Polycystic Ovary Syndrome (PCOS): What it is, Causes, Treatment & More

What is PCOS?

PCOS, which stands for Polycystic Ovary Syndrome, is a widespread hormonal disorder that affects women, especially in their 20s or 30s. It occurs when there is an imbalance in reproductive hormones. Usually, higher levels of androgens (male hormones) interfere with the regular menstrual cycle. As a result, the body stops or reduces its natural ovulation process. The signs of PCOS include irregular menstruation, weight gain, acne, excessive hair growth on the face or body, and infertility issues. Moreover, the ovaries can develop multiple fluid-filled sacs in some cases, but not all women with PCOS have cysts.

How Common is PCOS in India?

PCOS is becoming increasingly common among women of reproductive age in India. Globally, it affects an estimated 10-13% of women, and studies suggest that nearly 1 in 5 women may have PCOS. However, a major concern is that around 70% of cases go undetected, meaning many women live with symptoms without proper diagnosis or treatment. In India, the numbers appear to be even higher in some groups. For example, a study conducted among 1,164 college-going women aged 18-25 years in Delhi reported a PCOS prevalence of 17.4%, which is the second-highest rate in the country. These figures highlight that PCOS is not rare and is a growing health concern, especially among young women.

Symptoms of PCOS

The PCOS symptoms can vary from one person to another. Some women develop symptoms soon after their first menstrual period, while others may not notice them until later in life, especially when trying to conceive.

Related Diseases Comparison

Although PCOS, PCOD, and uterine fibroids can all affect a woman's reproductive health and may cause irregular periods or fertility problems, they are different conditions with different causes and treatment approaches.

PCOS vs PCOD vs Uterine Fibroids

Medicines Used to Treat PCOS

PCOS treatment is personalised, based on a woman's symptoms, age, fertility goals, and underlying hormonal or metabolic abnormalities. Different medicines may be prescribed to regulate menstrual cycles, improve ovulation, manage insulin resistance, reduce androgen-related symptoms, or support fertility.

Common medicines used to treat PCOS include:

• Combined oral contraceptive pills (COCs), such as Ethinyl estradiol + drospirenone, Ethinyl estradiol + desogestrel, Ethinyl estradiol + norgestimate, or Ethinyl estradiol + levonorgestrel

• Insulin-sensitising medicines like Metformin

• Ovulation-inducing medicines (for women trying to conceive), including Letrozole, Clomiphene citrate, and Gonadotropins (FSH injections)

• Anti-androgen medicines, like Spironolactone, Finasteride (selected cases), or Flutamide (rarely used due to risk of liver toxicity)

• Fertility support, such as Human chorionic gonadotropin (hCG) and Human menopausal gonadotropin (hMG)

Living with PCOS in India: Daily Challenges, Caregiving

Living with Polycystic Ovary Syndrome (PCOS) involves more than managing irregular periods. The condition can affect physical health, emotional well-being, fertility, body image, and long-term metabolic health. With regular medical care, healthy lifestyle habits, and family support, most women with PCOS can effectively manage their symptoms and lead healthy lives.

PCOS Treatment Cost in India

The cost of treating Polycystic Ovary Syndrome (PCOS) varies depending on the severity, the symptoms being treated, and the type of medical care required. While most women with PCOS can be successfully treated by making some alterations to their lifestyles and taking medicines, there are some cases where surgery or assisted reproductive techniques may be needed, increasing the costs.

Disclaimer: The above-mentioned costs are rough estimates and may vary depending on the city, hospital, healthcare professional, tests conducted, treatment regimen, and the patient's general health.

What Causes PCOS?

PCOS usually develops due to a combination of genetic, hormonal, and lifestyle factors. Some of the main causes of PCOS include:

• Hormonal Imbalance: High levels of androgen hormones can influence the process of ovulation and lead to the development of PCOS.

• Insulin Resistance: When the body does not respond properly to insulin, it can increase insulin levels and result in high production of androgen hormones.

• Genetic Factors: PCOS often appears in people who have a family history of it.

• Inflammation: Low-grade chronic inflammation in the body can cause high androgen levels and hormonal disruption.

• Lifestyle Factors: Unhealthy diet, inactivity, stress, and being overweight can affect hormonal balance negatively and cause PCOS.

Risk Factors of PCOS

PCOS can develop in any woman of reproductive age, but certain factors that are listed below can increase the likelihood of experiencing it:

• Family History: Women with a family history of PCOS have a greater risk of suffering from it.

• Insulin Resistance: When the body struggles to use insulin effectively, it might lead to a hormonal imbalance.

• Obesity: Excess body weight, especially around the abdomen, can worsen insulin resistance and hormone disruption.

• Sedentary Lifestyle: Lack of physical activity can lead to weight gain and metabolic imbalance.

• Poor Diet: An unhealthy diet, including high intake of sugar, refined foods, and saturated fat, can lead to increased risks.

