42-year-old Lina（pseudonym）walked into the Distinct Health Women’s Health Center with a hint of fatigue and worry on her face. She recalled, when she was young, her menstruation was always irregular, sometimes only coming once every few months, but she thought it was a “normal phenomenon” and never paid attention.
In her 30s, she sought medical attention for infertility and was diagnosed with Polycystic Ovary Syndrome（PCOS）. At that time, she only focused on fertility issues. Through ovulation induction treatment, she successfully gave birth to a healthy daughter. After that, her life became busy, and PCOS was forgotten.
It was not until recently, when she visited the doctor again due to abnormal uterine bleeding, that the examination results shocked her:
Lina’s story is not an isolated case.
not only was she diagnosed with type 2 diabetes, but she also found endometrial cancer. The doctor told her that these are all closely related to long-term unmanaged PCOS.
PCOS is the most common endocrine disorder in women, affecting about 5-15% of women of reproductive age worldwide, but as many as 70% of cases are undiagnosed. It not only causes irregular menstruation, acne, abnormal hair growth, obesity, infertility, but may also trigger diabetes, cardiovascular diseases, and endometrial cancer and other serious health problems, affecting women’s health from adolescence to menopause.
This article will take you in-depth to understand the nature and dangers of PCOS, and how to manage it scientifically at different stages of life, helping you to discover and manage PCOS comprehensively early on, so that you can embrace a healthier life.
Polycystic Ovary Syndrome（Polycystic Ovary Syndrome, abbreviated as PCOS）is an endocrine and metabolic disorder characterized by hyperandrogenism, ovulatory dysfunction, and/or polycystic ovary morphology. Its etiology is not yet fully understood, and it may be related to genetic factors, insulin resistance, hormonal imbalances, and inflammation.
Its main features include:
● High androgen levels: ● Abnormal ovulation: ● Polycystic ovary changes:
PCOS is like a “domino effect” in the body: high androgen interferes with ovulation, leading to menstrual irregularities and infertility, and long-term anovulation causes endometrial lesions; insulin resistance exacerbates hormonal imbalances, leading to obesity and diabetes, posing long-term health risks.
What is Polycystic Ovary Syndrome?
leading to acne, hirsutism, and hair loss;
irregular or anovulatory menstruation, affecting fertility;
ultrasound examination shows multiple immature follicles in the ovaries.
According to the updated data from the WHO in 2025, PCOS affects 6-13% of women of reproductive age worldwide, but as many as 70% of cases remain undiagnosed, and what is even more alarming is:
Rethinking PCOS —
An Underestimated Health Risk
PCOS is not only a gynecological disease but also a potential “metabolic storm”.
01 Insulin Resistance: About 50-70% of women with PCOS have insulin resistance, 50% of patients have impaired glucose tolerance at the time of diagnosis, the risk of diabetes increases by 30-40%.
Obesity:
Metabolic Issues
About 50% of women with PCOS are overweight, and obesity further exacerbates insulin resistance and hormonal imbalances.
02 Long-term menstrual irregularities may lead to endometrial hyperplasia, increasing the risk of endometrial cancer. Studies have shown that women with PCOS are at 5 times the risk of endometrial cancer compared to the general female population.
03 Although the exact relationship between PCOS and cardiovascular diseases is still a matter of debate, most studies still show that high blood pressure and high cholesterol increase the risk of heart disease and stroke, and the risk of cardiovascular events in women with PCOS is 1.5-2 times higher than the general population.
04 Non-alcoholic Fatty liver disease:
Sleep apnea:
Mental health:
These data remind us that PCOS is by no means a small problem, and neglecting it may lead to serious consequences.
Endometrial Cancer
Cardiovascular Diseases
Other Health Issues
Insulin resistance may lead to fat accumulation in the liver, and the incidence of non-alcoholic fatty liver disease reaches 42%(6 times higher than the general population);
Obese individuals with PCOS are more likely to experience sleep apnea.
Acne, hirsutism, and infertility may lead to anxiety and depression.
The symptoms and risks of PCOS vary with age and require personalized management throughout the life cycle. The following are the focus, management priorities, and specific measures for adolescence, reproductive age, and menopause.
Adolescence (12-19 years old)
PCOS Management at Different Age Stages
Warning and Focus Situations: Adolescence is the starting point for the manifestation of PCOS symptoms, and vigilance is needed —
Menstrual irregularities:
Persistent acne: acne on the face, chest, or back, conventional treatment is ineffective.
Hirsutism:
Other:
within 3 years after menarche menstruation is still not regular(e.g., cycles < 21 days or > 45 days, or fewer than 8 menstrual periods per year).
on the face(upper lip, chin), abdominal or inner thighs abnormal hair growth (hirsutism).
rapid weight gain or a family history of PCOS.
