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Overview

Polycystic ovary syndrome (PCOS) is a common hormone condition that affects how a woman's ovaries work. It can cause irregular periods, extra male hormones, and small fluid-filled sacs (cysts) on the ovaries. PCOS is not just about ovarian cysts—it affects many parts of the body.

Yes, PCOS is very common. It affects about 1 in 10 women and people assigned female at birth during their reproductive years. Many women do not know they have it until they seek help for irregular periods or trouble getting pregnant.

PCOS mainly affects girls and women from their teenage years through to menopause. It is one of the leading causes of fertility problems. Anyone with ovaries can be affected, regardless of weight or background, although it is more common in certain groups.

Symptoms

Common symptoms

• Irregular, missed, or very light periods
• Heavy or prolonged periods when they do happen
• Excess facial or body hair (often called hirsutism)
• Acne, especially on the face, chest, or back
• Thinning hair or hair loss from the scalp
• Weight gain, especially around the waist
• Difficulty getting pregnant due to irregular ovulation
• Oily skin and dandruff

Symptoms in children

• In teenagers, irregular periods are common, but PCOS may be the cause if periods are very irregular beyond the first year or two.
• Severe acne, excess hair growth, or weight gain that seems unusual for your family history can be early signs.
• Teens with PCOS may also experience mood swings, anxiety, or low self-esteem related to their symptoms.

Symptoms in older adults

• After menopause, PCOS symptoms like irregular periods stop, but other health issues may remain.
• Older adults with PCOS may face higher risks of type 2 diabetes, high blood pressure, and heart disease.
• Excess hair or acne can persist, but they may become less bothersome with age. Regular health check-ups are essential.

Causes

Main causes

• The exact cause of PCOS is not fully understood, but it is linked to an imbalance of hormones, including higher levels of androgens (male-type hormones).
• Most people with PCOS have some degree of insulin resistance, which means the body does not use insulin well, leading to higher insulin levels.
• Genetics plays a role – PCOS tends to run in families.

Risk factors

• Family history of PCOS or type 2 diabetes
• Being overweight or having obesity
• Insulin resistance or prediabetes
• Sedentary lifestyle
• Diet high in refined carbohydrates and sugar

When to see a doctor

See a doctor urgently if:

• If you have severe pelvic pain, very heavy bleeding, or any of the emergency symptoms listed above, call emergency services or go to the nearest emergency department.
• If you have a fever with pelvic pain, see a healthcare provider the same day.

Book a routine appointment if:

• If you have irregular periods, especially if they are more than 35 days apart or fewer than 8 periods a year, make an appointment.
• If you have been trying to get pregnant for a year (or 6 months if you are over 35) without success, see your doctor.
• If you have excess facial hair, deep acne, or thinning hair and it bothers you, discuss it with a healthcare provider.
• If you have weight gain that is hard to control along with other possible PCOS symptoms, get a check-up.

Diagnosis

There is no single test for PCOS. Your doctor will listen to your symptoms, do a physical exam (including checking your blood pressure, weight, and sometimes signs of excess hair or acne), and then order blood tests and an ultrasound of your pelvis. To be diagnosed with PCOS, you usually need to have at least two of these three features: irregular periods, high androgen levels, or polycystic ovaries seen on ultrasound.

Tests that may be done

• Medical history and symptom review – this is very important
• Physical examination, including height, weight, and blood pressure
• Blood tests to check hormone levels (such as testosterone), blood sugar, cholesterol, and thyroid function
• Pelvic ultrasound (also called imaging or scanning) – a wand is moved over the abdomen or inside the vagina to look at your ovaries and the lining of your womb
• Sometimes a glucose tolerance test to check for insulin resistance

What to expect at your appointment

During the ultrasound, you may feel some discomfort when the probe is moved, but it is usually quick and safe. Results from blood tests and the ultrasound are not always available immediately. It is normal for results to take a few days to a week. While you wait, try to keep a diary of your symptoms and any questions you have. Your healthcare team will explain the results and what they mean for you at your follow-up appointment. If the waiting feels hard to manage, you can ask the clinic if there is a patient coordinator you can call.

Treatment

Treatment for PCOS is not a one-size-fits-all. It depends on what matters most to you at the time: regular periods, managing symptoms like hair or acne, improving fertility, or reducing long-term health risks. Treatment may include lifestyle changes, medicines, and sometimes tailored support for fertility. In all cases, a healthcare provider will work with you to create a plan that fits your personal goals and overall health.

