PCOS is the most common hormonal disorder in women of reproductive age — affecting approximately 1 in 5 Pakistani women. Here is everything you need to know.
Polycystic Ovary Syndrome (PCOS) is a hormonal disorder affecting the ovaries. Despite the name, PCOS doesn't necessarily mean cysts — the name refers to the appearance of multiple follicles on the ovaries in ultrasound. The core issue is hormonal imbalance: elevated androgens (male hormones) and insulin resistance.
Globally: affects 8–13% of women of reproductive age. In South Asia including Pakistan: studies suggest prevalence of 15–20%, among the highest in the world. The reason: South Asian genetics combined with rising rates of insulin resistance (driven by diet high in refined carbohydrates, sedentary lifestyles, and vitamin D deficiency).
The Rotterdam criteria require 2 of 3: (1) irregular periods, (2) elevated androgens (blood test or clinical signs), (3) polycystic ovarian morphology on ultrasound. See a gynaecologist or endocrinologist. A full panel includes: testosterone, LH, FSH, prolactin, thyroid (to exclude thyroid issues), fasting glucose, and insulin.
PCOS is often hidden in Pakistani families due to the stigma around fertility issues and the association with irregular periods. Many women are not diagnosed until they have difficulty conceiving after marriage. Earlier diagnosis and treatment lead to significantly better outcomes. Discuss your symptoms with your doctor before marriage if possible — and reassure any future husband that PCOS is manageable and fertility is often treatable.
Low libido is common in PCOS due to elevated androgens (paradoxically, excess androgens can suppress rather than increase female libido), elevated oestrogen (relative to progesterone), fatigue from insulin resistance, and the psychological impact of body image concerns. Treatment of the underlying PCOS typically improves libido over time.