PCOS AND ITS LONG TERM HEALTH IMPLICATION: FROM INFERTILITY TO METABOLIC SYNDROME

The most common endocrine condition affecting women of reproductive age worldwide is polycystic ovarian syndrome, or PCOS. From the original 1990 NIH criteria to the 2003 Rotterdam criteria, which call for two of three markers—oligo-anovulation, hyperandrogenism, and polycystic ovarian morphology (PCOM)—this complicated disorder is marked by diagnostic variability. Due to ultrasound's limits and inconsistency, serum anti-Müllerian Hormone (AMH) has recently become a possible objective measure for diagnosis. A "central nexus" of insulin resistance, obesity (particularly visceral adiposity), and hyperandrogenism underlies the pathogenesis of PCOS. These elements produce a vicious cycle: Insulin resistance: Causes compensatory hyperinsulinemia, which exacerbates androgen excess by increasing ovarian testosterone synthesis and lowering sex hormone-binding protein (SHBG). Hyperandrogenism: Inhibits normal follicular growth and encourages the formation of belly fat. Metabolic risks include cardiovascular disease, metabolic syndrome, and type 2 diabetes. Malignancies: PCOS-related infertility and endometrial cancer are strongly correlated, and new studies are looking into possible connections with ovarian and breast cancers. Intergenerational Impact: Obesity, metabolic abnormalities, and neurodevelopmental or psychiatric problems are more common in children of PCOS-affected women. Although early detection is essential to avoiding these dire outcomes, many cases go undetected, impeding timely management. According to recent studies on the gut microbiome, dysbiosis may contribute to pathogenesis, opening up novel treatment options with probiotics and prebiotics.