Polycystic ovary syndrome (PCOS) is a common hormonal and metabolic disorder affecting women of reproductive age. It is characterized by a combination of ovulatory dysfunction, hyperandrogenism, and polycystic ovarian morphology. Beyond reproductive health, PCOS has significant metabolic implications, including insulin resistance, obesity, dyslipidemia, and increased risk of Type 2 diabetes.

The exact cause of PCOS is multifactorial and involves genetic predisposition, hormonal imbalance, and metabolic dysfunction. Insulin resistance plays a central role, leading to elevated insulin levels that stimulate excess androgen production by the ovaries. This hormonal imbalance disrupts ovulation and contributes to many of the clinical features of PCOS.

Symptoms vary widely and may include irregular or absent menstrual periods, infertility, acne, excessive hair growth, scalp hair thinning, weight gain, and difficulty losing weight. Psychological effects such as anxiety, depression, and reduced quality of life are also common and often underrecognized.

Diagnosis is based on clinical assessment, hormonal testing, and pelvic ultrasound. Diagnostic criteria typically require the presence of at least two of the following: irregular ovulation, clinical or biochemical signs of androgen excess, and polycystic ovarian appearance on imaging. Other endocrine conditions must be excluded before confirming the diagnosis.

Management of PCOS is individualized and depends on symptoms, reproductive goals, and metabolic risk profile. Lifestyle modification is foundational, particularly for overweight and obese individuals. Weight reduction improves insulin sensitivity, restores ovulatory cycles, and reduces androgen levels.

Medical treatment targets specific manifestations. Hormonal therapies help regulate menstrual cycles and control androgen-related symptoms, while insulin-sensitizing agents improve metabolic parameters. Fertility-focused treatment aims to induce ovulation in women seeking pregnancy.

Long-term care is essential, as PCOS is associated with increased risk of Type 2 diabetes, cardiovascular disease, and endometrial hyperplasia. Regular metabolic screening, weight management, and cardiovascular risk assessment are integral components of ongoing care. With a structured, multidisciplinary approach, women with PCOS can achieve hormonal balance, improved fertility outcomes, and better long-term health.