• Stress: Long-term stress can affect hormone levels and may worsen symptoms.

• Early Puberty: Early onset of menstruation may be linked with a higher chance of developing PCOS later.

What are the Complications of PCOS?

Polycystic Ovary Syndrome can result in various complications if it goes untreated.

• Infertility: This syndrome can result in infertility owing to issues such as irregular ovulation. However, many women have successfully conceived despite being diagnosed with PCOS.

• Pregnancy Complications: Increased risk of gestational diabetes, high blood pressure during pregnancy, miscarriage, or early childbirth.

• Type 2 Diabetes or Prediabetes: It can cause insulin resistance, leading to higher blood sugar levels.

• Cancer: In the long term, PCOS can cause thickening of the uterus, leading to the risk of uterine cancer. In some cases, it can also cause endometrial cancer.

• Liver Problem: PCOS causes the accumulation of fat in the liver and increases the risk of fatty liver issues or cardiovascular disorders.

• Metabolic Syndrome: A combination of conditions like high blood pressure, high blood sugar, and abnormal cholesterol, increases the risk of heart disease.

• Mental Health Issues: There is an increased risk of depression and anxiety due to hormonal imbalance.

When Should I See My Healthcare Provider?

It may be necessary for you to visit your healthcare provider if you observe any of the following:

• Your periods are irregular, rare, or absent.

• You are actively trying to get pregnant but are unable to conceive.

• You have excess facial or body hair or severe acne that does not clear up.

• You are gaining an unusual amount of weight, or you are unable to lose weight.

• You have signs of high blood sugar, such as increased thirst, frequent urination, or fatigue.

• You have dark patches of skin, particularly around your neck or armpits.

• You experience mood swings, anxiety, or signs of depression.

How is PCOS Diagnosed?

There is no single test to diagnose PCOS, so doctors usually look at the overall pattern before making a diagnosis.

How is PCOS Treated?

PCOS cannot be completely cured, but it can be managed very effectively with the right combination of lifestyle changes and medical support.

The treatment usually depends on whether a woman is trying to conceive or not.

If You Do Not Want to Conceive

• Lifestyle changes like a balanced diet, regular exercise, and weight management help improve insulin resistance and hormone balance.

• Birth control pills are often prescribed to regulate menstrual cycles and reduce symptoms like acne and excess hair growth.

• Medications may be used to control androgen levels if symptoms are more severe.

• Doctors may also recommend insulin-sensitising medicines in some cases to improve metabolic health.

If You Want to Conceive

• Weight management and lifestyle improvements are often the first step, as even small changes can help restore ovulation.

• Ovulation-inducing medicines may be prescribed to stimulate egg release.

• Hormonal treatments may be used to regulate the menstrual cycle.

• In some cases, assisted reproductive techniques like IVF may be recommended if other treatments do not work.

• Doctors rarely recommend surgery where the tissue that produces androgen hormones in your ovaries is removed.

Can PCOS be Prevented?

It is not always possible to prevent PCOS because the actual cause of PCOS is unknown and may be genetic and/or hormonal. But there are some practices one can adopt in order to reduce the risk of symptoms and complications. Maintaining a balanced diet, exercising regularly, managing weight, reducing stress, and getting enough sleep can all support better hormonal health and overall well-being.

Can I Get Pregnant if I Have PCOS?

Yes, many women diagnosed with Polycystic Ovary Syndrome can become pregnant. While PCOS makes conception more difficult, as it could lead to either irregular ovulation or prevent ovulation altogether, it is still possible for women diagnosed with this condition to become pregnant after treatment and making changes in their lifestyle.

Maintaining a healthy weight, eating a balanced diet, exercising regularly, and managing stress can help improve ovulation. For some patients, doctors may prescribe medication or fertility treatments to increase the chances of pregnancy.

In short, early diagnosis and proper medical guidance can greatly improve fertility outcomes for women with PCOS.

Does Health Insurance Cover PCOS?

Yes, most health insurance plans in India provide coverage for Polycystic Ovary Syndrome (PCOS) treatment. The coverage usually includes diagnostic tests, doctor consultations, hospitalisation expenses, daycare procedures, and surgeries related to the condition.

However, many insurers apply a waiting period of up to 2 years before you can claim expenses for PCOS treatment. It is always advisable to carefully review the policy terms to understand coverage and benefits under PCOS health insurance.

How Much Health Insurance is Needed for PCOS Treatment?

The amount of health insurance needed for PCOS treatment usually depends on the severity of the condition, the type of treatment required, and the city where you seek medical care. In most cases, a health insurance cover of around ₹5 to 10 lakh is considered suitable, as PCOS may involve regular doctor visits, hormone tests, medications, and sometimes hospitalisation or surgery.

In fact, if you are planning for future pregnancy-related expenses or fertility treatments, choosing a higher sum insured can provide better financial protection.