Polycystic Ovary Syndrome (PCOS)
Sources consulted
This article is original patient-education content.
- WHO—Health topics A–Z(2024)
- NHS—Health A to Z(2024)
- CDC—Health topics(2024)
Based on international clinical guidelines
Overview
Polycystic ovary syndrome (PCOS) is a common hormone problem that affects the ovaries (the organs that release eggs) during a woman's reproductive years. It can cause irregular periods, extra hair growth, acne, and trouble getting pregnant. The name comes from small fluid-filled sacs (cysts) that may form on the ovaries, but not everyone with PCOS has these cysts.
Key facts
- PCOS is a condition where the ovaries produce too much male hormone (androgen), which can interfere with ovulation.
- It is one of the leading causes of infertility (trouble getting pregnant) in women.
- PCOS is linked to higher risks of type 2 diabetes, heart problems, and mental health issues like anxiety and depression.
Yes, PCOS is very common. It affects about 1 in every 10 women of childbearing age. Many women have it but do not know it until they look for help with irregular periods or trouble getting pregnant.
PCOS mainly affects women and people assigned female at birth during their teenage years and up to menopause. It can start at any age after the first period. A family history of PCOS increases your chance of having it.
Symptoms
- Severe pain in the lower belly that comes on suddenly
- Vomiting or fainting with belly pain
- Heavy bleeding that soaks through a pad or tampon every hour for more than 2 hours
- ⚠A period that lasts longer than 7 days or is very heavy
- ⚠New or worsening depression, anxiety, or thoughts of harming yourself – talk to someone right away
Common symptoms
- Irregular periods – fewer than 9 periods a year, or very long gaps between periods
- Heavy or painful periods
- Extra hair growth on the face, chest, back, or belly (hirsutism)
- Acne on the face, chest, or back
- Thinning hair on the scalp (like male-pattern baldness)
- Weight gain or trouble losing weight, especially around the waist
- Dark, thick patches of skin on the neck, armpits, or groin (acanthosis nigricans)
- Difficulty getting pregnant (infertility)
Symptoms in children
- In teenage girls, symptoms often include irregular periods, acne, and unwanted hair growth. They may also have depression or anxiety about their body image. Early signs can start around the time of the first period.
Symptoms in older adults
- After menopause, some symptoms like acne and hair growth may improve, but the risks for diabetes, high blood pressure, and heart disease remain high. Irregular periods stop because periods naturally stop at menopause.
Causes
Main causes
- The exact cause is not fully understood, but it involves a mix of genes and environment.
- Insulin resistance – the body's cells do not respond well to insulin, causing the pancreas to make more insulin. High insulin levels can make the ovaries produce more male hormones.
- Higher than normal levels of male hormones (androgens) like testosterone, which stops eggs from being released regularly.
Risk factors
- Family history – having a mother, sister, or grandmother with PCOS increases your risk.
- Being overweight or obese can make insulin resistance worse.
- Having had an early first period (before age 11).
When to see a doctor
See a doctor urgently if:
- If you have sudden, severe belly pain or heavy bleeding – go to a hospital or call your local emergency number.
- If you feel depressed or anxious and are thinking about harming yourself – call a crisis helpline or go to A&E / emergency right away.
Book a routine appointment if:
- If your periods are irregular (fewer than 9 per year) for several months.
- If you have unwanted hair growth or acne that bothers you.
- If you are trying to get pregnant and have not been able to after one year (or after 6 months if you are over 35).
- If you notice dark patches of skin or thinning scalp hair.
Diagnosis
A doctor (usually your GP or a gynaecologist) will diagnose PCOS based on your symptoms, a physical exam, and some tests. There is no single test for PCOS. Doctors often use criteria that require you to have at least two of the following: irregular periods, signs of high male hormones (like hair growth or blood tests), or polycystic ovaries seen on an ultrasound.
Tests that may be done
- Blood tests to check hormone levels (like testosterone) and rule out other conditions (like thyroid problems or high prolactin).
- Blood tests to check sugar and cholesterol levels (to look for diabetes risk).
