Everything you need to know about Polycystic Ovary Syndrome
What it is · Symptoms · Hair loss · Pregnancy · Supplements

WHAT IS PCOS — QUICK ANSWER

Polycystic Ovary Syndrome (PCOS) is the most common hormonal disorder in reproductive- aged women, affecting an estimated 10–15% globally — yet up to 70% remain undiagnosed. It is characterised by higher-than-normal androgen (male hormone) levels, irregular or absent ovulation, and often the presence of small follicles on the ovaries visible by ultrasound. PCOS is not just a reproductive condition — it is a complex metabolic disorder affecting hormones, insulin, metabolism, skin, hair, and mood. There is no cure, but it is very manageable through lifestyle, supplements, and when needed, medication.

What Is PCOS?

Polycystic Ovary Syndrome (PCOS) is a complex hormonal and metabolic condition that affects the ovaries, the hormonal system, and the body's ability to regulate insulin. Despite its name — which suggests it is purely a condition of the ovaries — PCOS has far-reaching effects on nearly every system in the body, from metabolism to skin, mood, fertility, and long-term cardiovascular health.

The three defining features of PCOS To be diagnosed with PCOS, a woman typically needs to have at least two of the following three features, as defined by the internationally used Rotterdam Criteria:

Irregular or absent ovulation
MOST COMMON FEATURE

Irregular, infrequent, or absent menstrual periods are the hallmark of PCOS. This happens because the hormonal signals that trigger ovulation are disrupted — the ovaries don't reliably release an egg each cycle. Cycles may be fewer than 8 per year, or absent entirely.

Polycystic ovarian morphology
DIAGNOSED BY ULTRASOUND

On ultrasound, the ovaries may appear enlarged and contain 12 or more small follicles arranged around the periphery — often described as a 'string of pearls' appearance. These are not true cysts; they are immature follicles that failed to develop and release an egg.

Excess androgens (hyperandrogenism)
DRIVER OF MOST SYMPTOMS

Higher-than-normal levels of androgens (testosterone and DHEA) cause most of the visible symptoms of PCOS: excess facial or body hair (hirsutism), acne, oily skin, and female-pattern hair loss (thinning at the crown and temples).

The hormonal mechanics: what is actually going wrong

PCOS is not caused by one simple malfunction — it involves a cascade of hormonal disruptions that compound each other:

• The pituitary gland produces excess LH (luteinising hormone) relative to FSH (follicle-stimulating hormone), disrupting the normal ovulation trigger

• The ovaries respond by producing excess androgens (testosterone) instead of oestrogen

• High androgens prevent follicles from maturing fully, so ovulation is irregular or absent

• Many women with PCOS also have insulin resistance — their cells don't respond well to insulin, causing the pancreas to overproduce it

• Excess insulin further stimulates the ovaries to produce more androgens — creating a self- reinforcing cycle

• Chronic low-grade inflammation is present in most PCOS cases, further amplifying insulin resistance and androgen production1 in 4 : Adults following plant-based or flexitarian diets

10–15% : Of reproductive-age women have PCOS globally
70% : Of women with PCOS worldwide are undiagnosed
#1 : Most common cause of anovulatory infertility
4-8x : Higher risk of type 2 diabetes vs non-PCOS women

Who gets PCOS and when?

PCOS can start as early as adolescence — often becoming apparent around the first menstrual period — and is most commonly detected or diagnosed when women struggle to become pregnant in their 20s and 30s. It is a chronic condition that persists beyond the reproductive years, with metabolic effects continuing into menopause and beyond. PCOS runs in families — having a mother, sister, or aunt with PCOS or type 2 diabetes significantly increases your risk. It affects women of all ethnicities, though some evidence suggests higher prevalence or different symptom patterns in South Asian, Middle Eastern, and Black women.

IMPORTANT: PCOS IS A SPECTRUM

No two women with PCOS have identical presentations. Some have severe irregular periods but minimal skin or hair symptoms. Others have regular periods but significant hyperandrogenism. Some are lean with normal metabolic markers; others have significant insulin resistance and weight gain. The 'typical PCOS patient' doesn't exist — which is why diagnosis and management must always be personalised.