PCOD and PCOS Explained: Symptoms, Insulin Resistance, Tests and When to See a Gynaecologist

Your periods come every forty days, then every seventy, then skip a month altogether. The weighing scale keeps creeping up even though you eat less than your colleagues. There is new hair on your chin, pimples along the jawline that never quite clear, and a tiredness that makes the evening climb up the stairs feel like a trek. An ultrasound report finally says “polycystic ovaries”, someone at home says it is PCOD, a cousin calls it PCOS, and you are left wondering what you actually have and whether it is serious.

PCOD and PCOS are among the most common hormonal conditions in women of reproductive age in India. The good news is that they are very manageable once you understand what is driving your symptoms. In this guide, our doctors explain what the condition is, why insulin resistance sits at its heart, how weight, diet and exercise help, which tests are worth doing, why many women with PCOS also feel body aches and fatigue, and when you should see a gynaecologist.

PCOD vs PCOS: are they different?

In everyday Indian conversation, “PCOD” (polycystic ovarian disease) and “PCOS” (polycystic ovary syndrome) are used for the same thing. Some websites describe PCOD as a milder ovary problem and PCOS as a more serious whole-body disorder, but international medical guidelines use one name: polycystic ovary syndrome. It is called a syndrome because it is a group of features that show up differently in different women.

The word “cysts” also misleads people. The small round spots seen on ultrasound are not true cysts that need removal. They are immature follicles, tiny egg sacs that started to grow and then stopped because ovulation did not happen properly. Many women with PCOS have normal-looking ovaries, and many women with polycystic-looking ovaries do not have PCOS. That is why a scan alone never makes the diagnosis.

Common symptoms of PCOD and PCOS

Symptoms often begin in the late teens or twenties, though some women notice them only when they try to conceive or after gaining weight. You may have some or many of these:

• Irregular periods. Cycles longer than about 35 days, fewer than eight or nine periods a year, or periods that stop for months. Some women have very heavy bleeding when a period finally comes.
• Extra hair growth. Coarse hair on the chin, upper lip, chest, lower abdomen or back, called hirsutism.
• Acne and oily skin that persist beyond the teenage years, often along the jaw.
• Hair thinning on the crown or a widening parting.
• Weight gain around the waist and difficulty losing it.
• Dark, velvety skin patches on the back of the neck, armpits or groin (acanthosis nigricans), a visible sign of insulin resistance.
• Difficulty getting pregnant, because ovulation is irregular.
• Fatigue, low mood, anxiety and poor sleep, which are common and deserve attention in their own right.

Insulin resistance: the engine behind many PCOS symptoms

Insulin is the hormone that moves sugar from your blood into your muscles and liver. In insulin resistance, the body responds sluggishly, so the pancreas makes more and more insulin to keep blood sugar normal. For years your fasting sugar may look fine while insulin levels quietly stay high.

In PCOS, that extra insulin acts on the ovaries and encourages them to make more androgens such as testosterone. It also lowers a protein called SHBG that normally keeps these hormones in check. The result is a cycle: more androgens disturb ovulation and worsen acne and hair growth, while insulin resistance encourages fat storage around the waist, which in turn worsens insulin resistance.

Insulin resistance is seen in many women with PCOS who are overweight, and also in a good number who are slim, sometimes called “lean PCOS”. Over time it raises the risk of prediabetes, type 2 diabetes, diabetes during pregnancy, fatty liver and high cholesterol. Women with PCOS who already have diabetes and develop back or joint pain should know that repeated steroid injections can push sugar levels up sharply, as explained in why steroid-free care matters for people with diabetes and our guide to steroid side effects.

Tests for PCOD and PCOS: what your doctor may check

The diagnosis rests on your history and examination, supported by blood tests and sometimes an ultrasound. Equally important, tests rule out other conditions that look similar, such as thyroid problems or a raised prolactin level. In teenage girls within a few years of their first period, doctors usually avoid relying on ultrasound, because ovaries at that age often look “polycystic” anyway.