These symptoms can affect girls’ self-confidence and mental health, significantly reducing the social desire of adolescent females.
Management Focus: ● Establish a healthy menstrual cycle to prevent endometrial abnormalities. ● Control acne and hirsutism to improve appearance and self-confidence. ● Provide psychological support to alleviate anxiety and inferiority.
● Develop healthy living habits to lay the foundation for long-term management.
Specific Measures: Category Measures Lifestyle Develop a gradual exercise plan: such as 150 minutes of moderate-intensity exercise per week (brisk walking, swimming), combined with moderate strength training, to promote metabolic health. Low glycemic index（GI）diet plan: consume more unsaturated fatty acids, along with a rich intake of vitamins, minerals, and dietary fiber, reduce refined sugar intake, help control weight and insulin levels. Menstrual Management Establish a menstrual cycle monitoring file, record cycles and symptoms. Use progesterone or oral contraceptives if necessary (to regulate menstruation and androgen levels). Skin Management Local treatment: Use topical ointments, such as benzoyl peroxide, salicylic acid, tretinoin, etc. Oral medication: Moderate to severe acne may consider oral contraceptives or spironolactone to reduce androgens. Hirsutism management: Short-term use of depilatory creams or shaving, long-term consideration of laser hair removal. Skin care guidance: Use gentle cleansers and moisturizers, avoid irritating products. Psychological Support Provide psychological counseling to alleviate emotional distress about appearance and enhance self-confidence. Contraceptive Guidance Recommend progesterone-based contraception, such as Mirena (levonorgestrel intrauterine system), for contraception and endometrial protection.
Intervention
Reproductive Age (20-45 years old)
Warning and Focus Situations: Reproductive age is a high-incidence stage for PCOS symptoms and health risks, and attention is needed —
Infertility: Weight gain: Insulin Resistance: Other:
Management Focus: ● Improve fertility and help achieve pregnancy goals; ● Manage metabolic issues to prevent diabetes and cardiovascular diseases; ●Pay attention to mental health and relieve the pressure caused by infertility and appearance issues.
Specific Measures: Category Measures Lifestyle Personalized diet and exercise guidance: consume more unsaturated fatty acids, along with a rich intake of vitamins, minerals, and dietary fiber, reduce refined sugar intake, combined with 150 minutes of aerobic exercise and strength training per week, aiming for a weight loss of 5-10% to improve ovulation and metabolism. Fertility Management Ovulation monitoring: ultrasound monitoring of ovulation, use of ovulation induction drugs if necessary (letrozole or clomiphene). If drug treatment is ineffective, assisted reproduction may be necessary. Metabolic Management Regular blood lipid profile analysis and cardiovascular risk assessment, including blood pressure, total cholesterol, LDL, and HDL level monitoring. If necessary, use antihypertensive drugs or statins to control cardiovascular risk factors. Bone Health Management Annual bone density monitoring, assessment of osteoporosis risk, and if necessary, supplement with calcium or use bisphosphonate drugs. Endometrial Health Monitor abnormal uterine bleeding, ultrasound assessment of endometrial conditions, and the risk of endometrial lesions. Cognitive and Mental Health Conduct cognitive function screening, pay attention to changes in memory or attention, especially during menopausal hormone fluctuations. Comprehensive Health Annual physical examination: blood sugar, thyroid function, and liver function tests to ensure comprehensive health management.
In summary, the focus varies at different age stages, so it is necessary to:
Personalized Plan:
Multidisciplinary Collaboration:
Through scientific diagnosis, personalized management, and lifelong attention, women with PCOS can fully control their symptoms, reduce risks, and live a healthy and fulfilling life.
Whether it is adolescent girls, women planning for pregnancy, or women entering menopause, Distinct Health Women’s Health Center is committed to accompanying every woman, through lifelong management, to develop personalized lifelong health plans, and help them live a healthy and confident life. If you suspect you have PCOS or want to know more about health management, please consult a professional doctor. Let’s work together for health!
References
Due to irregular or anovulatory menstruation leading to difficulty in getting pregnant, PCOS accounts for more than 80% of anovulatory infertility.
About 50% of women with PCOS are overweight, and obesity exacerbates insulin resistance and hormonal imbalances.
May lead to blood sugar abnormalities, increasing the risk of type 2 diabetes.
Acne and hirsutism persist, and psychological pressure due to infertility or appearance issues intensifies.
Intervention
Monitoring
According to age, symptoms, and health needs, develop a tailored management plan.
Obstetrics and gynecology, internal medicine, nutrition, psychological counselors, and exercise therapists participate together to provide comprehensive support.
