PCOS symptoms specialist tests overview

Overview

Polycystic ovary syndrome, or PCOS, is a common condition that affects how a woman's ovaries work. It is a hormone problem where the body makes too much of a male hormone called androgen. This can cause irregular periods, excess hair growth, and difficulty getting pregnant.

Yes, PCOS is very common. It affects about 1 in 10 women of childbearing age. It is the most common cause of irregular periods and a leading cause of infertility.

PCOS mainly affects women and those assigned female at birth. It usually starts during the teenage years or early adulthood. It can affect people of all ethnicities, but some groups may have a higher risk.

Symptoms

Common symptoms

• Irregular or absent periods – you may have fewer than 8 periods a year, or none at all.
• Excess hair growth on the face, chest, back, or stomach (hirsutism).
• Acne or oily skin, especially on the face, chest, and upper back.
• Thinning hair on the scalp or male-pattern baldness.
• Weight gain or difficulty losing weight.
• Dark, thick patches of skin on the neck, armpits, or under the breasts (acanthosis nigricans).
• Difficulty getting pregnant (infertility) due to irregular ovulation.

Symptoms in children

• Early signs may include early puberty, such as early breast development or pubic hair.
• Irregular periods soon after starting menstruation.
• Excess hair growth or severe acne during the teenage years.
• Rapid weight gain that is hard to control.

Symptoms in older adults

• In older women, symptoms may change. Periods may become more regular as menopause approaches.
• Excess hair growth and acne may lessen with age.
• After menopause, the risk of other health problems, like diabetes and heart disease, may increase.

Causes

Main causes

• The exact cause of PCOS is not known, but it is linked to problems with hormones. The body makes too much androgen (male hormone), which can stop eggs from being released each month.
• Insulin resistance is another key factor. Many women with PCOS have trouble using insulin properly, which leads to higher insulin levels. High insulin can cause the ovaries to make more androgen.

Risk factors

• Having a family history of PCOS – if your mother, sister, or aunt has it, you are more likely to have it too.
• Being overweight or obese – excess weight can make insulin resistance worse.
• Having a condition called metabolic syndrome, which includes high blood pressure, high blood sugar, and high cholesterol.

When to see a doctor

See a doctor urgently if:

• If you have severe pelvic pain, heavy bleeding, or signs of a stroke or heart attack, call emergency services immediately.

Book a routine appointment if:

• If you have irregular periods – for example, if you go more than 35 days between periods for several months.
• If you are having trouble getting pregnant and have not had a period for months.
• If you notice excess hair growth or acne that bothers you.
• If you have risk factors like a family history of PCOS or type 2 diabetes.

Diagnosis

Doctors diagnose PCOS based on a combination of your symptoms, a physical exam, blood tests, and sometimes an ultrasound. There is no single test for PCOS. To be diagnosed, you usually need to have at least two of the three main features: irregular periods, high androgen levels, and polycystic ovaries on an ultrasound.

Tests that may be done

• Blood tests to check hormone levels, including testosterone and other androgens. Your doctor may also check for insulin resistance, blood sugar, and cholesterol.
• Pelvic ultrasound (sonogram) to look at your ovaries. The ultrasound uses sound waves to create a picture. It checks if your ovaries are enlarged and have many small cysts (polycystic appearance).
• Physical exam to check for signs of excess hair, acne, or skin changes.
• Sometimes a glucose tolerance test to see how your body handles sugar.

What to expect at your appointment

During your appointment, the doctor will ask about your periods, weight changes, and any symptoms. You may have a physical exam and blood drawn. An ultrasound is usually done in a radiology clinic; you may need a full bladder for the test. The whole process is not painful, and your doctor will explain each step. Results may take a few days to come back.

Treatment

Treatment for PCOS focuses on managing symptoms and reducing the risk of long-term health problems. The best treatment depends on your personal goals – whether you want to regulate your periods, reduce hair growth, improve fertility, or prevent diabetes. Lifestyle changes, such as a healthy diet and exercise, are often the first step. Medicines and other treatments can help with specific symptoms.

