Polycystic ovary syndrome (PCOS) in India: symptoms, tests, treatment and daily care

Written by Riya Puri, Registered Dietitian, and Dr Rajan Kumar, MBBS Published on 24 September 2026

Short answer

Polycystic ovary syndrome (PCOS), renamed polyendocrine metabolic ovarian syndrome (PMOS) in 2026, is a common, long-term hormonal condition. It can cause irregular periods, excess facial or body hair, acne and a higher risk of type 2 diabetes. If your periods are irregular, see a doctor: diagnosis needs a combination of features, not one scan or blood test. A national Indian Council of Medical Research (ICMR) study found PCOS in 7.2–19.6% of Indian women aged 18–40, depending on the criteria used.

What PCOS is

PCOS is a long-term hormonal and metabolic condition. Ovulation, the monthly release of an egg, becomes irregular or stops, and androgens (hormones such as testosterone, which all women make in small amounts) are often higher than usual. Because diagnosis needs two of three features, one woman may have regular periods but marked facial hair, while another has long gaps between periods and none. The international guideline suggests the diagnosis can be considered lifelong, although symptoms change with age.

A new name: PMOS

In May 2026, a global consensus involving 56 organisations renamed the condition polyendocrine metabolic ovarian syndrome (PMOS), because the old name wrongly suggested that ovarian cysts were the problem. The new name is being phased in over three years. Most Indian reports and clinics still say PCOS, so this page does too.

Polycystic ovary disease (PCOD), PCOS and “cysts”

In India, PCOD is often described as a milder, “ovary-only” version of PCOS. The international guideline, FOGSI’s 2024 recommendations and World Health Organization (WHO) do not use PCOD as a separate diagnosis; they describe one condition, PCOS. If your report says PCOD, ask which features were actually found.

The “cysts” on a scan are usually many small follicles, fluid-filled sacs that each hold an immature egg. Professor Helena Teede, who led the renaming, said there is “no increase in abnormal cysts on the ovary”. Polycystic ovaries on a scan are not a diagnosis on their own, and WHO notes that some women with PCOS do not have them at all.

PCOS occurs at every body size, is not caused by one food and is not a failure of willpower. It is a leading cause of infertility, but WHO notes that women with PCOS can be supported to become pregnant.

Symptoms and signs

Symptoms can be mild or severe. The most common are:

irregular periods, long gaps between periods, or no periods;
excess coarse hair on the face, chin, chest or abdomen (hirsutism);
acne or oily skin, and thinning hair on the scalp;
weight gain or difficulty losing weight;
difficulty getting pregnant.

What counts as irregular? From three years after your first period, the international guideline and FOGSI count cycles shorter than 21 days or longer than 35 days, fewer than eight periods a year, or any single cycle longer than 90 days. In the first year after periods start, irregular cycles are normal.

Less obvious signs

Dark, velvety skin in the neck folds or armpits (acanthosis nigricans), low mood or anxiety, and loud snoring with unrefreshing sleep can all be part of PCOS.

Do not accept facial hair as “normal for Indian women”. The guideline says the severity of hirsutism may vary by ethnicity but its prevalence appears similar across ethnicities. Tell your doctor if you thread, wax or use laser, because hair removal can hide the pattern.

Conditions that can look similar

Doctors rule out other causes first: pregnancy, thyroid disease, high prolactin (a pituitary hormone), non-classic congenital adrenal hyperplasia (an inherited adrenal condition), perimenopause, stress, breastfeeding, some contraceptives, and periods stopping because of low body fat or intense exercise. Rarely, an androgen-secreting tumour or Cushing’s syndrome is responsible.

Causes and risk factors

The exact cause is unknown. National Health Service (NHS) says it may be to do with hormones such as insulin and testosterone not working properly. Insulin resistance, where the body needs more insulin to keep blood glucose normal, is a key feature, and FOGSI notes it also occurs in some lean women. Risk is higher if a close relative has PCOS or type 2 diabetes, and NHS notes PCOS is more likely in people from an Asian background.

