation, heredity, and excessive androgen production may play a role (3).
The main factors that may contribute to PCOS development include:
- Insulin Resistance: Reduced response of the body to insulin may affect blood sugar and hormone balance.
- High Androgen Levels: Increased androgen hormones may contribute to excess hair growth, acne, and ovulation problems.
- Genetic Predisposition: The risk may increase in people with a family history of PCOS.
- Weight and Lifestyle Factors: Excess weight may increase insulin resistance and worsen PCOS symptoms.
- Metabolic Factors: Disturbances in blood sugar, cholesterol, and blood pressure balance may be seen together with PCOS.
How Is PCOS Diagnosed?
PCOS is not diagnosed with a single test. The patient’s menstrual pattern, signs of androgen excess such as excess hair growth and acne, blood hormone tests, metabolic evaluation, and ultrasound findings are assessed together. The Endocrine Society guideline recommends using the Rotterdam criteria for diagnosing PCOS in adults and excluding other diseases that may cause similar symptoms (4).
According to the Rotterdam criteria, the presence of at least two of the following three findings may support a PCOS diagnosis:
- Menstrual irregularity due to infrequent ovulation or lack of ovulation,
- Clinical or laboratory evidence of high androgen levels,
- Polycystic ovarian appearance on ultrasound.
However, these criteria must be evaluated by a physician. This is because thyroid diseases, high prolactin levels, adrenal gland diseases, or some hormonal disorders may cause symptoms similar to PCOS.
Which Tests Are Performed in PCOS Diagnosis?
The purpose of PCOS evaluation is not only to make a diagnosis, but also to identify accompanying metabolic risks. According to Cleveland Clinic, physical examination, blood tests, and ultrasound may be used in PCOS diagnosis; metabolic values such as blood sugar and cholesterol may also be evaluated (5).
Tests that may be requested for PCOS diagnosis include:
- Gynecological examination and detailed medical history,
- Evaluation of menstrual pattern,
- Androgen hormone tests such as total and free testosterone,
- Differential diagnosis tests such as TSH and prolactin,
- Fasting blood glucose, insulin, or oral glucose tolerance test,
- Cholesterol and triglyceride evaluation,
- Evaluation of the ovaries with pelvic ultrasound.
How Is Polycystic Ovary Syndrome Treated?
There is no single standard treatment for PCOS. Treatment is personalized according to the patient’s age, symptoms, pregnancy plans, weight status, insulin resistance, acne and hair growth complaints, and menstrual pattern. Mayo Clinic states that PCOS treatment focuses on a person’s individual concerns such as menstrual irregularity, excess hair growth, acne, or obesity (6).
Approaches that may be used in PCOS treatment include:
- Lifestyle Changes: Nutrition, exercise, sleep, and weight management are fundamental parts of PCOS treatment.
- Menstrual Regulation Treatments: Birth control pills or progesterone treatments may help regulate menstruation.
- Anti-Androgen Treatments: These may be used for androgen-related symptoms such as excess hair growth and hair loss.
- Insulin Resistance Treatment: Medications such as metformin may be preferred in suitable patients to manage insulin resistance.
- Ovulation Treatment for Those Planning Pregnancy: Medications that stimulate ovulation may be used under physician supervision.
- Psychological Support: Supportive treatments are important in patients with anxiety, depression, or body image problems.
“ The goal of PCOS treatment is not only to regulate periods; it is to reduce long-term metabolic risks, support fertility, and improve quality of life. ”
Why Are Lifestyle Changes Important in PCOS?
Lifestyle changes have an important place in PCOS management. Balanced nutrition, regular exercise, weight management, and sleep regulation may help reduce insulin resistance and support menstrual regularity.
In overweight patients, even 5-10% weight loss may have positive effects on menstrual regularity, ovulation, and metabolic values. However, PCOS does not occur only in overweight people; people with normal weight may also have PCOS. Therefore, the treatment plan should be prepared according to the person’s body structure and metabolic status.
- A low glycemic index diet may be preferred.
- Balanced meals rich in protein, fiber, and healthy fats may be planned.
- Regular walking, resistance exercises, and cardio exercises may be supportive.
- Sleep regulation and stress management should not be neglected.
- Smoking should be avoided.
Does PCOS Prevent Pregnancy?
PCOS may make it harder to conceive due to ovulation irregularity; however, this does not mean pregnancy is impossible. PCOS is one of the treatable causes of infertility. The chance of pregnancy may be increased by evaluating ovulation pattern, regulating weight and metabolic status, and using ovulation treatments when necessary.
In PCOS patients planning pregnancy, the treatment approach is different from treatments used to regulate menstruation. Therefore, patients who want to have children should share this clearly with their physician.
