Polycystic Ovary Syndrome (PCOS): Symptoms, Tests, and Treatment Options

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal conditions affecting women of reproductive age, yet it is often misunderstood. It can impact periods, fertility, weight, and overall well-being. The good news is that PCOS can be managed effectively once diagnosed, with the right combination of lifestyle changes, medical treatment, and ongoing support.

What is PCOS?

PCOS occurs when the ovaries produce higher-than-normal levels of androgens (male hormones). This hormonal imbalance disrupts ovulation and can cause small fluid-filled sacs, or cysts, to form on the ovaries. Despite the name, not all women with PCOS develop ovarian cysts, and having cysts alone doesn’t necessarily mean you have PCOS.

How Common is PCOS?

It’s estimated that 1 in 10 women in the UK have PCOS, though many are undiagnosed. Symptoms usually begin during teenage years or early adulthood, but they can vary widely in severity.

Key Symptoms of PCOS

1. Irregular or Absent Periods

Cycles may be longer than 35 days, unpredictable, or stop altogether. This happens because ovulation is disrupted.

2. Excess Hair Growth (Hirsutism)

Higher levels of androgens can lead to unwanted hair growth on the face, chest, or back.

3. Skin and Hair Changes

Acne, oily skin, and thinning hair on the scalp are common features.

4. Weight Gain and Difficulty Losing Weight

Many women with PCOS struggle with weight management, partly due to insulin resistance.

5. Fertility Challenges

Because ovulation is irregular, conceiving naturally may be more difficult. PCOS is one of the most common causes of infertility in women.

6. Other Health Risks

Women with PCOS may also be at increased risk of type 2 diabetes, high cholesterol, and endometrial cancer if left untreated.

If you have irregular periods or symptoms of PCOS, a private gynaecology consultation with hormone testing and ultrasound scans can provide answers.

How PCOS is Diagnosed

There isn’t a single test for PCOS. Instead, diagnosis usually involves:

• Blood tests: To measure hormone levels (LH, FSH, testosterone, prolactin, thyroid hormones, glucose, and insulin).
• Ultrasound scan: To check for enlarged ovaries or multiple small follicles.
• Medical history and symptoms: Period irregularity, excess hair growth, and acne are important diagnostic clues.

A diagnosis is often made if you have two out of three features: irregular periods, high androgen levels, and polycystic ovaries on scan.

Treatment Options for PCOS

While there is no cure for PCOS, symptoms can be managed effectively with the right approach. Treatment depends on your main concerns — whether it’s regulating periods, managing skin and hair symptoms, or improving fertility.

1. Lifestyle Changes

• Diet: A balanced diet low in refined sugars can help manage insulin resistance.
• Exercise: Regular activity improves insulin sensitivity and supports weight control.
• Weight management: Even a small weight loss (5–10%) can improve symptoms and fertility outcomes.

2. Medication

• Hormonal contraceptives: Pills, patches, or hormonal coils can regulate cycles and reduce excess hair or acne.
• Metformin: A diabetes medication that improves insulin resistance and may help restore regular periods.
• Fertility medication: If trying to conceive, ovulation induction drugs such as clomifene or letrozole may be prescribed.

3. Specialist Treatments

• Laser hair removal or electrolysis for unwanted hair.
• Dermatology treatments for acne and skin problems.
• Surgery (laparoscopic ovarian drilling): Rarely used but may improve ovulation in certain cases.

Living With PCOS

PCOS is a long-term condition, but with the right care, most women can manage their symptoms and live healthy, fulfilling lives. Regular monitoring is important to reduce long-term risks such as diabetes and heart disease. Support from a gynaecologist, dietitian, or endocrinologist can make a big difference.

Final Thoughts

PCOS affects millions of women, but it doesn’t have to define your life. With early diagnosis, tailored treatment, and lifestyle adjustments, you can manage symptoms, protect your health, and achieve your fertility goals.

If you’re worried about PCOS or experiencing irregular cycles

Book a private gynaecology consultation and hormone profile for expert support and guidance.

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