PCOS in India

The ICMR–PCOS Task Force study enrolled 8,993 women aged 18–40 across five zones of India between 2018 and 2022. Prevalence was 7.2% by the strict National Institutes of Health (NIH) criteria, 13.6% by Androgen Excess Society criteria and 19.6% by the Rotterdam criteria that today’s international guideline builds on: the definition changes the answer almost threefold. WHO estimates that up to 70% of women with PCOS worldwide are undiagnosed.

Women with PCOS have a higher risk of type 2 diabetes regardless of age and body mass index (BMI), and higher risks of high cholesterol, raised blood pressure, fatty liver, sleep apnoea, depression, anxiety, pregnancy complications and womb-lining cancer, although that cancer risk remains low overall. FOGSI adds that South Asian women with PCOS have more insulin resistance than women from other ethnic groups at the same BMI.

Weight and waist: Indian and international cut-offs

WHO’s international cut-offs call a BMI of 25 overweight and 30 obese. Indian bodies use lower thresholds because Indians tend to carry more body fat at the same BMI. They agree risk rises from 23 but differ on obesity: the 2009 Asian Indian consensus, which Disha’s BMI calculator follows, uses 23–24.9 for overweight and 25 or above for obesity, while Indian Council of Medical Research–National Institute of Nutrition (ICMR-NIN)’s 2024 guidelines use 23–27.5 and above 27.5. Both flag a waist above 80 cm in women.

Under either system, a BMI of 23 or more or a waist above 80 cm is a reason to ask about metabolic checks. BMI is a screening number, not a verdict, and the guideline asks professionals to avoid weight stigma.

Diagnosis and tests

PCOS is diagnosed by a doctor, not by one test. The 2023 international guideline, and FOGSI’s recommendations for adult Indian women, use criteria built on the 2003 Rotterdam definition: at least two of irregular or absent ovulation; clinical or blood-test signs of androgen excess; and polycystic ovaries on ultrasound or, in adults, a raised anti-Müllerian hormone (AMH) level. Other causes must be excluded first. If you have both irregular cycles and signs of androgen excess, neither a scan nor AMH is needed.

Test	What it measures	When it is useful	Important limitation
Period history and examination	Cycle pattern; excess hair (often scored on the modified Ferriman–Gallwey scale), acne, scalp thinning, weight, waist and blood pressure	Always the first step; with blood tests, often enough to diagnose	Cycles are normally irregular soon after periods begin and near menopause; hair removal can hide hirsutism
Total and free testosterone	Androgen levels in the blood	When excess hair is not obvious or the picture is unclear	Unreliable on hormonal contraception and dependent on laboratory method; never stop a medicine to be tested without medical advice
Pelvic ultrasound	Follicle count (20 or more in an ovary) or ovarian volume (10 mL or more)	Adults with only one of the other two features	Not recommended in adolescents (FOGSI: within eight years of the first period); polycystic ovaries alone do not mean PCOS; a transvaginal scan is more accurate but only if acceptable to you
Anti-Müllerian hormone (AMH)	A hormone made by small ovarian follicles	Adults, as an alternative to ultrasound, not in addition to it	Not a stand-alone PCOS test; not used in adolescents; cut-offs differ between laboratory kits
Thyroid-stimulating hormone (TSH), prolactin, 17-hydroxyprogesterone (17-OH progesterone), follicle-stimulating hormone (FSH) and a pregnancy test	Thyroid, pituitary, adrenal and ovarian causes of similar symptoms	At the first assessment	Normal results do not confirm PCOS; they rule out look-alikes
75-g oral glucose tolerance test (OGTT)	Blood glucose fasting and 2 hours after a glucose drink	At diagnosis in everyone with PCOS, whatever their weight, and before pregnancy	Takes about two hours; fasting glucose or glycated haemoglobin (HbA1c) are alternatives with significantly reduced accuracy

Often overused. Fasting insulin and “insulin resistance” panels are common in Indian labs, but the guideline says clinically available insulin assays “are of limited clinical relevance and should not be used in routine care”. Doing both a scan and AMH is discouraged because it can lead to over-diagnosis. A clinician should interpret every result alongside your history.

