Polycystic Ovary Syndrome (Pcos/Pcod): A Comprehensive Review

Polycystic Ovary Syndrome (PCOS), commonly referred to as Polycystic Ovarian Disease (PCOD), is a common endocrine disorder characterized by reproductive, hormonal and metabolic abnormalities. The condition may present with irregular menstrual cycles, ovulatory dysfunction, hyperandrogenism, acne, hirsutism, hair loss and fertility problems. Insulin resistance, hyperinsulinemia, abnormal androgen activity and altered ovarian function contribute to the pathophysiology of PCOS. PCOS is also associated with increased metabolic, cardiovascular, psychological and reproductive health risks. Diagnosis is based on clinical assessment, biochemical investigations and, when indicated, ovarian morphology assessment after excluding other causes of similar symptoms. The 2023 International Evidence-Based Guideline emphasizes individualized assessment, healthy lifestyle, metabolic risk evaluation, psychological wellbeing and evidence-based pharmacological management. Combined oral contraceptive pills may be used for menstrual irregularity and hyperandrogenic symptoms, while metformin has an important role in selected metabolic indications. Letrozole is recommended as the preferred first-line pharmacological treatment for ovulation induction in appropriate patients with PCOS-related anovulatory infertility. This review summarizes the etiology, pathophysiology, clinical manifestations, diagnosis, complications, management and emerging approaches in PCOS.[1–5]