PCOS: the metabolic side
Also known as:
Polycystic ovary syndrome
Insulin resistance drives much of PCOS. Treating it improves cycles, fertility and long-term health.
Written and reviewed by Farhan Tahir, MD · Last reviewed
VIDEO LESSON
What it is
Polycystic ovary syndrome combines irregular ovulation, androgen excess and often polycystic-appearing ovaries. Insulin resistance is present in many people with PCOS, at any weight, and raises androgen production.
Metabolic risks
• Prediabetes and type 2 diabetes
• Fatty liver disease
• Abnormal lipids and high blood pressure
• Sleep apnea
Treatment
Lifestyle changes and weight loss improve ovulation and metabolic markers. Metformin helps insulin resistance; combined oral contraceptives regulate cycles; letrozole treats anovulatory infertility. The 2023 international guideline notes anti-obesity medicines may be considered in adults with PCOS. Our sister site Youthful Hormones covers the reproductive side in depth.
Clinical pearls
Screen for diabetes with an OGTT, plus lipids, blood pressure, sleep apnea and mood.
Key studies and references
Educational content only, written and reviewed by Farhan Tahir, MD. It does not replace individual medical advice. For sudden chest pain, trouble breathing or stroke symptoms, call 911.
AT A GLANCE
Category
Weight & obesity
Also known as
Polycystic ovary syndrome
Reviewed by
Farhan Tahir, MD
Questions about your own care?
Dr. Tahir’s team offers consults through Youthful Medicine.
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