Where Indian and international advice differ

Glucose re-testing. The international guideline advises reassessing glucose every 1–3 years, depending on other diabetes risks. FOGSI recommends a 75-g OGTT at diagnosis and every year for all adolescents and adults with PCOS. Many Indian gynaecologists follow the yearly schedule; agree the interval with your doctor.
Ultrasound and age. The international guideline does not recommend ultrasound for diagnosis in adolescents; FOGSI sets the limit at eight years after the first period, and NHS offers a scan only to those over 18.
AMH. Both accept AMH instead of ultrasound in adults. FOGSI names a cut-off for one specific laboratory kit, while the international guideline asks for kit-specific cut-offs, so do not judge one lab’s AMH result against another lab’s range.

After diagnosis, follow-up usually includes a lipid profile, periodic glucose tests and yearly blood-pressure and mood checks.

Treatment and management overview

Treatment is built around what matters most to you: periods, skin and hair, metabolic health, mood or pregnancy. The guideline asks for shared decision-making.

Medical treatment

Depending on your goals, a doctor may discuss hormonal treatments that regulate periods and protect the womb lining, anti-androgen medicines for skin and hair, insulin-sensitising or weight-management medicines, and ovulation-inducing treatment if you want to conceive. Laser or electrolysis can remove unwanted hair, and psychological therapy should be offered for depression, anxiety or eating disorders.

Lifestyle management

The guideline recommends healthy eating, physical activity and behavioural support for all women with PCOS, though the certainty of that evidence is low. WHO says healthy habits help “even if they do not lead to weight loss”. If you are above a healthy weight, FOGSI notes that losing 5–10% of body weight is known to yield significant clinical improvements. Lifestyle cannot cure PCOS, guarantee regular periods or pregnancy, remove hair that has already grown, or replace treatment your doctor recommends.

What Disha can and cannot do

Disha, an AI health coach, can help with meals, movement, sleep and daily habits. It cannot diagnose PCOS, interpret tests, prescribe or change medicine, advise on fertility treatment or provide emergency care.

Medical disclaimer. This page is general education for adults (18+), not a diagnosis or an individual treatment plan. Do not start, stop or change any medicine because of it. If you are pregnant, trying to conceive, breastfeeding, or have a current or past eating disorder, get individual advice before changing how you eat or exercise. For an emergency, contact local emergency services; Disha does not provide emergency care.

Indian food and nutrition

There is no single best PCOS diet. The international guideline found no evidence that any one type of diet composition beats another, and advises sustainable healthy eating that follows population guidelines. For Indians, that means ICMR-NIN’s Dietary Guidelines for Indians 2024.

Giving up roti is not PCOS treatment. No single diet type has been shown to beat another, so keep the roti and add a katori of dal.

ICMR-NIN’s “My Plate for the Day” makes vegetables and fruits about half of the day’s food, limits cereals and millets to about 45% of energy, and asks that at least half of cereals be whole grains. At lunch or dinner, try half a plate of sabzi or salad, a quarter protein (dal, chana, rajma, soy, paneer, dahi, eggs, fish or chicken) and a quarter roti, rice or millet. This is a starting picture, not a prescription.

Instead of	Try	Why
Skipping breakfast, then biscuits at 11	Besan chilla with vegetables, or two idlis with sambar and dahi	Puts protein and fibre into the first meal
“PCOS-friendly” protein bars or powders	Roasted chana, peanuts or a katori of dahi	ICMR-NIN says protein powders are unnecessary for normal healthy life
Sweetened cold coffee or packaged “health” drinks	Plain chaas or unsweetened nimbu pani	Cuts added sugar without cutting out drinks you enjoy
A crash diet before a family function	Your usual meals with a smaller cereal portion and more sabzi	Crash dieting raises the risk of disordered eating

Vegetarian diets can meet protein needs through dals, beans, soy, dairy, nuts and seeds. Avoid long fasts or cutting out food groups without supervision: the guideline says disordered eating should be considered in PCOS regardless of weight. Pregnancy and breastfeeding need their own plan.