Your gynaecologist or endocrinologist will decide which of these you need. Some may also check AMH (anti-Müllerian hormone), which is often high in PCOS, though it is not used on its own to make the diagnosis.

Weight, diet and exercise: the first line of treatment

Lifestyle change is recommended for every woman with PCOS, whatever her weight. It is not about crash diets. In women who are overweight, losing around five to ten percent of body weight often brings back more regular cycles, eases insulin resistance and improves energy. For a 75 kg woman, that is roughly four to seven kilos over several months.

What to eat

• Cut down on refined carbohydrates and sugar. White rice in large heaps, maida, bakery snacks, sweets and sugary tea and coffee spike insulin. Swap some rice for millets such as ragi, jowar or foxtail millet, and keep portions sensible.
• Add protein to every meal. Dal, sprouts, curd, paneer, eggs, fish or chicken keep you full and steady blood sugar.
• Fill half the plate with vegetables and include fibre from whole grains, pulses and fruit rather than fruit juice.
• Watch the evening snacks. Fried namkeen, biscuits and chai between office and dinner add up quickly.

The same anti-inflammatory eating pattern that helps PCOS also helps aching joints, as we describe in the role of diet in managing arthritis pain.

How to move

Muscle is the biggest user of blood sugar in the body, so building it directly improves insulin sensitivity. Aim for brisk walking or cycling on most days, and two or three sessions a week of strength work such as squats, lunges, resistance bands or light weights. A ten-minute walk after lunch and dinner is a simple habit that blunts sugar spikes. If your knees or lower back protest, start gently with knee-friendly exercises at home and the daily habits for a healthy spine.

Medical treatment options for PCOS

Medicines are chosen according to what matters most to you at this stage of life: regular periods, skin and hair, blood sugar, or pregnancy. Your gynaecologist or endocrinologist may suggest:

• Combined hormonal pills to regulate periods, protect the lining of the womb and reduce acne and hair growth.
• Metformin, a diabetes medicine that improves insulin sensitivity and may help cycles and weight, especially alongside lifestyle change.
• Anti-androgen medicines for troublesome hair growth or acne, usually with reliable contraception because they are not safe in pregnancy.
• Ovulation-inducing medicines such as letrozole for women trying to conceive, with fertility care if needed.
• Progesterone courses to bring on a period when cycles are very far apart, which protects the womb lining.

Please do not stop or change any hormone tablets, metformin or other diabetes medicines on your own, even if you feel better or read something online. Discuss any concern with the doctor who prescribed them. Supplements such as inositol are popular, but the evidence is still limited, so check with your doctor before relying on them.

Why PCOS can cause body aches and fatigue

Many women with PCOS tell us they feel tired all the time, with aching legs, heavy shoulders and a stiff lower back. These complaints are real, and they usually have identifiable causes:

• Low vitamin D and B12. Both are very common in Indian women who spend their day indoors, and both can cause bone ache, muscle cramps, tingling and fatigue. Read more in vitamin D and B12 deficiency and body pain. Metformin, used long term, can also lower B12, so it is worth checking.
• Insulin resistance and sugar swings. The mid-afternoon slump, cravings and brain fog often settle when meals are balanced.
• Poor sleep. Women with PCOS, especially with extra weight, have a higher chance of snoring and sleep apnoea. Unrefreshing sleep makes every ache feel worse, as explained in sleep and chronic pain.
• Extra load on joints. Weight around the middle strains the knees, heels and lower back. See how extra kilos load your knees and back, and if the first steps of the morning hurt, read about plantar fasciitis heel pain.
• Iron deficiency from heavy, irregular bleeding, and an underactive thyroid, both of which cause tiredness and muscle aches.
• Stress and low mood, which are common in PCOS and can amplify pain. When aches are widespread with poor sleep and exhaustion, doctors also consider fibromyalgia.

Sometimes the pain has a separate cause that simply needs its own care, such as hip pain in women, morning joint stiffness from an inflammatory arthritis, or one of the common causes of lower back pain. Reaching for painkillers every day only hides these problems, which is why we explain why painkillers are not the answer for long-standing pain.

