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Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) is a common hormonal condition that affects how the ovaries function. It can affect menstrual cycles, hormone levels, fertility and metabolic health. Women with PCOS may have irregular periods, higher levels of androgens (male hormones) and multiple small follicles visible on the ovaries during ultrasound scans.

Commonality

PCOS is one of the most common hormonal conditions affecting women of reproductive age. It is estimated to affect around 1 in 10 women, although many remain undiagnosed for years.

Causes

The exact cause of PCOS is not fully understood, but several factors are believed to contribute.


These include:

  • Insulin resistance

  • Hormonal imbalance affecting ovulation

  • Genetic factors and family history


Many women with PCOS have insulin resistance, which can lead to increased insulin levels and excess androgen production by the ovaries.

Symptoms

Symptoms of PCOS can vary widely between individuals.


Common symptoms include:

  • Irregular or infrequent periods

  • Missed periods

  • Absent ovulation

  • Excess facial or body hair (hirsutism)

  • Acne or oily skin

  • Thinning hair on the scalp

  • Weight gain or difficulty losing weight

  • Fertility problems

  • Mood changes, anxiety or low mood

Effects on Fertility

PCOS is one of the most common causes of ovulatory infertility because it can disrupt normal ovulation.


However, many women with PCOS successfully conceive naturally or with treatment. Fertility support may include:

  • Ovulation tracking and monitoring

  • Ovulation induction medication

  • Assisted reproductive treatments such as IVF where required


With appropriate management, pregnancy outcomes are often very positive.

Diagnosis

PCOS is usually diagnosed using the Rotterdam criteria. Diagnosis requires two of the following three features:

  • Irregular or absent ovulation

  • Elevated androgen levels

  • Polycystic ovarian appearance on ultrasound


Assessment may include:

  • Detailed medical consultation

  • Pelvic ultrasound scan

  • Hormone blood tests

  • Metabolic screening, including cholesterol and glucose testing

  • Physical examination where appropriate


Other conditions that can cause similar symptoms are usually excluded before confirming the diagnosis.

Treatments

Although there is currently no cure for PCOS, symptoms can often be managed effectively.


Lifestyle measures may include:

  • Balanced nutrition

  • Regular physical activity

  • Weight management

  • Improving insulin sensitivity


Medical treatments may include:

  • Hormonal contraception to regulate menstrual cycles

  • Anti-androgen medications for acne and excess hair growth

  • Insulin-sensitising medications such as metformin

  • Ovulation induction medication for women trying to conceive


In selected cases, surgical treatment may include:

  • Laparoscopic ovarian drilling to help restore ovulation


Treatment is tailored to symptoms, metabolic health and fertility goals.

Ongoing Care

PCOS is a long-term condition that usually requires ongoing management.


Ongoing care may include:

  • Monitoring metabolic health

  • Hormonal management

  • Lifestyle optimisation

  • Fertility planning

  • Regular follow-up appointments

  • Review of treatment effectiveness over time


Early diagnosis and ongoing monitoring can help reduce the risk of long-term health complications.

Living with the Condition

PCOS can affect physical health, emotional wellbeing, fertility and confidence. Symptoms such as irregular periods, weight changes, acne and excess hair growth can have a significant impact on daily life.


Without appropriate management, PCOS may increase the risk of:

  • Type 2 diabetes

  • High blood pressure

  • High cholesterol

  • Metabolic syndrome

  • Sleep apnoea

  • Endometrial hyperplasia

  • Endometrial cancer


With the right combination of lifestyle measures, medical treatment and regular follow-up, most women manage their symptoms successfully and maintain good long-term health.

When to See a Specialist

You may benefit from specialist assessment if you experience:

  • Irregular or absent periods

  • Excess facial or body hair

  • Acne that persists despite treatment

  • Unexplained weight gain or difficulty losing weight

  • Fertility difficulties

  • Symptoms suggestive of hormonal imbalance


Early assessment can help confirm the diagnosis, improve symptom control and reduce long-term health risks.

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