The guideline says inositol could be considered based on personal preference, but it has limited clinical benefit and no type or dose can currently be recommended. That is weak evidence, so tell your doctor about any supplement. Our PCOS diet guide for Indian kitchens covers the plate, example day plans and common diet myths in detail.

Movement, sleep and stress

The international guideline advises adults to do 150–300 minutes of moderate or 75–150 minutes of vigorous activity a week, plus muscle strengthening on two non-consecutive days. Some activity is better than none. No type or intensity has been shown to be better for PCOS, so pick what you will keep doing; if you are new to exercise, starting at moderate effort is easier to sustain. A brisk walk after dinner, the stairs, cycling, dancing, yoga, chair squats or resistance bands all count.

Very intense training with too little food can itself stop periods; tell your doctor if that happens. If you are pregnant or have a heart or joint condition, ask before starting something new.

Sleep apnoea is significantly more common in PCOS, independent of BMI, so mention loud snoring or daytime sleepiness. Depression and anxiety are common too, and the guideline recommends screening all adults with PCOS for both. Distress about facial hair, acne or weight is a real health concern, not vanity; tell your doctor if it affects daily life.

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Myths and unsupported claims

Claim	What the evidence says	What to do instead
“PCOS means cysts that need to be removed.”	The “cysts” are usually normal small follicles. The condition was renamed partly because there is no increase in abnormal ovarian cysts.	Ask which diagnostic features were found; do not seek treatment aimed at “removing cysts”.
“You must quit roti, rice or dairy, or go keto or gluten-free.”	No diet composition has been shown to beat another in PCOS; the certainty of evidence is low.	Keep familiar foods; adjust portions and add protein and vegetables.
“Seed cycling, spearmint tea or a hormone-balancing supplement will fix PCOS.”	None of these is recommended in the international guideline. Inositol has limited clinical benefit and no recommended dose.	Discuss any supplement with an expert before spending on it.
“Slim women cannot have PCOS.”	PCOS occurs at every body size, and diabetes risk is raised regardless of BMI.	Seek assessment for symptoms, not for your weight.

When to see a doctor

Emergency: get help now

Very heavy bleeding that soaks through a pad soon after you put it on, or heavy bleeding with feeling faint, dizzy or losing consciousness.
If you could be pregnant: severe or one-sided lower tummy pain, pain in the tip of your shoulder, fainting, or heavy bleeding. These can signal an ectopic pregnancy or miscarriage.
Thoughts of harming yourself. Contact emergency services, or Tele Mental Health Assistance and Networking Across States (Tele-MANAS), the Government of India’s mental-health helpline.

Prompt review: within days to a few weeks

Excess hair, acne or scalp balding that worsens quickly over a few months, or a deepening voice or other masculine changes. Rapid change needs checking for rarer hormone-producing causes.
A missed period when you could be pregnant: take a pregnancy test and see a doctor if it is positive or you are unsure.
No period for three months or more. Long-standing untreated absence of periods is a risk factor for thickening of the womb lining.

Routine review

Book an appointment for irregular periods, unwanted hair, persistent acne, scalp thinning, dark skin patches or unexplained weight change. If you are planning pregnancy, see your doctor first; the guideline recommends checking glucose and blood pressure beforehand.

When specialist input may help

A gynaecologist usually leads PCOS care. An endocrinologist can help with unclear hormone results or diabetes; a dermatologist with severe acne, hair loss or hirsutism; a fertility specialist when pregnancy does not happen; a sleep specialist for suspected sleep apnoea; and a mental-health professional with depression, anxiety or disordered eating.