Self-care at home

• Eat a balanced diet with plenty of vegetables, fruits, whole grains, and lean proteins
• Be physically active for at least 30 minutes most days – brisk walking counts
• If you are overweight, losing even 5–10% of your body weight can make a big difference in symptoms
• Get enough sleep – aim for 7–9 hours a night
• Manage stress with activities you enjoy, like reading, meditation, or talking with friends

Medical treatments

Medical treatment for PCOS is tailored to you. Your doctor may prescribe hormonal contraceptives or other hormone-based therapies to regulate your period, reduce androgen levels, and improve acne or hair growth. If you are trying to get pregnant, there are fertility medicines that can help you ovulate more regularly. For insulin resistance, a doctor may recommend a medicine that improves how your body uses insulin. Always ask your provider about the options, their benefits, and possible side effects. Do not start or stop any medicine without discussing it with your healthcare team.

When is surgery considered?

Surgery is rarely needed for PCOS. In some cases, a procedure called laparoscopic ovarian drilling (making a few tiny holes in the ovary) may be offered if fertility medicines have not worked and the person is trying to conceive. This can help restore ovulation in some women. Talk to your specialist about whether this is right for you.

Living with this condition

Living with PCOS means building sustainable habits that you can keep for life. This includes regular check-ups with your healthcare provider, staying on top of your blood pressure, blood sugar, and cholesterol, and noticing how your body feels. PCOS is not a single event – it is a lifelong condition, but many women manage it well with small steps each day.

Lifestyle tips

• Follow a regular routine for meals and sleep to help with insulin and hormone balance
• Move your body in ways you enjoy, not just for weight loss
• Try to sit less during the day – stand up, stretch, or walk every hour
• Limit sugary drinks and refined snacks – they can spike blood sugar and worsen symptoms
• Speak kindly to yourself – PCOS is not your fault

Diet and exercise

A Mediterranean-style diet, rich in vegetables, fruits, nuts, whole grains, and healthy fats like olive oil, is often recommended for PCOS. Protein from beans, fish, or chicken can help you feel full. Regular exercise, such as walking, cycling, or swimming, improves the way your body uses insulin and helps manage weight. It is more important to be consistent than to do intense workouts. A registered dietitian can help you create a plan that fits your life and preferences.

Mental health and emotional wellbeing

PCOS can affect how you feel about yourself. Excess hair, acne, and difficulty getting pregnant can cause stress, anxiety, and feelings of low self-worth. It is very common. If you feel this way, please talk to your healthcare provider about your mental health. Counselling, support groups, and sometimes medication (for anxiety or depression) can help. You deserve care for your emotional health as much as your physical health.

Prevention

There is no known way to prevent PCOS itself, but you can reduce the risk of complications by maintaining a healthy weight, being physically active, and following a balanced diet. If you have a family history of PCOS or diabetes, talk to your healthcare provider about ways to lower your risks.

Vaccines

There is no vaccine to prevent PCOS. However, keeping up to date with recommended vaccines is important because PCOS can increase the risk of conditions like diabetes, which can affect your immune system. Ask your doctor about which vaccines are right for you.

Screening programmes

If you have PCOS, regular screening is essential. This may include blood pressure checks, blood glucose (sugar) tests, cholesterol checks, and sometimes ultrasounds to monitor your ovaries or the lining of your womb. Early detection of changes helps prevent complications. There is no standard national screening for PCOS, but your doctor will recommend a schedule based on your personal health.

Complications

If left untreated

• Type 2 diabetes – because of insulin resistance
• High blood pressure and unhealthy cholesterol levels, which increase the risk of heart disease
• Sleep apnea – pauses in breathing during sleep, more common in women with PCOS
• Infertility – difficulty getting pregnant without medical help
• Cancer of the womb lining (endometrial cancer) – risk is slightly higher if periods are very infrequent, because the womb lining builds up without shedding
• Mood disorders like anxiety and depression

Long-term outlook

The outlook for PCOS is generally positive. Most people who receive proper care can manage their symptoms, improve their fertility, and reduce their risk of long-term health problems. While there is no cure, a combination of lifestyle changes and medical help works very well. You can lead a healthy, fulfilling life with PCOS, and the earlier you get support, the better your chances of preventing complications. Many women with PCOS go on to have successful pregnancies and enjoy good overall health.

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