Hi there - I hope I can shed some light on your questions.
PCOS is caused by a problem with the way the ovaries produce their hormones, leading to an increased production of androgens (male type hormones). This then leads to the symptoms that go along with PCOS - irregular periods (as ovulation does not occur regularly) which may be light or heavy or absent, difficulties falling pregnant (again due to ovulation not occurring regularly), skin changes (acne, excess unwanted body hair).
PCOS also causes alterations to the metabolism which can make it difficult to lose weight and also increase the risk of conditions like type 2 diabetes in the long term.
The cornerstone of treatment in most cases begins with optimisation of body weight. This can be difficult so seeking advice from a dietitian, GP, exercise physiologist etc is often required to help achieve and maintain an optimal body weight (even a modest weight loss can in many cases lead to a return to regular cycles and increased chance of falling pregnant).
Having said all that, the management of PCOS is best to be individualised, depending on your own sypmtoms and wishes with respect to fertility. If you've been diagnosed with PCOS I'd advise seeing a gynaecologist for further discussion on what is the best management for you and for referral to other health professionals (dietitian etc) as needed.
I hope this has been helpful in answering your questions.
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