The Relationship Between PCOS and Insulin Resistance
Insulin resistance may be common in PCOS. When insulin resistance is present, the body produces more insulin to balance blood sugar. High insulin levels may increase androgen production and worsen PCOS symptoms.
Insulin resistance may be seen together with weight gain, fat accumulation around the waist, sugar cravings, sleepiness after meals, skin darkening called acanthosis nigricans, and blood sugar imbalances. Therefore, monitoring blood sugar and metabolic risks is important in PCOS evaluation.
What Happens If PCOS Is Not Treated?
If PCOS is not treated and followed up, it may be associated with problems such as menstrual irregularity, prolonged exposure of the uterine lining to estrogen, infertility, insulin resistance, increased risk of type 2 diabetes, high cholesterol, and psychological effects. These risks are not the same in every patient; however, regular follow-up is important for long-term health.
Very infrequent menstruation may lead to irregular thickening of the uterine lining. Therefore, in patients who do not menstruate for a long time, it is important to regulate menstruation under physician supervision.
How Are Excess Hair Growth and Acne Managed in PCOS?
Excess hair growth and acne in PCOS usually develop due to the effects of androgen hormones. Birth control pills, anti-androgen medications, dermatological treatments, and long-term hair reduction methods may be used in treatment. However, the effects of these treatments appear over time; several months may be needed to see a noticeable response in excess hair growth treatment.
Since anti-androgen medications may be unsafe during pregnancy, a different approach is required in patients planning pregnancy. Therefore, treatment for excess hair growth and acne must be planned under physician supervision.
Assoc. Prof. Dr. Nazlı Korkmaz’s Approach to PCOS
Polycystic Ovary Syndrome is a condition that can affect quality of life, but it can be managed with proper follow-up and personalized treatment. In Assoc. Prof. Dr. Nazlı Korkmaz’s approach, not only menstrual irregularity, but also insulin resistance, excess hair growth, acne, weight management, pregnancy plans, and long-term metabolic risks are evaluated together.
- Early Diagnosis and Regular Follow-Up: If symptoms such as menstrual irregularity, excess hair growth, or acne are present, evaluation should not be delayed.
- Personalized Treatment: Each PCOS patient’s symptoms and goals are different; the treatment plan should be created accordingly.
- Lifestyle Support: Nutrition, exercise, sleep, and stress management are important parts of treatment.
- Approach Suitable for Pregnancy Plans: Treatment options differ in patients who want pregnancy and those who do not.
- Long-Term Health Follow-Up: Blood sugar, cholesterol, blood pressure, and uterine lining health should be monitored regularly.
Frequently Asked Questions
PCOS is a chronic tendency condition; however, symptoms can be controlled with appropriate treatment, lifestyle changes, and regular follow-up. The treatment goal is determined individually.
Yes. PCOS may make pregnancy more difficult, but it is not an absolute barrier to pregnancy. In patients with ovulation irregularity, pregnancy chances may be increased with lifestyle changes and ovulation treatments when necessary.
Yes. PCOS is not seen only in overweight people. It may also occur in people with normal weight, presenting with menstrual irregularity, excess hair growth, acne, or ovulation problems.
No. The small follicles seen in PCOS are not the same as a single large ovarian cyst in the classic sense. Ovarian cysts may be of different types and should be evaluated separately.
No. Birth control pills may be used in some patients for menstrual regularity, acne, and excess hair growth; however, they are not mandatory for everyone. Pregnancy plans, risks, and symptoms determine the treatment choice.
Insulin resistance may be common in PCOS. This may make weight control more difficult and increase androgen levels. Regular monitoring of blood sugar and metabolic values is important.
Polycystic Ovary Syndrome Treatment Prices 2026
Polycystic ovary syndrome treatment prices may vary depending on the examination, ultrasound, hormone tests, metabolic tests, medication treatment, follow-up for pregnancy planning, and additional evaluations to be performed.
The most accurate information about current PCOS treatment prices for 2026 can be provided after examination and personal evaluation. This is because each patient’s symptoms, pregnancy plan, metabolic condition, and treatment needs are different.
References
- World Health Organization (WHO). Polycystic ovary syndrome. (https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome)
- American College of Obstetricians and Gynecologists (ACOG). Polycystic Ovary Syndrome (PCOS). (https://www.acog.org/womens-health/faqs/polycystic-ovary-syndrome-pcos)
- Mayo Clinic. Polycystic ovary syndrome (PCOS) - Symptoms and causes. (https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439)
- Endocrine Society. Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline. (https://academic.oup.com/jcem/article/98/12/4565/2833703)
- Cleveland Clinic. PCOS (Polycystic Ovary Syndrome): Symptoms & Treatment. (https://my.clevelandclinic.org/health/diseases/8316-polycystic-ovary-syndrome-pcos)
- Mayo Clinic. Polycystic ovary syndrome (PCOS) - Diagnosis and treatment. (https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443)