Quick answer. Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions in women of reproductive age, affecting an estimated 5-15%. It is recognised by a combination of irregular or absent periods, signs of excess male hormones (such as acne or excess hair growth), and polycystic ovaries on ultrasound – diagnosed using the Rotterdam criteria (any 2 of these 3 features, after excluding other causes). PCOS is closely linked to insulin resistance, a higher risk of type 2 diabetes, weight gain and difficulty conceiving. It cannot be cured, but it is very manageable: lifestyle and weight management are first-line, the combined contraceptive pill helps regulate cycles and androgen symptoms, metformin addresses metabolic and insulin issues, and ovulation induction supports those trying to conceive. See a GP, gynaecologist or endocrinologist for assessment.
Polycystic ovary syndrome (PCOS) is a common hormonal condition affecting women throughout their reproductive years, and it is a frequent reason for visits to gynaecologists and endocrinologists in Singapore. Although the name suggests it is only about the ovaries, PCOS is really a whole-body hormonal and metabolic condition that can affect periods, fertility, skin, weight and long-term health. The good news is that with the right diagnosis and a tailored plan, most women can manage their symptoms well and protect their future health.
At a glance
| Goal | Treatment approach | Notes |
|---|---|---|
| Overall health and symptom improvement | Lifestyle and weight management (healthy diet, regular exercise) | First-line for everyone; ~5-10% weight loss can meaningfully improve symptoms |
| Regulate periods / reduce acne and excess hair | Combined oral contraceptive pill (+/- anti-androgens) | Also protects the womb lining; not used if trying to conceive |
| Insulin resistance / metabolic risk | Metformin | Targets insulin resistance; may help cycles and lower diabetes risk |
| Trying to conceive | Ovulation induction (e.g. letrozole, clomiphene) | Encourages ovulation; further fertility options if needed |
| Long-term health | Periodic monitoring of weight, blood pressure, blood sugar, cholesterol | Reduces risk of type 2 diabetes and cardiovascular disease over time |
What is PCOS?
PCOS is one of the most common endocrine (hormonal) disorders in women of reproductive age, affecting an estimated 5-15% of women. It involves three interlinked problems that often occur together: irregular or absent ovulation, higher-than-usual levels of male hormones (androgens), and an ovarian appearance with many small follicles on ultrasound.
Importantly, the name is somewhat misleading. The “cysts” are actually small, immature follicles, and a woman does not need to have polycystic-looking ovaries to be diagnosed. Equally, having polycystic ovaries on a scan does not automatically mean a woman has PCOS. The diagnosis depends on the overall picture of hormones and symptoms – not the ovary appearance alone.
Common symptoms and features
PCOS can present differently from woman to woman, and symptoms range from mild to more troublesome. Common features include:
- Irregular or absent periods – infrequent cycles (often longer than 35 days apart) or missed periods are among the most common signs.
- Signs of excess androgens – persistent acne, oily skin, excess facial or body hair growth (hirsutism), and sometimes scalp hair thinning.
- Difficulty conceiving – because ovulation is irregular, PCOS is one of the leading causes of difficulty getting pregnant.
- Weight gain – many women find it harder to lose weight, though PCOS also occurs in women of normal weight.
Symptoms may change over time and can be more noticeable during periods of weight gain.
How PCOS is diagnosed
There is no single test for PCOS. Doctors use the internationally recognised Rotterdam criteria, which require at least two of the following three features, after other conditions have been excluded:
- Irregular or absent ovulation – reflected in infrequent or absent periods.
- Signs of excess androgens – either clinical (acne, excess hair growth) or shown on blood tests (raised testosterone).
- Polycystic ovaries on ultrasound – multiple small follicles and/or enlarged ovaries.
Assessment typically includes a medical history and examination, blood tests (hormone levels, and often glucose and cholesterol to check metabolic health), and a pelvic ultrasound. Because other hormonal conditions – such as thyroid problems or raised prolactin – can mimic PCOS, these are usually ruled out before confirming the diagnosis.
Why PCOS matters for long-term health
PCOS is strongly associated with insulin resistance, where the body’s cells respond less effectively to insulin. This contributes to weight gain and significantly raises the long-term risk of type 2 diabetes – studies cite a 5- to 10-fold increased risk. PCOS is also linked to higher risks of high cholesterol and cardiovascular problems.
Irregular periods mean the womb lining may not shed regularly, which over many years can increase the risk of endometrial (womb lining) changes. Because of these risks, PCOS is best diagnosed early and monitored over the long term, with periodic checks of weight, blood pressure, blood sugar and cholesterol. Emotional wellbeing also matters – PCOS can affect mood and self-esteem, and support should be part of care.
Treatment and management
PCOS cannot be cured, but it can be managed effectively. There is no one-size-fits-all approach – treatment is tailored to your symptoms, your stage of life and your goals (for example, regulating periods, improving skin, or trying to conceive).
- Lifestyle and weight management (first-line) – a healthy diet and regular exercise are the foundation of treatment. Even a modest weight loss of around 5-10% (for those who are overweight) can significantly improve cycles, ovulation, insulin resistance and androgen symptoms.
- Combined oral contraceptive pill – helps regulate menstrual cycles, protect the womb lining and reduce androgen-related symptoms such as acne and excess hair growth. Anti-androgen medicines are sometimes added for skin and hair concerns.
- Metformin – used to address insulin resistance and metabolic issues, and may help with cycles and reduce diabetes risk in those at higher risk.
- Fertility treatment – for women trying to conceive, ovulation induction (with medicines such as letrozole or clomiphene) is commonly used to encourage ovulation, with further options available where needed.
A doctor will help you choose the combination that fits your priorities, and the plan can be adjusted as your needs change.
When to see a doctor and who treats PCOS
It is worth getting assessed if you have irregular or absent periods, trouble conceiving, or troublesome acne or excess hair growth. Early assessment helps you manage symptoms and protect your long-term metabolic health.
PCOS can be managed by several types of doctor depending on your needs: a GP can do an initial assessment and start basic management; a gynaecologist (O&G specialist) is well suited to cycle, ovary and fertility concerns; and an endocrinologist focuses on hormonal and metabolic aspects such as insulin resistance and diabetes risk. Many women benefit from a combined approach.
Related guides
- Best Gynaecology Clinics in Singapore — our editorial shortlist
- gynaecology clinics directory
- Menopause & HRT
- Endometriosis treatment
- Uterine fibroids treatment
Sources
- SingHealth – Polycystic Ovary Syndrome (PCOS)
- KK Women's and Children's Hospital (KKH), SingHealth – Polycystic Ovary Syndrome
- Singapore Medical Journal – Managing polycystic ovary syndrome in primary care
- HealthHub (Health Promotion Board, Singapore) – Diseases and Conditions
See also
Related conditions & guides
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