by
Mehreen Firdous
SRINAGAR: For decades, Polycystic Ovary Syndrome (PCOS) was largely regarded as a reproductive disorder linked to irregular menstrual cycles and infertility. However, medical experts now say the condition is far more complex, affecting metabolism, hormones, mental health, and long-term cardiovascular health.
Specialists at Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, have emphasised the need for greater awareness, early diagnosis, and sustained lifestyle management, warning that untreated PCOS can silently progress into serious complications such as diabetes, fatty liver disease, hypertension, and cardiovascular disorders.
Doctors from endocrinology, gynaecology, and research backgrounds said PCOS should no longer be viewed merely as a gynaecological condition.
“PCOS is a syndrome because it involves multiple interconnected disturbances, including hormonal imbalance, metabolic dysfunction, and reproductive irregularities,” said Dr Aafia Rashid, who works on cardio-metabolic and endocrine aspects of the disorder.
She explained that the earlier term PCOD referred only to ovarian cysts and did not reflect the broader hormonal and metabolic impact of the condition.
According to Dr Rashid, lack of awareness remains a major reason many women fail to recognise early symptoms of PCOS. Signs such as irregular periods, acne, and weight gain are often dismissed as normal developmental changes, while social stigma around menstrual and reproductive health further delays diagnosis.
“PCOS does not present in the same way in every individual. Some women may have menstrual irregularities without weight gain, while others may show metabolic symptoms without obvious reproductive issues,” she said.
She added that insulin resistance lies at the core of the disorder and affects multiple organs simultaneously.
“In the ovaries, excess insulin stimulates testosterone production, which disrupts ovulation and leads to irregular cycles, acne, and excess hair growth. In the liver, it promotes fat accumulation and increases the risk of fatty liver disease,” Dr Rashid said.
She warned that untreated insulin resistance significantly increases the risk of type 2 diabetes, hypertension, and cardiovascular disease later in life.
From an endocrine perspective, Dr Najam-us-Saqib said long-standing hormonal imbalance and insulin resistance gradually affect major metabolic organs.
Dr Najam-us-Saqib, an endocrinologist, said the pancreas is forced to produce higher levels of insulin continuously, which over time strains insulin-producing cells and increases the risk of pre-diabetes and type 2 diabetes at a relatively young age.
He further said the liver is vulnerable to fat accumulation caused by metabolic dysfunction, which may progress to inflammation and damage if left untreated.
“The cardiovascular system is affected through chronic inflammation, hormonal imbalance, and metabolic disturbance. Blood vessels may gradually stiffen, circulation may be impaired, and the long-term risk of heart disease increases, often without early symptoms,” he said.
He added that PCOS disrupts hormonal communication between the brain and ovaries, affecting the body’s overall endocrine balance.
“PCOS represents a disorder of whole-body hormonal coordination rather than a localised reproductive problem,” he said.
Meanwhile, Dr Saima Wani said infertility remains one of the most common misconceptions associated with PCOS.
“While PCOS can interfere with regular ovulation, most women with the condition can conceive, either naturally or with minimal medical assistance,” she said.
Dr Wani noted that even modest lifestyle changes, including a 5 to 10 per cent reduction in body weight, can help restore ovulation in many cases.
She also cautioned against diagnosing PCOS solely on ultrasound findings, particularly among adolescents.
“Many adolescents may show ovarian patterns resembling PCOS during normal hormonal development. This does not necessarily indicate disease,” she said, adding that accurate diagnosis requires clinical evaluation, hormonal testing, and age-appropriate assessment.
Addressing common misconceptions, Dr Wani said many women wrongly believe that PCOS resolves after marriage or childbirth.
“In reality, it is a lifelong condition that requires continuous management,” she said.
She stressed that structured physical activity, balanced nutrition, and sustained weight management are key components of long-term treatment.
The specialists also highlighted the psychological impact of the condition, noting that hormonal imbalance, irregular cycles, weight gain, and anxiety about fertility often contribute to stress, low self-esteem, and emotional strain.
“Emotional support, accurate information, and reassurance are essential parts of comprehensive care,” Dr Wani said.
Despite long-term challenges, the doctors emphasised that women with PCOS can lead healthy and productive lives with proper treatment and regular monitoring.
“With proper medical guidance, lifestyle management, and regular monitoring, women with PCOS can live healthy, productive, and fulfilling lives,” she added.
The experts collectively stressed that PCOS should be understood as a lifelong metabolic and hormonal disorder rather than solely a reproductive issue, calling for greater awareness, timely diagnosis, and early intervention to prevent long-term complications and safeguard women’s health.
