What is PCOS?

It is Polycystic ovarian syndrome.

PCOS is a common condition affecting women from 13 to 45 years. It affects up to 15% of women worldwide, depending on the diagnostic criteria used.

PCOS is a collection of signs and symptoms that can tell the future of a woman’s health. Despite many suffer with major complications, affected women remain undiagnosed,

PCOS (earlier called PCOD) is due to insulin resistance, which affects 2 main hormones.

  1. Luteinizing Hormone: needs to rise only before ovulation to release an egg. But in PCOS, due to insulin resistance, it is high the whole month. That pauses the natural way of monthly egg maturation and release. This causes irregular or scanty periods and prevents a natural pregnancy.
  2. Androgen Hormone: is low in normal women without PCOS. But in PCOS it androgen or testosterone derivatives are slightly high. This causes excess acne, female pattern hair loss, and excess body hair.

The following are the signs and symptoms of PCOS.


  • Presence of thick hair in places where they are not meant to be. Like the chin, upper lip, jawline, front of the chest, around the nipple, below the belly button, and around the anus.
  • Acne
  • Female pattern hair loss

Ovulation dysfunction:

  • Less than 6-8 menstrual cycles per year
  • Periods more than 35 days
  • Sometimes even regular periods, especially those with features of hyperandrogenism

There are three main criteria for diagnosing PCOS.

  • NIH criteria 1992
    • Clinical and or biochemical hyperandrogenism and
    • Menstrual problem
  • Rotterdam criteria 2004- 2 out of 3
    • Clinical and or biochemical hyperandrogenism and
    • Less periods or no periods
    • Polycystic ovaries on ultrasound
  • Androgen excess society criteria 2006
    • Clinical and or biochemical hyperandrogenism and
    • Less or no periods and or polycystic ovaries on ultrasound

It is important to note that obesity, insulin resistance and type 2 diabetes are not in the diagnostic criteria, even when they go hand in hand with PCOS.

The diagnostic criteria for PCOS have evolved over the last century. The current diagnosis for PCOS depends on expert opinion. There has never been a formal process to determine criteria for diagnosing. This might be one of the reasons why so many PCOS women go undiagnosed.

Diagnosis of PCOS, thus, depends on treatment goals. We need an ultrasound assessment only to manage pregnancy success. But it is unnecessary for weight loss, regulating periods, or correcting acne.

Any overweight woman with a period problem is at risk of complications due to PCOS.

PCOS complications look like

  • irregular periods,
  • hair loss,
  • body image issues,
  • infertility.

During pregnancy, PCOS women are prone for

  • miscarriages,
  • preterm births,
  • twins or triplets,
  • diabetes, or
  • high blood pressure.

In the future, they can get

  • type 2 diabetes,
  • obesity,
  • hypertension,
  • heavy periods,
  • depression,
  • anxiety, and
  • many other types of cancers.

We cannot avoid PCOS, but we can work around it to cut our risk of getting the above sufferings. By adjusting to a

  • PCOS-safe diet for the rest of our life,
  • Including regular PCOS exercises in a daily routine,
  • Managing our mind to reduce stress.

Reversing PCOS is when we make every effort to become insulin sensitive. It is possible if we work on our mindset to stay committed using our higher brain.

Learn more about it in my podcast series on reversing PCOS.

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