What is the Classic Triad of PCOS?

Why Irregular Periods, Unwanted Body Hair, and Extra Weight Are Common with PCOS

Severe morning stomach pain. Debica, Poland
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The classic triad of PCOS (polycystic ovarian syndrome) refers to a cluster of symptoms that are extremely common in women with the syndrome. These three symptoms are hirsutism, anovulation, and obesity. This basically means that researchers and physicians have observed these three symptoms as being the most frequently seen in women with polycystic ovarian syndrome, or PCOS.

The Classic Triad of PCOS

It does not mean that just because you only have two, one, or none of these symptoms that you don't have PCOS.

Women with PCOS can experience a wide variety of symptoms, but here is a closer look at each of the symptoms of the classic triad:


Hirsutism is excessive body hair in places such as the face, neck, chest, back, and toes. This symptom is caused by an excess of male hormones, or androgens, such as testosterone circulating in the blood stream.

For women, hirsutism can be extremely distressing. Fortunately, there are many hair removal options available today, from over-the-counter products to professional services and prescription medications. Each method has its ups and downs, and it's important for a woman to determine what works best for her.


Anovulation is when the body fails to ovulate, or release a mature egg. Ovulation normally occurs around 14 days before the next period.

Anovulation results in irregular periods, missed periods, infertility and abnormal bleeding. And, once again, high levels of androgens — male hormones — are the root cause of the problem.

It can be sometimes difficult to track anovulation as some women still have monthly cycles. However, if you are having regular monthly periods, it is most likely that you are ovulating. Your doctor can determine for sure if ovulation has occurred through blood work or transvaginal ultrasound.

Anovulation can be treated in a few different ways.

The diabetes drug Metformin has been shown to improve insulin sensitivity, which can help to induce regular menstrual cycles.

If you are not trying to get pregnant, your doctor will likely prescribe hormonal contraception, such as the pill, which regulates menstrual cycles.

When you are ready to get pregnant, your doctor can prescribe medications to stimulate ovulation, which include clomid, follical stimulating hormone (FSH), luteinizing hormone (LH), human chorionic gonadotropin (hCG) and gonadotropin-releasing hormone (GnRH).

You will want to work closely with a reproductive endocrinologist to develop the best plan for you.


Extra body weight and PCOS go hand in hand, however experts aren't sure which came first: Does PCOS cause weight gain or does weight gain cause PCOS?

Many women with PCOS follow a healthy diet and exercise plan, but still have a weight problem. Clearly, this isn't as simple as too many calories in and not enough out. There is something more complex at work.

Insulin resistance — a condition where the body produces extra insulin but the cells cannot use it properly resulting in high blood sugar — is common among women with PCOS.

Insulin resistance can make losing weight difficult.

Other hormonal issues common with PCOS may also bring challenges to weight loss. Yet, studies show losing as little as 10 percent of your body weight may reduce other PCOS symptoms, including anovulation.

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