Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions in women of reproductive age, affecting roughly one in ten women worldwide. Many women in Uganda live with it for years without a diagnosis, attributing irregular periods, acne or weight gain to other causes. Understanding PCOS helps you get the right care and protect your long term health.
What is PCOS?
PCOS is a hormonal imbalance where the ovaries produce higher levels of male type hormones (androgens) and ovulation (release of eggs) becomes irregular or stops. Despite the name, not every woman with PCOS has cysts on her ovaries, and having small follicles on a scan does not alone mean you have PCOS.
Common symptoms
- Irregular, infrequent or absent periods
- Difficulty getting pregnant
- Excess hair growth on the face, chin, chest or belly (hirsutism)
- Acne and oily skin
- Thinning hair on the scalp
- Weight gain or difficulty losing weight, especially around the waist
- Dark, velvety skin patches on the neck, armpits or groin (acanthosis nigricans)
How PCOS is diagnosed
Doctors usually diagnose PCOS when at least two of these three are present, after ruling out other conditions:
- Irregular or absent ovulation, shown by irregular periods
- Signs of high androgens, either clinical (excess hair, acne) or in blood tests
- Polycystic appearing ovaries on ultrasound
Your doctor may also test thyroid function, prolactin, blood sugar and cholesterol, because other conditions can mimic PCOS and PCOS raises metabolic risks.
Treatment options
Lifestyle changes (first line for many women)
- Even a 5 to 10 percent weight loss in women with excess weight can restore ovulation and improve symptoms.
- Regular exercise improves insulin sensitivity.
- Eat more vegetables, beans, whole grains like millet and brown rice, and lean proteins; reduce sugary drinks, white bread, cakes and fried snacks.
- Prioritise sleep and stress management.
Medicines
- Hormonal contraceptives to regulate periods and reduce acne and hair growth, for women not trying to conceive.
- Metformin to improve insulin resistance in some women.
- Anti androgen medicines for excess hair, with medical supervision.
- Treatments for acne and hair removal options.
For women trying to get pregnant
- Ovulation induction medicines such as letrozole or clomiphene, prescribed and monitored by a doctor.
- Monitoring with ultrasound to track follicle growth.
- Advanced options such as IVF when other treatments do not work.
Many women with PCOS conceive successfully with proper treatment.
Long term health risks
- Type 2 diabetes
- High blood pressure and high cholesterol
- Sleep apnoea
- Endometrial (womb lining) problems if periods are very infrequent
- Depression and anxiety
Regular check ups for blood sugar, blood pressure and cholesterol are recommended.
Myths about PCOS
- "PCOS means you can never have children." False. Many women with PCOS have children, sometimes with treatment.
- "Only overweight women get PCOS." False. Slim women can also have PCOS.
- "Herbal teas cure PCOS." There is no cure, and unproven remedies can delay proper care.
When to see a doctor
- Cycles longer than 35 days, or more than three months without a period (if not pregnant)
- Trying to conceive for 12 months without success (6 months if over 35)
- Excess hair growth or severe acne
- Signs of high blood sugar such as excessive thirst and urination
Talk to a doctor
Book a quick video consultation with a verified doctor or gynaecologist on The Quick Consult to discuss symptoms and next steps. This article is general information, not a substitute for medical care.