PCOS symptoms day of procedure tips

Overview

PCOS, or polycystic ovary syndrome, is a common hormonal condition. People with PCOS have higher levels of a hormone called androgen, which can affect how the ovaries work. This can lead to irregular periods, extra hair growth, acne, and sometimes small fluid-filled sacs (cysts) on the ovaries. PCOS affects many parts of the body, not just the ovaries.

Yes. PCOS is one of the most common hormone problems in people of reproductive age. It can affect anyone with ovaries, no matter their background or lifestyle.

PCOS usually starts during the teenage years or early adulthood. It affects people who have ovaries, including women, transgender men, and non-binary people.

Symptoms

Common symptoms

• Irregular, missed, or very heavy periods
• Excess hair growth on the face, chest, or back
• Acne, especially on the face, chest, and back
• Weight gain or trouble losing weight
• Thinning hair or hair loss on the head
• Darkened patches of skin, often on the neck, groin, or under the breasts

Symptoms in children

• For young people who have started periods, symptoms may include periods that stay irregular for more than two years after the first one.
• Some teens have severe acne or early pubic hair growth before periods even begin.

Symptoms in older adults

• As people age, periods may become more regular, but metabolic changes like higher blood sugar and cholesterol can become more noticeable.
• Excess hair and acne may improve, but other health risks increase if PCOS is not managed.

Causes

Main causes

• The exact cause of PCOS is not known, but it often runs in families, suggesting a genetic link.
• Insulin resistance is common in PCOS. This means the body doesn't use insulin well, which can raise blood sugar and lead to more androgen production.
• Low-grade inflammation may also play a role, as it is linked to insulin resistance.

Risk factors

• Having a parent or sibling with PCOS
• Overweight or obesity, which can worsen insulin resistance
• A history of prediabetes or type 2 diabetes
• A sedentary lifestyle or a diet high in processed foods

When to see a doctor

See a doctor urgently if:

• Call your local emergency number if you have severe pelvic pain, very heavy bleeding, or signs of a heart attack or stroke.
• If you have thoughts of harming yourself, contact a crisis or emergency service right away.

Book a routine appointment if:

• If your periods are irregular, very heavy, or you haven't had a period in months
• If you have acne, excess hair growth, or hair thinning that bothers you
• If you are trying to get pregnant and it has taken longer than expected
• If you have PCOS and are scheduled for any medical procedure, review your medications and symptoms with your doctor beforehand

Diagnosis

A healthcare provider will ask about your symptoms, periods, and medical history. They may also do a physical exam to check for signs like acne, excess hair, or weight changes. Doctors usually look for at least two of three main signs: irregular periods, high androgen levels (from blood tests or physical signs), and polycystic ovaries on an ultrasound.

Tests that may be done

• Blood tests to check hormone levels, including testosterone and other androgens
• Blood sugar and insulin tests to screen for insulin resistance or diabetes
• Pelvic ultrasound, which uses sound waves to look at your ovaries

What to expect at your appointment

There is no single test that confirms PCOS. It may take a couple of visits and some blood work. Your doctor will also check for other conditions that can cause similar symptoms, like thyroid problems or high prolactin.

Treatment

Treatment for PCOS focuses on your specific symptoms and goals, not a one-size-fits-all plan. It may include lifestyle changes, medicines to help with insulin or hormones, and fertility support if you want to become pregnant. If you have a procedure planned, your care team can adjust your usual treatment to keep you safe and comfortable on the day.

Self-care at home

• Aim for regular physical activity, like brisk walking or swimming, most days of the week.
• Focus on a balanced diet rich in vegetables, whole grains, and lean proteins.
• Try stress-reducing activities like yoga, deep breathing, or talking to a friend.
• Maintain a healthy weight. Losing even 5% of your body weight can improve symptoms.
• Get enough sleep to help keep blood sugar and moods stable.

Medical treatments

Medical options may include hormonal contraceptives to make periods more regular, medicines that help the body respond better to insulin, and treatments for acne and excess hair. If you are trying to conceive, your doctor may discuss fertility medicines. Always ask about the names, doses, and possible side effects of any treatment you receive. Never start or stop a medication without talking to your healthcare provider, especially around the time of a procedure.

When is surgery considered?

Surgery is rarely the first choice for PCOS. Sometimes, if ovulation is still irregular after trying medicines, a small operation called laparoscopic ovarian drilling may help. It is not a cure, but it can help with ovulation for some people. Your doctor will only recommend surgery if other options haven't worked and you have a clear medical reason.

Living with this condition

Living with PCOS often means checking in with your body. Tracking your periods, symptoms, and mood can help you and your doctor spot changes. If you have a procedure coming up — like an ultrasound, biopsy, or surgery — tell your care team about your PCOS ahead of time. On the procedure day, follow their instructions about eating, drinking, and taking your usual medicines. Because PCOS can affect blood sugar, fasting for a procedure might make you feel dizzy or shaky. Let staff know if you feel unwell and ask exactly what is safe to take that morning. It is also a good idea to have someone with you and to carry a list of your medicines and any allergies. If you have PCOS and prediabetes or diabetes, ask your doctor if you need special instructions for the procedure day.

Lifestyle tips

• Involve a partner, family member, or friend in your healthy routine for extra motivation.
• Try gentle activities like walking, cycling, or dancing — find what you enjoy.
• Plan meals that are simple, affordable, and satisfying without extreme diets.
• Keep a symptom diary to share with your healthcare provider at visits.

Diet and exercise

There is no special 'PCOS diet', but a balanced, lower-glycaemic approach can help with insulin resistance. This means choosing whole foods, including plenty of fibre, and having healthy fats in moderation. Regular exercise, even a brisk 30-minute walk five days a week, can improve how your body uses insulin, help with weight management, and boost your mood. Always talk to your healthcare team before making major diet or exercise changes, especially if you have other health conditions.

Mental health and emotional wellbeing

Living with PCOS can affect mental health. Many people feel self-conscious about symptoms like excess hair or weight gain, and the stress of irregular periods or fertility challenges is real. It's important to know you're not alone. Talking to a counsellor or joining a support group can help. If you ever have thoughts of self-harm or suicide, call your local emergency number or crisis helpline immediately.

Prevention

There is no known way to prevent PCOS because the exact cause is not yet understood. However, you can prevent or reduce some symptoms by keeping a healthy weight, staying active, and eating well. Early diagnosis and treatment also help prevent complications like type 2 diabetes and changes in the lining of the uterus.

Screening programmes

If you have PCOS, your doctor may recommend regular checks for type 2 diabetes, high blood pressure, and high cholesterol. You may also be offered an ultrasound to look at the lining of your uterus if your periods are very irregular, as this can lower the risk of endometrial changes.

Complications

If left untreated

• Type 2 diabetes or prediabetes
• High blood pressure and unhealthy cholesterol levels
• Infertility or difficulty getting pregnant
• Sleep apnea (paused breathing during sleep) and poor sleep quality
• Endometrial hyperplasia or cancer, due to long periods without a shedding cycle

Long-term outlook

With early diagnosis and ongoing care, most people with PCOS live full, healthy lives. Symptoms can often be managed well with lifestyle choices and medical care. Even if PCOS affects your fertility, many people go on to have children with the help of supported treatments. The key is to stay engaged with your care team, follow your treatment plan, and always ask questions — especially before any procedure.

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