Polycystic ovary syndrome, or PCOS, is a complex endocrine disorder that we frequently encounter in our practice as an endocrinologist. PCOS is often characterized by a constellation of symptoms, but irregular periods are a hallmark feature. These menstrual irregularities result from hormonal imbalances, particularly elevated levels of androgens and insulin resistance. Managing irregular periods in PCOS patients involves a personalized approach, which may include hormonal contraceptives to regulate the menstrual cycle and reduce androgen levels. Additionally, addressing the underlying insulin resistance is crucial, as it not only impacts menstrual regularity but also increases the risk of diabetes. For diabetic patients with PCOS, we emphasize the importance of meticulous glucose control through lifestyle modifications and, if necessary, medications like metformin. By addressing both the hormonal and metabolic aspects of PCOS, we strive to improve the overall health and well-being of our patients while enhancing their fertility prospects when desired. Collaborative care and patient education play pivotal roles in achieving these goals.