PCOS symptoms self care basics

Overview

PCOS (polycystic ovary syndrome) is a common condition that affects how the ovaries work. It involves an imbalance of hormones that can affect periods, fertility, and metabolism. Despite the name, not everyone with PCOS has cysts on the ovaries.

Yes. PCOS affects about 1 in 10 people assigned female at birth, though many may not know they have it.

PCOS usually begins during the reproductive years, around ages 15 to 44. It can affect people of any weight, background, or lifestyle.

Symptoms

Common symptoms

• Irregular, missed, or very heavy periods
• Excess facial or body hair (hirsutism)
• Acne, oily skin, or dandruff
• Weight gain or difficulty losing weight
• Thinning hair on the scalp
• Dark, velvety patches of skin, often on the neck, groin, or under the breasts
• Mood changes, including feeling anxious or down

Symptoms in children

• Irregular periods or no periods during the teenage years
• Acne that is severe or hard to treat
• Unusual weight gain, especially around the belly
• Excess hair growth on the face, chest, or back

Symptoms in older adults

• Symptoms like excess hair or acne may lessen after menopause, but periods become less predictable and then stop.
• Long-term metabolic risks may continue, including insulin resistance, higher cholesterol, and high blood pressure.
• Weight management may become more difficult during perimenopause and menopause.

Causes

Main causes

• The exact cause of PCOS is not fully understood, but it is linked to hormonal imbalances, including higher levels of androgens (male-type hormones).
• Insulin resistance, where the body does not use insulin properly, is common in PCOS and can make symptoms worse.
• Genetics may play a role, as PCOS often runs in families.

Risk factors

• Having a mother, sister, or daughter with PCOS
• Being overweight or having obesity, especially with extra weight around the waist
• Having a family history of type 2 diabetes or metabolic syndrome

When to see a doctor

See a doctor urgently if:

• See a healthcare provider the same day or go to urgent care if you have worsening pelvic pain, fever with pelvic pain, or very heavy bleeding.
• If you have severe mood changes or thoughts of harming yourself, seek help immediately.

Book a routine appointment if:

• Make an appointment if you have irregular periods, you have missed several periods, or you have symptoms like excess hair growth, acne, or weight gain that bother you.
• If you have been trying to conceive for a year without success, talk to your doctor about fertility concerns.
• If you have a diagnosis of PCOS, have regular check-ups to monitor your blood pressure, blood sugar, and cholesterol.

Diagnosis

There is no single test for PCOS. A doctor will ask about your symptoms, your health history, and your family history. They may also do a physical exam. A diagnosis is usually made when you have at least two of the following: irregular or no periods, signs of high androgens (like excess hair or acne, or blood tests showing raised androgen levels), and an ultrasound showing polycystic ovaries.

Tests that may be done

• Blood tests to check hormone levels, blood sugar, insulin, cholesterol, and thyroid function.
• An ultrasound of the pelvis to look at your ovaries and womb.
• Sometimes a pregnancy test or other tests to rule out conditions that can cause similar symptoms.

What to expect at your appointment

Your doctor will explain your results and talk through what they mean for you. You may be referred to a gynecologist (specialist in female reproductive health) or an endocrinologist (specialist in hormones) for further care.

Treatment

There is no cure for PCOS, but symptoms can be managed with a combination of lifestyle changes and, if needed, medical treatment. Your treatment plan will depend on your symptoms, your overall health, and whether you are trying to become pregnant.

Self-care at home

• If you are above a healthy weight, losing even 5% of your body weight can improve periods and other symptoms.
• Stay physically active on most days of the week.
• Eat regular, balanced meals with plenty of vegetables, whole grains, lean proteins, and healthy fats.
• Aim for good-quality sleep and a consistent sleep routine.
• Try stress-reducing activities like yoga, meditation, or breathing exercises.
• Track your periods and symptoms in a diary or app to help you and your doctor see patterns.

Medical treatments

Medicines may be offered to help regulate periods, reduce symptoms like acne or excess hair, or help your body use insulin better. Some treatments are used to support ovulation if you are trying to give birth. Always discuss any medicine with your healthcare provider before starting or stopping it.

When is surgery considered?

Surgery is rarely needed for PCOS. In specific circumstances, a minor procedure called laparoscopic ovarian drilling may be considered for people who have difficulty ovulating and have not responded to fertility medicines. This is not a first-line treatment and is only used after careful discussion with a specialist.

Living with this condition

Living with PCOS can feel overwhelming at times. Focus on small, realistic goals. Track your symptoms, take your medicines as prescribed, and attend regular check-ups. Be patient with yourself, because changes take time.

Lifestyle tips

• Make physical activity a regular part of your day, even if it is just a brisk walk.
• Limit processed foods, sugary drinks, and refined carbohydrates.
• Eat a balanced diet and try to have meals at regular times.
• Prioritise good sleep and try to manage stress.
• Avoid smoking and limit alcohol.
• Build a healthcare team you trust and feel comfortable talking to.

Diet and exercise

A balanced diet alongside regular physical activity is one of the most effective ways to manage PCOS. Choose whole foods like vegetables, fruits, whole grains, lean proteins, and healthy fats. Limit refined bread, white rice, and sugary snacks. Exercise helps improve insulin sensitivity and supports weight management. Aim for at least 150 minutes of moderate activity per week, or follow the guidance of your healthcare provider.

Mental health and emotional wellbeing

PCOS can affect your mood and confidence. It is not unusual to feel frustrated or sad about symptoms like weight gain, acne, or excess hair. These feelings are valid. If you notice low mood, anxiety, or if your emotions are interfering with daily life, talk to your doctor. Professional support, including counselling, can help. You can also reach out to a mental health helpline in your area for immediate support.

Prevention

PCOS cannot be prevented because it is linked to genetics and hormones. However, a healthy lifestyle can reduce the impact of symptoms and help prevent complications like type 2 diabetes and heart disease.

Screening programmes

If you have PCOS, your doctor may recommend regular checks of blood pressure, blood sugar, and cholesterol. If you have a family history of diabetes, ask your doctor about earlier screening.

Complications

If left untreated

• Irregular periods over a long time can increase the risk of changes in the lining of the womb.
• Insulin resistance can develop into type 2 diabetes.
• Higher risk of high blood pressure and abnormal cholesterol levels.
• Fertility difficulties can occur, but many treatment options are available.
• Increased risk of sleep apnoea and non-alcoholic fatty liver disease.

Long-term outlook

With the right care, most people with PCOS can manage their symptoms and live full, healthy lives. Fertility challenges can often be treated successfully. The earlier you seek support, the better the outcome. Be hopeful, because many people with PCOS lead very normal lives.

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