PCOS Treatment in Pune: Symptoms, Diagnosis and Your Options in 2025

What Is PCOS, Exactly?

PCOS is a hormonal condition defined by a combination of factors. The name is slightly misleading: you do not have to have cysts on your ovaries to have PCOS, and having multiple small follicles on an ultrasound does not automatically mean you have PCOS.

The Rotterdam Criteria — the internationally accepted diagnostic standard — require two of the following three features for a PCOS diagnosis:

• Irregular or absent periods (oligomenorrhoea or amenorrhoea), indicating that ovulation is not happening consistently
• Evidence of elevated androgens (male hormones) — either on a blood test (raised testosterone, DHEAS) or clinically (acne, excess facial or body hair, thinning scalp hair)
• Polycystic ovary morphology on ultrasound — defined as 20 or more follicles per ovary, or an ovarian volume above 10 ml

Crucially, other conditions that mimic PCOS — thyroid disorders, elevated prolactin, congenital adrenal hyperplasia — must be ruled out first. A diagnosis of PCOS made without this exclusion process is not a complete diagnosis.

Why Is PCOS So Prevalent in Indian Women?

The Indian diet, high in refined carbohydrates and low in fibre, combined with increasingly sedentary urban lifestyles, creates a hormonal environment that significantly promotes PCOS. The mechanism is well established: when insulin levels are chronically high — as they are in insulin-resistant states — the ovaries produce more androgens than normal. These excess androgens disrupt the delicate hormonal cycle that governs ovulation.

Add to this a genetic predisposition — PCOS runs strongly in families — and the result is that Indian women face a significantly higher risk than their European counterparts. A large Indian study published in the Journal of Human Reproductive Sciences found PCOS prevalence of around 22% in urban women, compared to 9 to 13% globally.

PCOS Is More Than a Fertility Problem

One of the most important things to understand about PCOS is that it is a lifelong metabolic condition, not simply a phase that ends when you finish having children. Women with PCOS face elevated long-term risks of:

• Type 2 diabetes — insulin resistance is a core feature of PCOS in most women, and this worsens with age and weight gain
• Cardiovascular disease — elevated androgens, high insulin, and abnormal cholesterol profiles increase heart and blood vessel risk
• Endometrial hyperplasia and endometrial cancer — when ovulation is absent for extended periods, the uterine lining builds up without the progesterone that a normal cycle would provide, increasing cancer risk
• Obstructive sleep apnoea — underdiagnosed in women with PCOS
• Depression and anxiety — two to three times more common in women with PCOS than in the general population

Treating PCOS only when you want to get pregnant, and ignoring it at other times, misses the point entirely. At Solo Clinic, we treat PCOS as the lifelong health condition it is.

PCOS and Fertility: What Actually Happens

The most common fertility problem in PCOS is anovulation — eggs are not released reliably, so conception cannot occur naturally in most months. The good news is that PCOS-related infertility is among the most treatable forms of female infertility. Women with PCOS who do ovulate — even irregularly — have normal egg quality in most cases.

The treatment ladder for PCOS-related infertility typically follows this sequence:

Step 1: Lifestyle Optimisation

For women who are overweight or have signs of insulin resistance, losing even 5 to 10% of body weight can restore ovulation spontaneously. This is not about aesthetics — it is about hormonal chemistry. Reducing processed carbohydrates, managing insulin through dietary change and (often) metformin, and increasing physical activity can resume ovulation in a meaningful proportion of women within 3 to 6 months.

Step 2: Ovulation Induction

When lifestyle changes alone are insufficient, oral medications — typically letrozole (first-line) or clomiphene citrate — are used to trigger ovulation. When combined with timed intercourse or intrauterine insemination (IUI), these treatments achieve pregnancy in a good proportion of PCOS patients without needing IVF.

Step 3: IVF with PCOS-Specific Protocols

When ovulation induction fails or when other factors (such as tubal disease or male factor) are present, IVF is used. Women with PCOS require careful stimulation — their ovaries tend to over-respond, creating a risk of ovarian hyperstimulation syndrome (OHSS). Modern IVF protocols for PCOS use lower-dose stimulation, careful monitoring, and a "freeze all" strategy (freezing embryos rather than transferring fresh) to minimise OHSS risk significantly.

Managing PCOS Beyond Fertility

Whether or not you want to conceive, PCOS management addresses:

• Cycle regulation — using low-dose combined oral contraceptives or progesterone to induce regular withdrawal bleeds, protecting the endometrium
• Metabolic management — metformin or lifestyle therapy to address insulin resistance, reducing long-term diabetes risk
• Skin and hair symptoms — anti-androgens and topical treatments for acne and hirsutism
• Mental health support — recognising and addressing the significant psychological burden PCOS carries
• Long-term screening — regular checks for blood pressure, glucose, cholesterol, and endometrial thickness

Frequently Asked Questions About PCOS

Q1. Can PCOS be cured?

PCOS cannot be cured in the way an infection can be treated and eliminated. It is a lifelong condition that can be very effectively managed. Many women find that their symptoms improve significantly with the right lifestyle changes and medical support, and that these improvements last as long as the healthy habits are maintained.

Q2. Can I get pregnant naturally with PCOS?

Yes — many women with PCOS conceive naturally, particularly if they ovulate even irregularly. Women with PCOS who are a healthy weight and have no other fertility factors often conceive without medical intervention. Those who do need help typically respond well to simple treatments like ovulation induction. IVF is required in a minority of PCOS cases.

Q3. Is PCOS caused by weight gain or does PCOS cause weight gain?

Both are true, and they form a vicious cycle. Insulin resistance — a core feature of PCOS — promotes weight gain by making it harder for the body to burn fat and easier to store it. Weight gain, in turn, worsens insulin resistance and amplifies the hormonal imbalance. Breaking this cycle — through targeted dietary changes and physical activity — is one of the most powerful PCOS treatments available.

Q4. Does PCOS go away after menopause?

The hormonal features of PCOS — irregular cycles, elevated androgens — do change after menopause, as ovarian function declines anyway. However, the metabolic features (insulin resistance, elevated cardiovascular risk) persist and require ongoing attention. PCOS does not simply disappear at menopause.

Q5. What tests are needed to diagnose PCOS?

A thorough PCOS evaluation includes: a detailed history (cycle regularity, symptoms, family history); a hormonal blood panel (LH, FSH, testosterone, DHEAS, prolactin, thyroid function, fasting insulin and glucose); an ultrasound of the ovaries and uterus; and sometimes an AMH level. It is a diagnosis of specific criteria, not just a label applied to any woman with an irregular cycle.

MEDICAL DISCLAIMER: Medically reviewed by Dr. Sunita Tandulwadkar. This article is for informational purposes only and does not constitute medical advice. PCOS management varies by individual; consult a qualified gynaecologist for personalised guidance.