It is not known why some women develop the syndrome although it is likely to be a genetic disorder. The word ‘polycystic' means many cysts and women with this condition have several cysts in their ovaries. Women with this condition have an imbalance of the female hormones that prevents their ovaries form releasing an egg every month and the many unreleased eggs in the ovaries result in the characteristic polycystic appearance of the ovaries.

Since both fertility and a normal menstrual cycle rely on a regular release of an egg each month from the ovary, these women have difficulty in conception and low, irregular or absent periods.

Many women with PCOS also tend to produce too much male hormone (which normally all women produce in small quantities) which results in male pattern hair growth, for example on the chin, chest inner thighs etc., and the formation of acne. 

These women tend to gain weight quite rapidly and the obesity makes the hormonal imbalance worse hence resulting in a ‘chicken and egg' situation.

Metformin and other insulin sensitising drugs - Metformin improves the effectiveness of insulin produced by the body. It is used to treat the insulin abnormalities associated with PCOS in selected patients. This medication can decrease the ovary's production of androgens and restore the body's normal hormone balance resulting in improvement of some signs and symptoms of PCOS.