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Polycystic Ovary Syndrome (PCOS): Symptoms, Diagnosis, Treatment - ClinicsJo platform
Overview of PCOS, its hormonal symptoms, impact on fertility, and treatment strategies.
Women's Health, Pregnancy & Childbirth

Polycystic Ovary Syndrome (PCOS): Symptoms, Diagnosis, Treatment

ClinicsJo Editorial Team
3 min read 208
Medically reviewed by Dr. Ahmad Arafat HasanReviewed on:

Quick summary

A complete guide to PCOS: hormonal causes, symptoms (acne, excess hair, irregular cycles, weight gain), treatment, and impact on fertility.

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Polycystic Ovary Syndrome (PCOS): Symptoms, Diagnosis, Treatment - ClinicsJo platform
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Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders in women of reproductive age, affecting 8–13% of women globally and roughly 15% of Jordanian women. It causes a spectrum of issues: irregular periods, acne, excess hair, weight gain, and delayed pregnancy. The ClinicsJo Editorial Team reviews symptoms and treatments.

What Is PCOS?

PCOS is a hormonal disorder characterized by three main features:

  • Irregular ovulation: irregular or absent menstrual cycles.
  • Elevated androgens: causing excess hair and acne.
  • Polycystic ovaries: immature follicles visible on ultrasound.

Common Symptoms

  • Irregular periods (>35 days) or absent for months.
  • Difficulty or delay in conception.
  • Excess facial, chest, and back hair (hirsutism).
  • Scalp hair loss (androgenic alopecia).
  • Severe acne, especially on the jaw and chin.
  • Weight gain, especially around the belly.
  • Difficulty losing weight.
  • Dark skin in neck folds and armpits (acanthosis nigricans).
  • Mood swings and depression.
  • Chronic fatigue.

Causes and Risk Factors

  • Insulin resistance: most common — elevated insulin stimulates ovaries to produce androgens.
  • Genetics: 50% of patients have an affected relative.
  • Obesity: worsens resistance.
  • Chronic low-grade inflammation.

Diagnosis — Rotterdam Criteria

PCOS is diagnosed when two of three criteria are present:

  1. Irregular ovulation (cycle >35 days or <8 cycles per year).
  2. Signs of high androgens (clinical or biochemical).
  3. Polycystic ovaries on ultrasound (12+ follicles per ovary).

Required Tests

  • Ovarian ultrasound (transvaginal preferred).
  • Hormone tests: FSH, LH, testosterone, DHEAS, prolactin, TSH.
  • Fasting glucose and HbA1c.
  • Lipid panel.
  • Liver function (to rule out fatty liver).

Long-Term Complications

  • Type 2 diabetes (4–7x risk).
  • Cardiovascular disease.
  • High cholesterol and blood pressure.
  • Metabolic syndrome.
  • Fatty liver disease.
  • Sleep apnea.
  • Endometrial cancer (from irregular cycles).
  • Depression and anxiety.

Treatment

1. Lifestyle Modification (Foundation)

Losing just 5–10% of body weight dramatically improves symptoms. Includes:

  • Low glycemic index diet.
  • Reducing refined carbs and sugar.
  • Increasing protein and fiber.
  • 150 minutes of exercise weekly.
  • Strength training 2–3 times weekly.
  • 7–8 hours of sleep.

2. Metformin

First-line for insulin resistance. Improves cycles, aids weight loss, and reduces diabetes risk. Dose: 500–2000 mg daily.

3. Combined Oral Contraceptives

For women not currently seeking pregnancy:

  • Regulate cycles.
  • Lower androgens — improve acne and excess hair.
  • Protect the endometrium.
  • Preferred types: containing drospirenone or cyproterone acetate.

4. Anti-Androgens

  • Spironolactone: for excess hair and acne.
  • Finasteride: occasionally for hair.

5. Fertility Treatments

For women wishing to conceive:

  • Clomiphene (Clomid): first-line ovulation induction.
  • Letrozole (Femara): better than Clomid in PCOS per recent studies.
  • Metformin: with Clomid improves results.
  • Gonadotropin injections: for resistant cases.
  • Ovarian drilling: laparoscopic surgery.
  • IVF: last resort.

6. Treating Acne and Excess Hair

  • Topical creams.
  • Oral isotretinoin.
  • Laser hair removal.
  • Topical eflornithine (Vaniqa).

7. Helpful Supplements

  • Inositol (myo-inositol): improves ovulation and insulin resistance.
  • Vitamin D.
  • Omega-3.
  • Chromium.
  • Magnesium.
Medical tip: There's no magic pill for PCOS. Success comes from sustained lifestyle change + tailored medical treatment based on your goals (cycle regulation, pregnancy, or symptom control).

PCOS and Pregnancy

Many women conceive with PCOS, but complication rates are higher:

  • Gestational diabetes.
  • Pregnancy hypertension and preeclampsia.
  • Early miscarriage.
  • Preterm birth.

Careful monitoring and pre-pregnancy insulin resistance control significantly improves outcomes.

Recommended Diet in PCOS

  • Leafy and colorful vegetables.
  • Lean protein (chicken, fish, legumes).
  • Whole grains (oats, quinoa, brown rice in moderate amounts).
  • Healthy fats (olive oil, nuts).
  • Anti-inflammatory spices (turmeric, cinnamon).
  • Reduce whole-fat dairy and sugars.

For accurate assessment and a personalized plan, book an appointment with a gynecologist or endocrinologist on ClinicsJo.

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Overview of PCOS, its hormonal symptoms, impact on fertility, and treatment strategies.