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Expert insights by Dr. Amruta Jaiswal (Katakwar), Consultant Gynaecologist and Laparoscopic Surgeon.
PCOS (Polycystic Ovarian Syndrome) is a common hormonal disorder affecting women during their reproductive years. It is characterized by the development of multiple small, fluid-filled sacs along the outer edge of the ovaries. These sacs, known as cysts, contain immature eggs that often fail to be released, disrupting the natural menstrual cycle and leading to various reproductive and metabolic concerns.
Although the exact cause of PCOS remains unknown, several factors may contribute to its onset. One of the most significant is insulin resistance, where the body does not efficiently process insulin, leading to elevated blood sugar and increased androgen production. Hormonal imbalance, particularly an increase in male hormones (androgens), further disrupts normal ovarian function. Chronic low-grade inflammation has also been observed in women with PCOS and is thought to stimulate androgen production in the ovaries. Additionally, a hereditary component exists, as PCOS tends to run in families.
Women with PCOS typically experience a disruption in hormonal levels. There is often an increase in testosterone, luteinizing hormone (LH), and insulin, accompanied by a decrease in estrogen, progesterone, and follicle-stimulating hormone (FSH). This imbalance interferes with ovulation, leading to irregular or absent menstrual periods. It can also cause other symptoms such as acne, excessive hair growth (hirsutism), oily skin, and hair thinning or loss from the scalp. Many women may struggle with weight gain, mood disturbances, skin tags, and darkened skin patches, especially around the neck and underarms — a condition known as acanthosis nigricans.
Dr. Amruta Jaiswal (Katakwar) takes a comprehensive and personalized approach to diagnosing PCOS. She begins with a detailed evaluation of the patient’s symptoms, medical history, and menstrual patterns, followed by a clinical examination to assess signs of androgen excess, such as hirsutism, hair thinning, acne, and skin changes. Diagnostic imaging such as a pelvic ultrasound is used to examine the ovaries and uterine lining, while blood tests help assess hormone levels, glucose tolerance, lipid profile, and inflammation markers. A diagnosis is generally confirmed when a woman presents with two or more features: irregular or absent periods, high androgen levels, or polycystic ovaries visible on ultrasound.
Treatment of PCOS is tailored to the individual, focusing on symptom management, reproductive goals, and long-term health. Dr. Amruta integrates non-surgical and advanced laparoscopic or robotic surgical options depending on the severity of the condition.
The foundation of treatment includes lifestyle modifications such as a healthy, low-calorie diet combined with regular physical activity, both of which contribute to improved hormone regulation and menstrual regularity. Medical treatment is determined by the patient’s specific symptoms and reproductive intentions. Hormonal contraceptives are commonly prescribed to regulate periods, reduce androgen levels, and manage skin and hair-related concerns. Insulin-sensitizing agents like Metformin help control blood sugar and androgen levels. For women wishing to conceive, ovulation-inducing medications such as Clomiphene or Letrozole may be recommended.
In cases where symptoms are not controlled with medication or lifestyle changes, Dr. Amruta offers Laparoscopic Ovarian Drilling — a minimally invasive surgical procedure that helps restore ovulation by targeting ovarian tissue producing excess androgens. This surgery is considered especially for women with infertility due to anovulation who are not responding to other treatments.
The symptoms of PCOS may begin around the first menstrual period or develop later in life. Common signs include irregular or prolonged menstrual cycles, acne, excessive hair growth on the face and body, and thinning hair or pattern baldness. Women may also experience sudden weight gain, difficulty losing weight, and the appearance of dark, velvety skin in body folds. Each woman may present with a unique combination of these symptoms, making individualized care essential.
