Medically reviewed by Dr. Shweta Agarwal, MBBS, DGO. Last updated: June 2026.
Information on this page is educational and does not replace a medical consultation. Outcomes depend on individual clinical factors.
What exactly is PCOS, and how is it different from PCOD?
PCOS (Polycystic Ovary Syndrome) is a metabolic and hormonal disorder characterised by chronic elevation of androgens, disrupted ovulation, and polycystic-appearing ovaries on ultrasound. PCOD (Polycystic Ovarian Disease) is a descriptive term for ovaries that contain many immature follicles; it is generally milder and often manageable with lifestyle changes alone.
Diagnosis of PCOS requires at least two of three Rotterdam criteria:
- Irregular or absent ovulation (oligomenorrhoea or amenorrhoea).
- Clinical or biochemical evidence of excess androgens.
- Polycystic ovaries on ultrasound.
Both conditions are common, and both are managed effectively with the right combination of lifestyle, medical, and (where needed) fertility care.
What are the symptoms of PCOS?
The most recognisable symptoms are irregular, infrequent, or prolonged periods. Other common signs include:
- Hirsutism: Excess hair growth on the face, chin, chest, or back, caused by elevated androgens.
- Acne and oily skin: Persistent breakouts.
- Scalp hair thinning: Widening part or diffuse thinning at the crown.
- Unexplained weight gain: Particularly abdominal weight, linked to insulin resistance.
- Acanthosis nigricans: Darkening of skin creases at the neck, underarms, or groin.
- Difficulty conceiving: Unpredictable ovulation makes natural conception challenging.
You can use our PCOS symptom self-check tool to better understand your specific symptoms before visiting.
What causes PCOS?
PCOS does not have a single cause. Current evidence points to an interplay of:
- Insulin resistance: Excess insulin signals the ovaries to produce more androgens. This is present in approximately 70–80% of women with PCOS.
- Elevated LH: Raised luteinising hormone disrupts the normal LH:FSH ratio, preventing egg release.
- Genetic predisposition: A first-degree relative with PCOS or type 2 diabetes increases your risk.
- Low-grade inflammation: Chronic systemic inflammation stimulates androgen production.
How is PCOS diagnosed?
Diagnosis is clinical, based on a comprehensive evaluation by Dr. Shweta Agarwal. The assessment includes:
Medical history and physical examination
Menstrual pattern, weight history, and clinical signs of androgen excess.
Blood tests (hormonal profile)
- FSH, LH, and LH:FSH ratio.
- Total and free testosterone, DHEAS.
- Fasting insulin and fasting glucose.
- Thyroid function and Prolactin.
- AMH (anti-Müllerian hormone).
For more details on diagnostic tests, visit our fertility tests page.
Pelvic ultrasound
A transvaginal ultrasound counts follicles per ovary and measures ovarian volume.
How does PCOS affect fertility?
PCOS is a common cause of anovulatory infertility. Without regular ovulation, conception cannot occur naturally in a predictable cycle. However, PCOS does not mean permanent infertility.
Many women with PCOS conceive naturally, while others respond beautifully to ovulation induction treatment. If you are struggling to conceive, consider scheduling a free second opinion.
What are the treatment options for PCOS?
Lifestyle and weight management
A 5–10% reduction in body weight can restore ovulation without medication. A low-glycaemic-index diet reduces insulin levels and androgen production.
Medical management
- Metformin: Reduces insulin resistance and improves cycle regularity.
- Combined oral contraceptive pill: Regulates cycles in women not currently trying to conceive.
- Anti-androgen agents: For hirsutism or hair loss.
Fertility treatment (when trying to conceive)
- Ovulation induction: Oral agents stimulate a follicle to mature and release.
- IUI: Timed insemination after ovulation induction.
- IVF treatment: Indicated when simpler methods have not resulted in pregnancy.
Learn more about treatment expenses on our IVF cost & 0% EMI page.
When should I see a specialist about PCOS?
You should consult a fertility specialist if:
- Your periods are consistently fewer than eight per year.
- You have been trying to conceive for 6–12 months without success.
- You have noticeable excess facial hair or hair thinning.
- You have a family history of PCOS or type 2 diabetes.
Early evaluation protects long-term metabolic health and fertility. We provide transparent, evidence-based care, with diagnosis and treatment available in-house.