Common symptoms of PCOS include:

• Ovarian Cysts – is not a necessary symptom as many do not have cyst issues, likewise having cysts does not prove PCOS as many women without any medical problems have ovarian cysts.
• Irregular, few or absent menstrual periods; cycles that do occur may be heavy
• Infertility, generally resulting from chronic lack of ovulation
• Elevated serum (blood) levels of androgens (male hormones), specifically testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS), causing increased hair growth in face or body and occasionally masculinization
• Pain during sexual intercourse
• Male pattern baldness
• Acne, oily skin especially on face and back
• Dark patches of skin, tan or brown a sign of insulin resistance, which is associated with PCOS
• Skin tags (tiny flaps of skin)
• Prolonged periods of PMC-like symptoms (bloating, mood swings, pelvic pain, backaches)
• Sleep apnea (airway obstruction during sleep causing the person to gasp for air or snore loudly)

Other causes of irregular or absent menstruation and hirsutism, such as congential adrenal hyperplasia, Cushing’s syndrome, hyperprolactinemia, and other pituitary or adrenal disorders, should be investigated.

PCOS develops when the ovaries are stimulated to produce excessive amounts of male hormones (androgens), particularly testosterone, either through the release of excessive luteinizing hormone (LH) by the anterior pituitary gland or through high levels of insulin in the body (hyperinsulinaemia) in women whose ovaries are sensitite to this stimulus. This syndrome’s name derived from a common sign which is multiple (poly) ovarian cysts. These form where egg follicles matured but were never released from ovary because of abnormal hormone levels. These generally take on a ‘string of pearls’ appearance.  Research to date suggests that insulin resistance could be a leading cause, another probability is also a genetic predisposition, although no specific gene has been identified.

Medical treatment of PCOS is tailored to the patient’s goals. Broadly, these may be considered under 3 categories:

• Restoration of fertility
• Treatment of hirsutism or acne
• Restoration of regular menstruation, and prevention of endometrial hyperplasia and endometrial cancer

General interventions that help to reduce weight or insulin resistance can be beneficial for all these aims, because they address what is believed to be the underlying cause of the syndrome. Where PCOS is associated with overweight or obesity, successful weight loss is probably the most effective method of restoring normal ovulation/menstruation, but many women find it very difficult to achieve and sustain significant weight loss. Low-carbohydrate diets and sustained regular exercise may help, and some experts recommend a Low -GI (Low Glycemic Index Diet) in which a significant part of the total carbohydrates are obtained from fruit, vegetables and wholegrain sources.

Many find insulin-lowering medications such as metformin hydrochloride (Glucophage), pioglitazone hydrochloride (Actos) and rosiglitazone maleate (Avandia) helpful, and ovulation may resume when they use these agents. Many report that metformin use is associated with upset stomach, diarrhea, and weight loss. Such side effects usually resolve in 2-3 weeks.