PCOS: Myths and Reality

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women, affecting up to 10-15% of women of reproductive age. Despite its name, ovarian "cysts" are only one possible sign, and many women with PCOS do not have them. A more accurate name would be hyperandrogenism syndrome, since the key issue is an excess of male sex hormones (androgens).

There are many myths surrounding PCOS. Myth one: PCOS is only an ovarian problem. Reality: PCOS is a systemic metabolic disorder linked to insulin resistance, chronic inflammation, and disruptions in the hypothalamic-pituitary system. Myth two: PCOS only affects overweight women. Reality: up to 30% of women with PCOS have a normal weight. Myth three: pregnancy is impossible with PCOS. Reality: PCOS is the most common but also the most treatable cause of anovulatory infertility.

PCOS diagnosis is based on the Rotterdam criteria: the presence of two of three signs — irregular menstruation, clinical or biochemical signs of hyperandrogenism, and polycystic ovarian morphology on ultrasound. It is important to rule out other causes: thyroid dysfunction, hyperprolactinemia, and congenital adrenal hyperplasia.

PCOS treatment begins with lifestyle: regular physical activity, a low-glycemic-index diet, and stress management can significantly improve the hormonal profile. Pharmacological therapy includes metformin (for insulin resistance), combined oral contraceptives (for cycle regulation), anti-androgens, and ovulation induction agents when planning pregnancy.