Polycystic Ovary Syndrome (PCOS)

About

Specialities

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About

Specialities

Find Your Region

About the disease & condition

Polycystic ovary syndrome is a common endocrine disorder characterised by chronic anovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology on ultrasound. It is a heterogeneous condition with significant metabolic and reproductive implications.

⁠Aetiology & Pathophysiology

Aetiology: Multifactorial with strong genetic predisposition; insulin resistance plays a central role.
Pathophysiology: Insulin resistance leads to hyperinsulinemia, which stimulates ovarian androgen production and reduces sex hormone-binding globulin (SHBG), increasing free testosterone. Disrupted gonadotropin secretion (elevated LH relative to FSH) further contributes to anovulation and androgen excess.

⁠Symptoms & Signs

Common symptoms:
Menstrual irregularities (oligomenorrhea, amenorrhea).
Hirsutism, acne, alopecia.
Weight gain (especially central obesity), acanthosis nigricans.
Red flags: Rapid virilisation (suggestive of androgen-secreting tumours), severe insulin resistance, or signs of Cushing’s syndrome warrant further investigation.

⁠Diagnosis

Diagnostic criteria (Rotterdam criteria): Requires at least two of:
Oligo-/anovulation.
Clinical or biochemical hyperandrogenism.
Polycystic ovaries on ultrasound.
Assessments:
Hormonal profiling (testosterone, LH, FSH, SHBG).
Glucose tolerance test and fasting insulin.
Pelvic ultrasound (≥12 follicles per ovary and/or increased ovarian volume).
Exclusion of other disorders: Thyroid dysfunction, hyperprolactinemia, congenital adrenal hyperplasia.

Management & Treatment

Lifestyle modification: Weight loss (5–10% of body weight) improves metabolic and reproductive parameters.
Pharmacological:
Combined oral contraceptives (regulate cycles, reduce androgens).
Anti-androgens (e.g., spironolactone) for hirsutism.
Metformin to improve insulin sensitivity.
Ovulation induction agents (e.g., clomiphene citrate) for infertility.
Procedural: Ovarian drilling (laparoscopic) in select resistant cases.

Potential Complications

Reproductive: Infertility, early pregnancy loss.
Metabolic: Type 2 diabetes, dyslipidemia, metabolic syndrome.
Long-term risks: Endometrial hyperplasia (due to unopposed estrogen), cardiovascular disease, obstructive sleep apnea.

Prevention & Follow-up

Prevention: Early lifestyle intervention in high-risk individuals; no definitive preventive measures.
Follow-up:
Annual screening for glucose intolerance, lipid profile, and blood pressure.
Endometrial surveillance in patients with prolonged amenorrhea.
Regular monitoring of weight, hirsutism, and metabolic parameters.

Relevant Specialities

Endocrinology

Endocrinology is the medical specialty that focuses on hormone-related conditions and the body’s metabolic processes.

It supports the management of health conditions influenced by hormonal balance, helping patients maintain overall well-being through long-term monitoring and care.

At KIMSHEALTH, endocrinology care is delivered with a patient-first approach, emphasizing accurate diagnosis, continuous monitoring, and personalized management.

Who we are

Here for you, every step of the way

Healthcare can feel overwhelming at times. At KIMSHEALTH Bahrain, we believe care should be transparent and supportive, allowing you to move forward with confidence and comfort. You deserve care you can trust, delivered with understanding and respect.

Our medical teams bring together advanced expertise with a deeply human approach to care. From everyday care to highly specialised treatment, we ensure you feel informed, reassured, and supported throughout your journey - so your experience with us is seamless and secure.