Self-care at home

• Eat a balanced diet rich in vegetables, fruits, whole grains, and lean protein. Limit sugary foods and refined carbohydrates.
• Get regular physical activity – at least 30 minutes of moderate exercise most days of the week. Exercise helps lower insulin levels and improve weight management.
• Maintain a healthy weight. Even losing 5% to 10% of your body weight can improve symptoms and make your periods more regular.
• Manage stress through relaxation techniques, yoga, or talking to a therapist.

Medical treatments

Depending on your symptoms, doctors may prescribe medicines to help regulate your menstrual cycle, reduce androgen levels, or improve fertility. These may include hormonal birth control (pills, patch, or ring) to make periods regular, metformin to improve insulin resistance, or medicines that help with ovulation if you are trying to get pregnant. Always discuss the risks and benefits with your healthcare provider.

When is surgery considered?

Surgery is rarely needed for PCOS. In some cases, a procedure called ovarian drilling (making small holes in the ovaries with a laser) may be considered if medicines do not help with ovulation. This is not a common treatment and is only done in specific situations.

Living with this condition

Living with PCOS means managing symptoms every day. You may need to track your periods, follow a healthy lifestyle, and keep up with regular check-ups. Many women find that small changes, like eating well and staying active, make a big difference. It helps to have a support system, whether it is family, friends, or a support group.

Lifestyle tips

• Stay active – try walking, swimming, or cycling. Exercise helps with weight and insulin resistance.
• Eat regular meals with plenty of fiber and protein. Avoid skipping meals, as that can affect blood sugar.
• Get enough sleep – aim for 7 to 9 hours each night. Poor sleep can make insulin resistance worse.
• Limit alcohol and avoid smoking, as these can worsen symptoms and increase health risks.

Diet and exercise

A healthy diet and regular exercise are at the heart of managing PCOS. Focus on whole foods and limit processed sugars. Include foods that help with insulin sensitivity, such as leafy greens, nuts, and berries. Exercise helps lower blood sugar and improve how your body uses insulin. Aim for a mix of aerobic exercise (like brisk walking) and strength training (like lifting weights).

Mental health and emotional wellbeing

PCOS can affect your mood because of hormone changes, difficulties with fertility, and body image concerns. Many women with PCOS experience anxiety or depression. It is important to talk to your doctor if you feel down or overwhelmed. Counseling, support groups, and sometimes medicines can help.

Prevention

There is no known way to prevent PCOS because its exact cause is not clear. However, maintaining a healthy weight and being active from a young age may help reduce the risk of developing severe symptoms. If you have a family history, staying alert to early signs can help you get treatment sooner.

Vaccines

There are no vaccines for PCOS.

Screening programmes

There is no routine screening test for PCOS. If you have symptoms or risk factors, talk to your doctor about being evaluated. Regular check-ups can also help catch related conditions like diabetes or high cholesterol early.

Complications

If left untreated

• Type 2 diabetes – insulin resistance can lead to high blood sugar and diabetes.
• High cholesterol and high blood pressure, which increase the risk of heart disease and stroke.
• Endometrial (uterine) cancer – if you have very few periods, the lining of the uterus can build up and increase cancer risk.
• Infertility – difficulty getting pregnant without treatment.
• Sleep apnea – a condition where you stop breathing briefly during sleep, which is more common in women with PCOS.

Long-term outlook

With the right care, most women with PCOS can manage their symptoms and lead healthy, full lives. Treatment can help regulate periods, improve fertility, and reduce the risk of long-term health problems. It is important to work with your healthcare team and stay proactive about your health. Many women with PCOS go on to have children and live well.

Find support

Local organisations

• Verity – PCOS Charity (UK) · United Kingdom
• PCOS Awareness Association (USA) · United States

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