As a gynaecologist, one of the most frequent concerns I hear from young women revolves around irregular periods. While occasional variations in the menstrual cycle can be completely normal—especially during adolescence or times of stress—persistent irregularity is often the body’s way of signalling that something deeper may be going on. One of the most common underlying causes is Polycystic Ovary Syndrome, or PCOS.
PCOS is a hormonal condition that affects a significant number of women in their reproductive years—up to one in five. Despite its prevalence, it remains widely misunderstood. Many women associate PCOS solely with missed periods or fertility issues, but it is far more complex. PCOS is a whole-body condition that can influence hormonal balance, metabolism, physical appearance, and emotional well-being.
At the core of PCOS is a hormonal imbalance. Women with PCOS often have elevated levels of androgens, sometimes referred to as “male hormones.” While all women naturally produce small amounts of these hormones, higher levels can disrupt normal ovarian function. This can interfere with ovulation, meaning the ovaries may not release an egg regularly. As a result, menstrual cycles become irregular or absent altogether.
The symptoms of PCOS can vary widely, which is one reason it is often overlooked or diagnosed late. Irregular periods are usually the first noticeable sign. Some women may have very infrequent cycles, while others may stop menstruating altogether. Persistent acne—especially beyond the teenage years—is another common symptom and is often resistant to typical treatments. Excess hair growth on the face, chest, abdomen, or back, known as hirsutism, can also occur due to elevated androgen levels.
On the other hand, some women experience thinning of hair on the scalp, which can be distressing and confusing. Weight gain or difficulty losing weight is frequently reported, even when lifestyle habits have not significantly changed. For women trying to conceive, difficulty with ovulation may present as challenges with fertility.
One of the biggest challenges with PCOS is that these symptoms often develop gradually. Many young women normalise them or attribute them to genetics, stress, or lifestyle. This is why awareness is so important. Early recognition allows for timely intervention, which can significantly improve both short-term symptoms and long-term health outcomes.
Beyond the visible signs, PCOS has important metabolic implications. It is closely linked with insulin resistance, a condition in which the body does not respond effectively to insulin. This can lead to higher blood sugar levels and increase the risk of developing type 2 diabetes. Women with PCOS are also more likely to experience high cholesterol and, over time, may face an increased risk of cardiovascular disease. These risks highlight why PCOS should never be viewed as “just a period problem.”
Unfortunately, there are many myths surrounding PCOS that can create confusion and unnecessary anxiety. One common myth is that all women with PCOS will have cysts on their ovaries. In reality, not every woman with PCOS has visible cysts, and the diagnosis is based on a combination of symptoms, hormonal findings, and clinical evaluation—not ultrasound alone.
Another widespread misconception is that PCOS only affects overweight women. While weight can influence the severity of symptoms, PCOS occurs in women of all body types. Lean women can have PCOS as well, and their symptoms may sometimes be overlooked because they do not fit the stereotypical image.
Perhaps one of the most distressing myths is that women with PCOS cannot get pregnant. This is simply not true. While PCOS can make ovulation less predictable, many women conceive naturally or with appropriate medical support. With the right treatment and guidance, fertility outcomes are often very positive.
There is also a belief that PCOS is something that will simply “go away” with time. In reality, it is a longterm condition that requires ongoing management. However, this does not mean it is unmanageable—far from it.
Management of PCOS is highly individualised and depends on a woman’s symptoms, priorities, and stage of life. Lifestyle measures form the cornerstone of treatment. A balanced diet, regular physical activity, and maintaining a healthy weight can significantly improve hormonal balance and metabolic health. Even a modest reduction in weight can restore ovulation and regulate menstrual cycles in some women.
Medical treatments are also available and can be very effective. Hormonal contraceptives are commonly used to regulate cycles and reduce androgen-related symptoms such as acne and excess hair growth. Other medications may be prescribed to improve insulin sensitivity or to induce ovulation in women seeking pregnancy.
Equally important is the emotional aspect of PCOS. Dealing with visible symptoms like acne or unwanted hair, or facing uncertainty around fertility, can take a toll on self-esteem and mental health. It is essential that women feel supported—not only medically, but also emotionally.
To every young woman: your symptoms are valid. Irregular periods, persistent acne, or changes in hair growth are not things to ignore or simply “live with.” Seeking medical advice early can make a significant difference.
PCOS is not a life sentence. With proper understanding, timely diagnosis, and a comprehensive approach to care, women with PCOS can lead healthy, confident, and fulfilling lives. Awareness is the first step—and it starts with listening to your body and challenging the myths that too often stand in the way of proper care.
Dr Sherene Kalloo
MDW, MBBS, DGO, DM, FACOG.
Specialist Obstetrician & Gynaecologist