- An ultrasound of your pelvis (a scan that uses sound waves to see your ovaries and womb). It can show many small cysts on the ovaries, but not everyone with PCOS has cysts.
What to expect at your appointment
Your doctor will talk to you about your symptoms, your periods, and any family history. They may ask about your weight, skin, and hair growth. The ultrasound is usually done through the tummy (if you are not sexually active) or through the vagina (if you are). It is not painful but can be a little uncomfortable. The results will help your doctor confirm if PCOS is likely and discuss next steps with you.
Treatment
Treatment for PCOS aims to manage symptoms and reduce the risk of long-term health problems. There is no cure, but many treatments can help. The right treatment depends on your symptoms, whether you want to get pregnant, and your overall health. Always talk to your doctor before starting any new treatment.
Self-care at home
- Maintain a healthy weight – even a 5% weight loss can improve symptoms and help with ovulation.
- Eat a balanced diet with plenty of vegetables, whole grains, and lean protein – aim for foods that help control blood sugar.
- Stay active – aim for at least 150 minutes of moderate exercise per week (like brisk walking, cycling, or swimming).
- Try stress-reducing activities like meditation, yoga, or talking to a trusted friend.
Medical treatments
Doctors may offer medicines to help with specific symptoms. For example, hormonal birth control (pills, patch, or ring) can help regulate periods, reduce acne, and slow extra hair growth. A medicine called metformin (used for diabetes) can improve insulin resistance and help with ovulation. For those trying to get pregnant, medicines that help the ovaries release an egg (ovulation induction) may be used. Always ask your doctor about the benefits and risks – they will explain what is right for you. Never take any medicine without a prescription.
When is surgery considered?
Surgery is rarely needed. Sometimes, a minor operation called ovarian drilling (tiny holes made in the ovaries to lower male hormone production) may be considered if medicines do not work and you still have trouble getting pregnant. This is not common.
Living with this condition
Living with PCOS means managing symptoms that can change over time. You may need to see your doctor regularly to check your blood pressure, blood sugar, and cholesterol. Many women find that small lifestyle changes make a big difference. It helps to keep track of your periods and any changes in your body.
Lifestyle tips
- Set realistic weight goals – start with losing 5-10% of your current weight if you are overweight.
- Include strength training (like lifting weights or yoga) to help your body use insulin better.
- Get enough sleep – 7 to 9 hours a night can help hormone balance.
Diet and exercise
A diet that helps control blood sugar is key – choose foods with a low glycaemic index (like whole grains, legumes, and non-starchy vegetables) and limit sugary drinks and refined carbs like white bread and pasta. Exercise can be any activity you enjoy – aim to move your body most days. Even a 30-minute walk can help.
Mental health and emotional wellbeing
PCOS can affect how you feel about your body, especially if you have unwanted hair, acne, or trouble getting pregnant. Many people with PCOS experience depression, anxiety, or low self-esteem. These feelings are real and you deserve support. Talk to a doctor or a mental health professional. If you are in distress, please reach out to a crisis helpline.
Prevention
There is no known way to prevent PCOS because it is partly genetic. However, maintaining a healthy weight, staying active, and eating a balanced diet may help lower the risk of developing more severe symptoms or complications like diabetes and heart disease.
Complications
If left untreated
- Type 2 diabetes – because of insulin resistance
- High blood pressure and high cholesterol – increasing the risk of heart disease and stroke
- Endometrial cancer (cancer of the lining of the womb) – because of irregular periods, the womb lining can build up and become abnormal
- Infertility (difficulty getting pregnant)
- Sleep apnoea – a condition where breathing stops and starts during sleep
- Depression and anxiety
Long-term outlook
With the right care and lifestyle changes, most women with PCOS can manage their symptoms and lead a healthy life. Many women are able to get pregnant with treatment, and the risks of long-term problems can be greatly reduced. It is a condition that you can live well with – take it one step at a time, and do not hesitate to ask for help.
Find support
International organisations
Local organisations
- NHS (UK) – PCOS ↗ · United Kingdom
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.