Polycystic Ovary Syndrome (PCOS) and Insulin Resistance

PCOS affects about 6–13% of women of reproductive age and is a whole-body metabolic and hormonal syndrome, not just an ovarian condition.

Diagnosis (Rotterdam Criteria)

At least two of: irregular or absent ovulation, clinical or biochemical androgen excess, and polycystic ovaries on ultrasound — after excluding thyroid disease, high prolactin, congenital adrenal hyperplasia and Cushing's syndrome.

Insulin Resistance

Present in most women with PCOS, regardless of weight; high insulin increases ovarian androgen production.

Long-Term Risks

Prediabetes and type 2 diabetes, gestational diabetes, dyslipidaemia, fatty liver, sleep apnoea, endometrial thickening and mood disorders.

Treatment

Weight loss of 5–10% when overweight, oral contraceptives and anti-androgens for cycles and hirsutism, metformin for metabolic risk, anti-obesity medication when appropriate and fertility treatment with a gynaecologist.