How Disha can help

Disha is an AI health coach that chats and calls in Hindi, English and Hinglish; it does not replace your doctor. Its onboarding call of about 15–20 minutes is conducted by Disha, the AI; no human doctor or dietitian is on the call. Disha helps you plan meals around familiar Indian food, build movement and sleep routines, and stay consistent with goals agreed with your doctor. It does not diagnose, interpret tests, prescribe or provide emergency care. The app is free to download; coaching is paid, with prices shown only in the app.

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Frequently asked questions

Can I keep eating normal Indian food with PCOS?

Yes. The international PCOS guideline found no evidence that one type of diet beats another, so roti, rice, dal, sabzi, dahi and idli can stay. What helps is balance: more vegetables and protein, measured portions of cereals, whole grains more often, and fewer sugary drinks and fried snacks. Needs change with pregnancy, medicines and other conditions, so ask your doctor or a dietitian for an individual plan.

Does lifestyle still matter if I already take PCOS medicine?

Yes. The guideline recommends healthy eating and physical activity for all women with PCOS, alongside any treatment. Lifestyle and medicine work on different parts of the condition, and one does not make the other unnecessary. Never stop, reduce or change a prescribed medicine because your habits or weight have changed; discuss it first with the doctor who prescribed it.

How long does it take for PCOS symptoms to improve?

There is no guaranteed timeline. Different features change at different speeds, and results vary a great deal between women. Keep a note of your period dates, waist and how you feel over several months instead of judging from one week or one weigh-in. Your doctor can tell you what to monitor for the treatment you are on and when to review it.

Can PCOS be cured or reversed?

No. There is currently no cure for PCOS, and the international guideline suggests the diagnosis can be considered lifelong. Symptoms can improve a lot with treatment and lifestyle, and they change with age, but “reversal” claims promise more than the evidence supports. Regular checks of glucose, blood pressure and mood remain useful even when you feel well.

Which PCOS tests should I discuss with my doctor?

For diagnosis: your period history and examination, total and free testosterone if needed, and tests that rule out look-alikes, such as TSH, prolactin and 17-OH progesterone. Adults with only one other feature may have an ultrasound or AMH test. After diagnosis, ask about a 75-g oral glucose tolerance test, a lipid profile and blood pressure. Routine fasting-insulin tests are not recommended.

When should I get medical help urgently?

Seek emergency care for bleeding that soaks through a pad soon after you put it on, heavy bleeding with dizziness or fainting, or, if you could be pregnant, severe one-sided tummy pain, shoulder-tip pain or fainting. See a doctor within days for rapidly worsening facial hair, a deepening voice or other masculine changes. Book a review if you have gone three months or more without a period.

Can thyroid problems cause PCOS-like symptoms?

Yes. An underactive or overactive thyroid can cause irregular or missed periods, tiredness and weight change, all of which overlap with PCOS. That is why a TSH test is part of the first assessment for PCOS. Symptoms alone cannot tell the two apart, so a doctor interprets your blood tests and history before labelling either condition.

Is PCOD different from PCOS?

Not as a medical diagnosis. “PCOD” is widely used in India, often to mean a milder, ovary-only problem, but the international guideline, FOGSI’s 2024 recommendations and WHO describe one condition, PCOS, diagnosed with the same criteria. A scan showing polycystic ovaries is not a diagnosis on its own. If your report says PCOD, ask which features were found and what follow-up you need.

Will PCOS go away after marriage or pregnancy?

No. You may hear that marriage or having a baby will “settle” PCOS, but neither treats it. The international guideline suggests PCOS can be considered lifelong, although symptoms change with age. Women with PCOS also have a higher risk of pregnancy complications such as gestational diabetes, so plan pregnancy with your doctor rather than treating it as a cure.

Can I get pregnant if I have PCOS?

Yes, it is possible. PCOS is a leading cause of infertility because ovulation is irregular, but WHO notes that women with PCOS can be supported to become pregnant. If you are planning pregnancy, see your doctor first: the guideline recommends checking glucose and blood pressure beforehand because PCOS raises the risk of pregnancy complications. Fertility treatment decisions belong with a gynaecologist or fertility specialist.

