Living with PCOS symptoms

Overview

Polycystic ovary syndrome (PCOS) is a common hormone condition that affects how a woman's ovaries work. It can cause irregular periods, acne, weight gain, and extra hair on the face and body because of higher-than-normal levels of certain 'male-type' hormones called androgens.

Yes. PCOS is very common. It affects about 1 in 10 women and people with ovaries during their childbearing years.

PCOS usually begins in girls and young women, often around puberty. You are most at risk during your teens and twenties, but it can affect you at any age during your reproductive years.

Symptoms

Common symptoms

• Irregular, missed, or very heavy periods
• Acne or oily skin
• Extra hair on the face, chest, or back (called hirsutism)
• Thinning hair on your head
• Weight gain or trouble losing weight
• Skin tags or dark patches around the neck, armpits, or groin
• Pelvic pain, sometimes due to multiple small cysts on the ovaries

Symptoms in children

• Periods that don't come on time or are very heavy
• Acne, especially on the face and chest
• Excessive hair growth
• Rapid weight gain, especially around the middle

Symptoms in older adults

• Acne and hair growth may get better with age, but irregular periods can continue
• Higher risk of type 2 diabetes, high blood pressure, and heart disease
• It is important to keep going for regular health checks even if symptoms improve

Causes

Main causes

• The exact cause is not known, but hormones called androgens are higher than normal, and the body often does not use insulin properly (called insulin resistance). This can disrupt ovulation and cause cysts on the ovaries.
• Genetics play a role – PCOS tends to run in families.
• The ovaries may not regularly release eggs (ovulation), which can cause irregular periods and fertility issues.

Risk factors

• Family history of PCOS
• Obesity or weight gain around the abdomen
• Insulin resistance or prediabetes
• Physical inactivity

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, call your local emergency number right away.
• If you have signs of diabetes like extreme thirst and frequent urination, seek care the same day.
• Possible pregnancy with pelvic pain or bleeding: get urgent care without delay.

Book a routine appointment if:

• Your periods are irregular, absent, or very painful
• You have acne or extra hair growth that bothers you
• You are trying to get pregnant
• You have weight gain and are concerned about PCOS
• You think you might have PCOS and want to be checked

Diagnosis

A doctor or specialist (like a gynecologist or endocrinologist) will ask about your symptoms and health history, check your body, and often do tests to rule out other causes. In many cases, you need to have at least two of these three things: irregular periods, high androgen levels (with physical signs), and polycystic ovaries seen on ultrasound.

Tests that may be done

• Blood tests to check hormone levels (including testosterone) and a pregnancy test to rule out pregnancy
• Blood tests to check blood sugar, cholesterol, and thyroid function
• Pelvic ultrasound to look at your ovaries and the thickness of your uterine lining
• Clinical examination for signs like acne, hair pattern, and weight distribution

What to expect at your appointment

PCOS is usually diagnosed by a combination of your symptoms, physical exam, and test results. It may take more than one visit. Your doctor will talk through the results with you and explain the next steps, but no single test is 'positive' for PCOS.

Treatment

There is no cure for PCOS, but the condition is very treatable. Treatment depends on your symptoms, whether you want to become pregnant, and your risk for type 2 diabetes. Most treatment plans focus on healthy lifestyle habits plus medication, skin care, and support for any emotional or mental health concerns.

Self-care at home

• Eat a balanced diet, rich in vegetables, fruit, whole grains, and lean proteins
• Move your body regularly – aim for at least 30 minutes, 5 days a week
• Aim for a healthy weight – losing even 5 to 10% of your current weight can improve symptoms
• Prioritise sleep and manage stress with breathing exercises or talking to someone you trust
• Track your periods with an app or calendar to notice any changes

Medical treatments

Your doctor may recommend medicines to help regulate your periods, improve how your body uses insulin, lower androgens, or reduce symptoms like acne and hair growth. Any medication should be discussed with your doctor; there is no one-size-fits-all option. For women trying to get pregnant, a specialist can discuss ovulation-inducing treatments and other safe options.

When is surgery considered?

Surgery is rarely used for PCOS and is only considered after other treatments have not helped, especially for fertility issues. A specialist can explain if this might ever be relevant to your situation.

Living with this condition

Living with PCOS can be challenging, but small, steady changes make a real difference. Keep your medical appointments, monitor your symptoms (especially your periods), and talk openly with your doctor. You may need to try different approaches to find what works best for you.

Lifestyle tips

• Find an exercise you enjoy, like walking, swimming, or dancing
• Eat meals and snacks at regular times to support blood sugar control
• Take time each day to relax – even 5 minutes of deep breathing counts
• Get support from a friend, family member, or an online community
• Be patient with yourself. Change takes time and you are doing your best.

Diet and exercise

Focus on a Mediterranean-style diet with plenty of vegetables, fruits, whole grains, and healthy fats. Limit refined carbohydrates like white bread, sugary drinks, and processed snacks. Combine this with regular physical activity – both aerobic exercises (like walking or cycling) and light strength training help insulin work better and can reduce PCOS symptoms.

Mental health and emotional wellbeing

PCOS can affect your self-esteem, mood, and mental health. It is very common to feel frustrated, anxious, or down. Please talk to your doctor about how you are feeling and consider talking to a counsellor or therapist. If you are having thoughts of harming yourself, reach out for crisis support right away – ask your GP or local health service for details.

Prevention

PCOS itself cannot be prevented, but healthy habits from a young age may help reduce the severity of symptoms and lower your risk of related problems like type 2 diabetes.

Screening programmes

If you have PCOS, your doctor will likely recommend regular checks for type 2 diabetes, high blood pressure, and cholesterol, because these conditions are more common in PCOS. Screening tests are simple and usually done with blood tests and a blood pressure reading. Always ask your doctor how often you should be screened.

Complications

If left untreated

• Type 2 diabetes and prediabetes
• High blood pressure and high cholesterol
• Sleep apnea (pauses in breathing during sleep)
• Increased risk of uterine (endometrial) cancer if periods are very infrequent
• Difficulty getting pregnant (infertility)
• Anxiety and depression are more common

Long-term outlook

The outlook for PCOS is very good. There is no cure, but most women are able to manage their symptoms well with lifestyle changes and medical treatment when needed. Many women with PCOS become pregnant and have healthy babies. The key is to work closely with your healthcare team, attend regular check-ups, and reach out for support when you need it.

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