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If fatigue persists despite these interventions, or if it is accompanied by other concerning symptoms, further medical evaluation is warranted to exclude alternative diagnoses

Without lifestyle changes (diet, exercise, behavior modification), results may not be sustained

The overlapping vessels indicated markedly dilated capillaries in rete ridges and the background brown pigmentations can be explained by melanins and melanophages at all levels of the epidermis or the dermis1, 2

Regulatory status is subject to change

Many women with PCOS don't ovulate regularly, which can lead to irregular periods and difficulty getting pregnant