PCOS is a hormonal and metabolic condition affecting a large proportion of women of reproductive age. It is frequently diagnosed on an ultrasound alone, which is not sufficient — diagnosis requires a combination of clinical features, hormone testing and imaging, with other causes excluded.
Why it needs an endocrinologist
PCOS is not only a gynaecological issue. Insulin resistance sits at the centre of it for most women, which is why it travels with weight gain, prediabetes, abnormal cholesterol and fatty liver. Treating the hormonal symptoms without addressing the metabolic side leaves half the problem in place.
Treatment
Management depends entirely on what matters most to you at this stage of life — regularising periods, managing hirsutism and acne, protecting long-term metabolic health, or conceiving. Options range from lifestyle and weight interventions to metformin, hormonal treatment, anti-androgens and ovulation induction in coordination with a gynaecologist.
The long view
PCOS is a lifelong condition whose presentation changes with age. Periodic review for blood sugar, blood pressure and lipids is worthwhile even during phases when symptoms are quiet.