Polycystic Ovary Syndrome (PCOS)
is the most common endocrine
disorder affecting 5-15% of
women in the reproductive age.
It is characterised by chronic
and polycystic ovaries.
PCOS is a complex condition that
may require management by a
multidisciplinary team. Despite the
fact that no cure is available for
this condition, good control of the
symptoms can be achieved with
lifestyle and dietary modifications.
PCOS should be diagnosed early
to promote long-term health and
prevent metabolic and cardiovascular
Approximately 60-70 percent of
women with PCOS exhibit menstrual
dysfunction related to anovulation.
The most common abnormalities are
infrequent periods (oligomenorrhoea)
and absence of period (amenorrhoea).
Frequent and prolonged periods
(polymenorrhoea) are very uncommon
(less than two percent). One quarter of
patients have regular periods.
They are either markers of
production of male hormones) or
The difficulty in conceiving is mainly
due to chronic anovulation. PCOS
accounts for approximately 75 percent
of anovulatory subfertility.
Obesity is often associated with PCOS
(30-70 percent), but many patients with
PCOS are of normal weight.
The exact causes remain unclear but more than one can be involved. Genetic and environmental contributors combined with obesity, ovarian dysfunction and hormonal changes contribute to PCOS.
The diagnosis criteria follows the
2003 Rotterdam diagnosis consensus
The diagnosis of PCOS is present if any
two out of the following three criteria
are met and other hormonal conditions
And exclusion of other causes such
as pregnancy, thyroid diseases,
adrenal hyperplasia, hypothalamic
amenorrhoea, premature ovarian
insufficiency, androgen secreting
tumour, Cushing syndrome and
To prevent endometrial cancer, a
woman should have at least four to six
periods in a year. This can be achieved
through the following methods:
Choice of options depends on the
patient’s preferences, impact on
wellbeing, and access and affordability:
The following options are available:
Studies with clomiphene citrate show ovulation rates of 60–85 percent and pregnancy rates of 30-50 percent after six ovulatory cycles.