Why is PCOS now called PMOS?

In May 2026, a global consensus involving 56 organisations renamed PCOS polyendocrine metabolic ovarian syndrome (PMOS). The old name implied that ovarian cysts were the problem; the new one reflects effects on weight, metabolic and mental health, skin and the reproductive system. The change is being phased in over three years, so you will see both names on reports and websites for now.

Sources

Teede HJ, Tay CT, Laven JJE, Dokras A, Moran LJ, Piltonen TT, Costello MF, Boivin J, Redman LM, Boyle JA, Norman RJ, Mousa A, Joham AE — Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome — Journal of Clinical Endocrinology and Metabolism, 2023 — diagnostic criteria and algorithm, irregular-cycle definitions, AMH and ultrasound rules, 10–13% prevalence, hirsutism and ethnicity, OGTT and insulin assays, glucose reassessment every 1–3 years, cardiometabolic, sleep-apnoea, endometrial and psychological risks, diet and exercise recommendations, weight stigma, eating disorders, inositol and preconception checks.
Teede HJ, et al. — Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process — The Lancet, 2026 — the new name, the 56 participating organisations, why the old name was inaccurate, and the managed transition period.
Endocrine Society — Polyendocrine Metabolic Ovarian Syndrome: New name to improve diagnosis and care of condition affecting 170 million women worldwide — 12 May 2026 — Professor Teede’s statement on ovarian cysts, the three-year transition and full implementation in the 2028 guideline update.
FOGSI–ICOG — Good Clinical Practice Recommendations: Update in Managing PCOS in Women — 2024 — Rotterdam criteria for adult Indian women, ultrasound and gynaecological age, AMH use and kit-specific cut-off, yearly OGTT, BMI above 23 as a risk factor, insulin resistance in lean PCOS and South Asian women, and 5–10% weight loss.
Ganie MA, Chowdhury S, et al. — Prevalence, Phenotypes, and Comorbidities of Polycystic Ovary Syndrome Among Indian Women — JAMA Network Open, 2024 — observational national ICMR–PCOS Task Force study: 8,993 women aged 18–40, five zones, 2018–2022; prevalence of 7.2%, 13.6% and 19.6% by NIH, AE-PCOS and Rotterdam criteria.
World Health Organization — Polycystic ovary syndrome fact sheet — current fact sheet, accessed 24 September 2026 — 10–13% prevalence, up to 70% undiagnosed, symptoms, family history, cysts not required for diagnosis, no cure, lifestyle benefits without weight loss, and pregnancy support.
NHS — Polyendocrine metabolic ovarian syndrome (PMOS) — current patient guidance — symptoms, possible hormonal cause, Asian background and family history, ultrasound only over 18, medicine categories, a balanced diet and regular exercise as self-help, and long-term risks including fatty liver.
NHS — Missed or late periods — current patient guidance — pregnancy, stress, contraception, breastfeeding and thyroid disease as other causes of missed periods, and seeing a doctor after three missed periods.
NHS — Ectopic pregnancy — current patient guidance — one-sided tummy pain, shoulder-tip pain, bleeding, dizziness and fainting as warning signs.
NHS — Vaginal bleeding in pregnancy — current patient guidance — heavy bleeding that soaks a pad soon after putting it on, and feeling faint or dizzy, as reasons for emergency care.
ICMR–National Institute of Nutrition — Dietary Guidelines for Indians — 2024 — My Plate for the Day, the 45% cereal limit, whole grains and millets, actual cereal and pulse intake, protein powders, Asian BMI cut-offs of 23 and 27.5, the 80 cm waist threshold for women, and sleep and screen time.
Misra A, Chowbey P, Makkar BM, Vikram NK, Wasir JS, Chadha D, Joshi SR, Sadikot S, Gupta R, Gulati S, Munjal YP, for Consensus Group — Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians — Journal of the Association of Physicians of India, 2009 — consensus BMI cut-offs of 23.0–24.9 for overweight and above 25 for obesity, and the 80 cm waist action level for women.

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