Hormonal Health1 in 10 women in the UK

Polycystic Ovary Syndrome (PCOS)

Also known as: PCOS, Polycystic Ovarian Syndrome, Stein-Leventhal Syndrome

PCOS is a common hormonal condition affecting how the ovaries work. It affects about 1 in 10 women in the UK and can cause irregular periods, excess hair growth, and fertility problems.

Last reviewed: 15 January 2026

What is Polycystic Ovary Syndrome (PCOS)?

PCOS occurs when the ovaries produce higher than normal amounts of androgens (male hormones). This can prevent eggs from developing properly and affect ovulation. Despite the name, many women with PCOS don't have cysts - the name refers to the appearance of the ovaries on ultrasound.

Who is affected?

Women of reproductive age. Symptoms often start in late teens or early 20s, but some women don't get diagnosed until they have trouble getting pregnant.

Symptoms of Polycystic Ovary Syndrome (PCOS)

Common Symptoms

  • Irregular periods or no periods
  • Difficulty getting pregnant
  • Excess hair growth (hirsutism) - face, chest, back
  • Weight gain, especially around the middle
  • Thinning hair or hair loss from the head
  • Oily skin or acne

Less Common Symptoms

  • Darkened skin patches (acanthosis nigricans)
  • Skin tags
  • Depression or anxiety
  • Sleep problems

When to Seek Urgent Help

  • Symptoms themselves aren't usually severe, but complications can develop

Causes & Risk Factors

Causes

  • Exact cause unknown - likely combination of genetic and environmental factors
  • Insulin resistance (affects about 70% of women with PCOS)
  • Higher levels of androgens
  • Low-grade inflammation
  • Hereditary factors

Risk Factors

  • Family history of PCOS
  • Being overweight or obese
  • Insulin resistance or type 2 diabetes
  • Family history of diabetes

Possible Complications if Untreated

  • Infertility
  • Type 2 diabetes
  • High cholesterol
  • High blood pressure
  • Heart disease
  • Endometrial cancer (womb lining)
  • Sleep apnoea
  • Depression and anxiety

Diagnosis & Blood Tests

PCOS is diagnosed using the Rotterdam criteria - you need 2 out of 3: irregular/absent periods, high androgens (blood test or symptoms), and polycystic ovaries on ultrasound.

Hormone Blood Tests

Tests for androgens, FSH, LH, and other hormones.

What to look for: High testosterone and/or raised LH:FSH ratio suggest PCOS.

Pelvic Ultrasound

Scans the ovaries to check for polycystic appearance.

What to look for: 12+ follicles in each ovary or enlarged ovaries suggest PCOS.

AMH (Anti-Müllerian Hormone)

Can help diagnose PCOS, especially when ultrasound isn't suitable.

What to look for: Often elevated in women with PCOS.

Glucose and Insulin Tests

Screen for insulin resistance and diabetes risk.

What to look for: High insulin or abnormal glucose tolerance is common.

Thyroid Function Tests

To rule out thyroid problems which can cause similar symptoms.

What to look for: Should be normal to confirm PCOS diagnosis.

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Treatment Options

Treatment focuses on managing symptoms and reducing long-term health risks. There's no cure, but symptoms can be well controlled.

  • Lifestyle changes (diet, exercise, weight loss)
  • Combined oral contraceptive pill (regulates periods, reduces androgens)
  • Metformin (helps with insulin resistance)
  • Treatments for hair growth (creams, laser, electrolysis)
  • Fertility treatments (clomifene, letrozole, IVF)
  • Weight loss surgery in severe cases

Living with PCOS

  • Even modest weight loss (5-10%) can improve symptoms significantly
  • Exercise regularly - it helps with insulin resistance and weight
  • Choose a balanced diet with plenty of fibre and protein
  • Limit processed foods and refined carbohydrates
  • Connect with PCOS support groups - you're not alone
  • Monitor for signs of depression and anxiety
  • Keep up with regular health checks for diabetes and cholesterol

Frequently Asked Questions

Can I get pregnant with PCOS?

Yes, many women with PCOS conceive naturally or with help. PCOS is a common cause of infertility, but treatments are available and often successful. Lifestyle changes can improve ovulation.

Will I always have PCOS?

PCOS is a lifelong condition, but symptoms often improve with treatment and lifestyle changes. Symptoms may also naturally improve after menopause, though health monitoring should continue.

What's the best diet for PCOS?

There's no specific PCOS diet, but a balanced, Mediterranean-style diet with plenty of vegetables, lean protein, and whole grains helps. Low GI foods may be particularly beneficial.

Does PCOS go away with weight loss?

PCOS doesn't go away, but weight loss can significantly improve symptoms and hormone levels. Even losing 5% of your body weight can help regulate periods and improve fertility.

When to See Your GP

  • Your periods are irregular or have stopped
  • You have excessive hair growth
  • You've been trying to conceive for over a year
  • You have severe acne that isn't responding to treatment
  • You're gaining weight and finding it hard to lose
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