PCOS Treatment in Mumbai: Symptoms, Diagnosis and What Actually Helps

PCOS treatment in Mumbai is provided by Dr. Vaishali Joshi, FRCOG, Senior Consultant Obstetrician & Gynaecologist at Kokilaben Dhirubhai Ambani Hospital, Andheri West. Polycystic ovary syndrome — renamed polyendocrine metabolic ovarian syndrome (PMOS) in 2026 — is a hormonal and metabolic condition, not simply a problem with the ovaries, and it is among the most common endocrine conditions affecting women of reproductive age. It is manageable — but it is managed rather than cured, and the treatment depends entirely on which of its effects is troubling you now.

PCOS is widely misunderstood, and two misunderstandings cause most of the distress around it. The first is that the name suggests the problem is cysts on the ovaries. It is not. What ultrasound shows are multiple small follicles — eggs that have started to develop and stalled — which is a sign of the underlying hormonal picture, not a disease of the ovary in itself.

The second is the assumption that a diagnosis of PCOS means infertility. It does not. PCOS is one of the commonest causes of difficulty conceiving, and it is also one of the most treatable. A great many women with PCOS conceive naturally, and most of those who need help conceive with relatively simple treatment.

The name has changed: PCOS is now PMOS

In May 2026 the condition was formally renamed polyendocrine metabolic ovarian syndrome (PMOS), following a global consensus process published in The Lancet and endorsed by more than fifty academic, clinical and patient organisations. You will still see “PCOS” used widely, including on this page, and both names refer to the same condition.

The change was made because the old name was misleading in two ways. It pointed at the ovaries, when this is a whole-body condition involving hormones, metabolism, skin, fertility and mood. And it pointed at cysts, which many women with the condition do not have — what a scan shows is small follicles that have started to develop and stalled, not cysts in the usual sense.

What are the symptoms of PCOS?

PCOS presents differently in different women, which is part of why diagnosis is often delayed. The features cluster into three groups.

Difficulty conceiving is often what brings a woman to a gynaecologist, and PCOS is then found as the explanation. Equally, many women are diagnosed years earlier because of irregular periods or acne.

How is PCOS diagnosed?

Diagnosis follows the internationally used Rotterdam criteria: PCOS is diagnosed when two of the following three are present, and other conditions that can mimic it have been excluded.

• Irregular or absent ovulation, usually evident as irregular or absent periods.
• Clinical or biochemical evidence of excess androgens — either the visible signs, or raised androgen levels on a blood test.
• Polycystic ovarian appearance on ultrasound.

The exclusion step matters and is sometimes skipped. Thyroid disease, raised prolactin, late-onset congenital adrenal hyperplasia and, rarely, Cushing's syndrome or an androgen-secreting tumour can all produce a similar picture and are managed entirely differently. A proper PCOS assessment therefore includes thyroid function, prolactin, and androgen levels alongside the ultrasound.

Because PCOS is a metabolic condition as much as a gynaecological one, assessment should also cover fasting glucose or HbA1c, a lipid profile and blood pressure. This is not thoroughness for its own sake — it identifies the risks that matter over the following decades.

How is PCOS treated?

There is no cure, and any clinic promising one should be treated with scepticism. What there is, is effective management — and the right treatment depends on what you want addressed. A woman trying to conceive, a woman troubled by hirsutism, and a woman whose main concern is irregular bleeding need three different plans.

Step one: lifestyle and weight, where relevant

This is first not because it is easy but because it works, and because it improves every strand of the condition at once. Where a woman with PCOS is overweight, a modest reduction in weight — in the region of 5 to 10 per cent of body weight — can restore ovulation, regularise cycles, improve androgen levels and reduce metabolic risk. The effect is disproportionate to the amount of weight involved.

Two honest caveats. PCOS makes weight loss harder through insulin resistance, so this advice given without support is not advice at all. And PCOS occurs in lean women too, in whom weight is not the lever — the focus there is on cycle regulation, androgen symptoms and metabolic screening.

Step two: regulating cycles and controlling androgen symptoms

• Combined hormonal contraception regularises bleeding, reduces androgen symptoms over several months and protects the lining of the uterus. Suitability depends on your individual risk profile.
• Cyclical progestogen is used where oestrogen is unsuitable, principally to induce a regular withdrawal bleed and protect the endometrium.
• Anti-androgen medication may be added for hirsutism, always with reliable contraception alongside, as these drugs are unsafe in pregnancy.
• Cosmetic measures such as laser hair reduction work well alongside medical treatment and are often what actually resolves the day-to-day distress of hirsutism.

Endometrial protection is the part of this most often overlooked. Where periods are very infrequent, the lining of the uterus is exposed to oestrogen without the regular shedding that progesterone brings, and over years this raises the risk of endometrial hyperplasia. Any woman having fewer than about four periods a year should be discussing this with her gynaecologist.

Step three: treatment for fertility

Where the goal is pregnancy, the approach changes. Ovulation induction — commonly with letrozole, or with clomifene citrate — is the usual first-line medical treatment, monitored with ultrasound tracking so that response is confirmed and multiple pregnancy risk is managed. Metformin may be used in selected women, particularly where insulin resistance is prominent.

Where ovulation induction does not succeed, laparoscopic ovarian drilling is an option in carefully chosen women — a keyhole procedure that can restore ovulation without the multiple-pregnancy risk of injectable stimulation. Beyond that, gonadotrophin stimulation and IVF are the next steps. Most women with PCOS who wish to conceive do so, though it may take longer and require assistance.

Why PCOS matters beyond fertility

PCOS — PMOS — is a lifelong metabolic condition, and its significance does not end once a family is complete. The renaming was driven precisely by this: the metabolic half of the condition was being overlooked while attention stayed on the ovaries. Women with PCOS have a higher lifetime risk of type 2 diabetes, gestational diabetes, hypertension and dyslipidaemia, and a higher risk of endometrial hyperplasia where cycles are very infrequent. There is also a well-documented association with anxiety and depression, which deserves to be asked about rather than waited for.

None of this is inevitable, and that is the point of saying it. Periodic screening — glucose or HbA1c, lipids, blood pressure — and attention to cycle frequency turn a set of risks into a set of things being watched. Continuing gynaecological review after childbearing is complete is worthwhile for exactly this reason.

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