When to see a gynaecologist

Book an appointment with a gynaecologist if any of these apply to you:

• Your periods are consistently irregular, or you have gone three months without one and are not pregnant.
• Bleeding is very heavy, lasts much longer than usual, or happens between periods.
• You have been trying to conceive for a year (or six months if you are over 35) without success.
• Hair growth, acne or hair loss is worsening or affecting your confidence.
• You notice dark skin patches, rising weight, or a family history of diabetes alongside irregular cycles.

Long gaps between periods matter because the lining of the womb keeps building up without being shed, which over many years raises the risk of abnormal thickening. An endocrinologist or diabetologist is helpful if your sugar tests are borderline, and a dermatologist can help with stubborn acne or hair fall.

How Dr Heal can help

PCOS is best managed by your gynaecologist, with an endocrinologist where needed. Alongside that care, many women come to us for the aches, fatigue and weight problems that often travel with it. Here is how we can support you:

1. Listen first, then test. Our doctors take a full history and examine you. Blood sugar, HbA1c, thyroid, vitamin D, B12, iron and cholesterol can be checked in our in-house laboratory, with radiology at the same facilities, so you are not running between centres.
2. Nutrition and lifestyle you can actually follow. Through functional medicine and clinical nutrition, we help you plan Indian meals that steady blood sugar, correct deficiencies, improve sleep and support gradual weight loss.
3. Treat the pain without adding to the problem. For knee, back, heel or shoulder pain that needs more than exercise, we use a steroid-free regenerative preparation made by Dr Heal Pharma, which avoids the sugar spikes and weight effects that steroids can bring. Learn more about regenerative medicine and our joint pain treatment.
4. Guided rehabilitation. A strength and mobility programme that respects sore joints, because stronger muscles both ease pain and improve insulin sensitivity.
5. Coordinate with the right specialist. When your symptoms need a gynaecologist, endocrinologist or dermatologist, we guide you to the right one and keep the whole picture in view.

You can meet our doctors, browse all our treatments, or read about our back pain treatment and knee pain treatment.

What you can do at home, starting this week

• Track your cycle on a calendar or app, and take it to your doctor.
• Walk after meals, even ten minutes around the apartment complex or office corridor.
• Sleep seven to eight hours at regular times and keep the phone away from the bed.
• Get morning sunlight on your arms for a short while, and test vitamin D before taking high-dose supplements.
• Measure your waist once a month rather than weighing yourself daily; it tracks insulin resistance better.
• Be kind to yourself. PCOS is not caused by anything you did wrong, and progress is usually slow and steady.

Frequently asked questions

Can PCOD or PCOS be cured completely?

There is no permanent cure, but symptoms can be controlled very well. Many women have regular cycles, clear skin and healthy pregnancies with lifestyle change and the right medicines when needed.

Can a thin woman have PCOS?

Yes. Lean PCOS is well recognised, and insulin resistance can be present even at a normal weight. Diet quality, strength exercise and sleep still help.

Can I get pregnant if I have PCOS?

Most women with PCOS can conceive, sometimes with help to ovulate. Getting blood sugar, weight and vitamin levels in order before pregnancy also lowers the risk of diabetes during pregnancy.

Does PCOS cause joint and back pain?

PCOS does not directly damage joints, but low vitamin D, insulin resistance, poor sleep and extra weight commonly cause body aches, knee pain and lower back pain in women with PCOS. These causes can be tested for and treated.

Should I stop my PCOS tablets if my periods become regular?

No, not on your own. Hormone tablets and metformin should only be stopped or changed by the doctor who prescribed them, who can plan the next step safely.

Where can I get PCOS-related tests and help for body aches in Bengaluru?

Dr Heal Pain Cure Hospital offers in-house blood tests, nutrition guidance and steroid-free care for related joint and back pain at its HSR Layout and Banashankari branches. Both are open 24 hours, and patients visit from across Karnataka.

This article is for general information and is not a substitute for a medical consultation. Please see a doctor for advice about your own symptoms.