Recognizing the Classic Triad of PCOS

The classic triad of polycystic ovary syndrome (PCOS) refers to a series of symptoms common to the syndrome. The three symptoms are hirsutism, anovulation, and obesity.

Classic Triad

The classic triad is not a complete indicator of PCOS. Just because you have two, one, or none of these symptoms doesn’t mean you don’t have PCOS. You can still diagnose PCOS without these features, but it’s helpful to know that they can occur. Women with PCOS experience a wide variety of effects, and here’s a closer look at each symptom of the classic triad:


Hirsutism is excess body hair on the face, neck, chest, back, and toes.This symptom is caused by too much male hormones, or androgens, such as testosterone circulating in the blood.

For women, hirsutism can be very distressing. Fortunately, there are many options for hair removal today, from over-the-counter products to professional services and prescription drugs. Each method has its pros and cons, and it’s important for a woman to determine what works best for her and to speak with her healthcare provider beforehand.

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Anovulation is when the body does not ovulate or release mature eggs. Ovulation usually occurs about 14 days before your next period.

Anovulation can lead to irregular periods, irregular periods, infertility, and abnormal bleeding. High levels of androgens along with changes in luteinizing hormone and insulin levels can lead to anovulation.

If you have regular menstrual cycles, chances are you are ovulating. Your doctor can find out if you are ovulating regularly with testing tests, including blood tests or a transvaginal ultrasound.

There are several different treatments for anovulation. Managing stress, weight, and exercising regularly can help reduce symptoms.

Medications to help treat anovulation include:

  • Climid citrate (CC)
  • Human Chorionic Gonadotropin (hCG) Injection
  • Follicle Stimulating Hormone (FSH) Injection
  • Gonadotropin-releasing hormone (GnRH) agonist and antagonist injections

If you don’t want to get pregnant, your doctor may prescribe hormonal contraceptives, such as those that regulate your menstrual cycle.

If you are trying to get pregnant, your healthcare provider may prescribe FSH, hCG, or GnRH. You will also need to work closely with a reproductive endocrinologist to develop the best plan for you.

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Extra weight and PCOS often coexist, however, experts are not sure which comes first: Does PCOS cause weight gain, or does weight gain cause PCOS?

Women who are overweight are more likely to develop PCOS, and data support that some people are genetically predisposed to both disorders (there is a genetic link between the two).

  • Epidemiological data support a strong association between obesity and PCOS, showing that 38% to 88% of women with PCOS are overweight or obese.
  • A meta-analysis of related studies reported in the literature showed that obese women had a 2.77 chance of developing PCOS compared with non-obese women.

However, many women with PCOS are not overweight or obese.

Many women with PCOS follow a healthy diet and exercise program but still have weight problems. It’s not as simple as eating too many calories and not eating enough. There are some more complicated things at play.

Insulin resistance is common in women with PCOS. In this condition, the body produces extra insulin, but the cells cannot use it properly, resulting in high blood sugar. Insulin resistance can make weight loss difficult. People with PCOS who are not overweight can develop insulin resistance, but weight gain can make it worse.

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Other hormonal problems common to PCOS can also present challenges for weight loss.

Research shows that losing 5 to 10 percent of your body weight may reduce other PCOS symptoms, including anovulation.