PCOS (Polycystic Ovary Syndrome) in Pakistan: Symptoms, Diagnosis and Treatment

PCOS affects roughly a tenth of women of reproductive age worldwide, and Pakistani hospital-based studies find high rates of depression and anxiety among those diagnosed with it.

By DoctorOS Editorial Team · July 31, 2026

PCOS (polycystic ovary syndrome) is one of the most common hormonal conditions affecting women of reproductive age — a large meta-analysis found a global prevalence around 12.1% using the widely used Rotterdam diagnostic criteria, with estimates ranging roughly 5–20% depending on which diagnostic criteria a study uses ("Prevalence of polycystic ovary syndrome: a global and regional systematic review and meta-analysis," Human Reproduction Update). What's specifically well-documented in Pakistan is the mental health toll it carries: in a study of women already diagnosed with PCOS at a tertiary care hospital in Islamabad, 38.5% had depression and 42.3% had anxiety ("Prevalence of Anxiety and Depression Among Women With Polycystic Ovarian Syndrome," a cross-sectional study from Islamabad). A separate Karachi-based study of PCOS patients found lower but still notable rates — 17.6% depression, 20.3% anxiety (a Karachi tertiary care hospital study) — and a broader meta-analysis of women with PCOS across low- and middle-income countries put pooled depression/anxiety prevalence around 53% (Frontiers in Global Women's Health, systematic review and meta-analysis). These figures describe women who already have a PCOS diagnosis, not the general population — but together they make a clear point: PCOS isn't only a reproductive or metabolic condition, it's frequently a mental health one too, and screening for both matters.

At a glance

PCOS affects roughly 1 in 8–10 women of reproductive age worldwide, depending on diagnostic criteria used

Among women already diagnosed with PCOS in Pakistani hospital-based studies, depression and anxiety rates ranged from ~18–42% depending on the study

It's diagnosed by a combination of symptoms, blood tests and ultrasound — not by ultrasound findings alone

It's manageable, though not curable — treatment targets whichever symptoms matter most to the individual (periods, fertility, skin/hair, or metabolic risk)

What is PCOS?

PCOS is a hormonal condition involving a combination of irregular ovulation, elevated androgen (male hormone) levels, and often — though not always — multiple small follicles on the ovaries visible on ultrasound. It affects periods, fertility, skin and hair, and is also linked to a higher long-term risk of insulin resistance and type 2 diabetes, which is why it's treated as more than a "periods problem."

Symptoms

Irregular, infrequent, or absent periods
Excess facial or body hair (hirsutism)
Acne, particularly along the jawline
Thinning hair on the scalp
Weight gain or difficulty losing weight
Difficulty conceiving
Skin darkening in body folds (a sign of insulin resistance)

Not everyone with PCOS has every symptom — presentation varies significantly from person to person, which is part of why diagnosis relies on a combination of findings rather than any single symptom.

Causes and risk factors

The exact cause isn't fully understood, but insulin resistance and genetics both play a role, and PCOS often runs in families. It isn't caused by anything a person did — a distinction worth stating plainly, given how often it gets tangled up in diet-and-lifestyle blame.

How it's diagnosed

Most guidelines use the Rotterdam criteria, which require at least two of: irregular or absent ovulation, clinical or blood-test evidence of elevated androgens, and polycystic ovaries on ultrasound. Diagnosis also typically rules out other conditions with similar symptoms, such as thyroid disorders — see our guide to thyroid problems, which a doctor will often screen for at the same time. A gynecologist typically leads diagnosis and ongoing management.

Treatment

There's no single "PCOS treatment" — management is tailored to what matters most to the individual:

For irregular periods or endometrial protection: hormonal treatment, often a combined oral contraceptive
For fertility: ovulation-inducing medication, sometimes alongside lifestyle changes, under fertility-focused care
For excess hair or acne: anti-androgen medication or targeted dermatological treatment
For insulin resistance or weight-related symptoms: metformin and lifestyle changes (diet, exercise) are often first-line
For mental health: given how commonly depression and anxiety co-occur (see above), screening and, where needed, referral for mental health support is increasingly recognised as part of standard PCOS care, not an optional add-on

When to see a doctor

Periods that are irregular, infrequent, or absent for several months
New or worsening excess hair growth or acne alongside period changes
Difficulty conceiving after trying for a year (or six months if over 35)
Low mood, anxiety, or changes in eating or sleep alongside a PCOS diagnosis — this is worth raising directly, not assuming it's unrelated

Frequently asked questions

Does PCOS mean infertility?

No — PCOS is a common cause of ovulation-related fertility difficulty, but many women with PCOS conceive, sometimes with the help of ovulation-inducing treatment.

Can PCOS be cured with diet alone?

Diet and weight management can meaningfully improve symptoms, particularly for people with insulin resistance, but PCOS is a hormonal condition that isn't "cured" by diet alone — it's managed, often with a combination of approaches tailored to the individual.

Is it normal to feel anxious or low with a PCOS diagnosis?

It's common — the studies above found meaningful rates of depression and anxiety among women already diagnosed with PCOS — and worth mentioning to your doctor directly rather than assuming it's separate from the physical diagnosis.

Sources

For practitioners: if you're a gynecologist in Pakistan, list your practice free on DoctorOS and start taking bookings from patients who are searching for exactly this kind of care.

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