PCOS symptoms procedure preparation

Overview

Polycystic ovary syndrome, usually called PCOS, is a common hormone condition that affects how the ovaries work. In PCOS, the ovaries may produce extra male-type hormones, and eggs may not be released regularly. This can lead to irregular periods, acne, extra hair growth, and sometimes difficulty getting pregnant.

Yes, PCOS is very common. It affects about 1 in 10 to 1 in 5 women and people assigned female at birth of reproductive age around the world, depending on the criteria used.

PCOS most often starts during the teenage years or young adulthood, but it can be diagnosed at any age after puberty. It affects people of all ethnicities and body sizes. It is more likely if a close family member has PCOS or related conditions like type 2 diabetes.

Symptoms

Common symptoms

• Irregular periods, missed periods, or no periods at all
• Heavy or prolonged menstrual bleeding
• Extra hair on the face, chest, back, or abdomen
• Thinning hair on the scalp
• Acne, oily skin
• Weight gain, especially around the belly, or trouble losing weight
• Darkened, thick patches of skin along the neck, armpits, or under the breasts (called acanthosis nigricans)
• Small, painless cysts (fluid-filled sacs) in the ovaries, seen on an ultrasound

Symptoms in children

• Early or unusually heavy pubic hair growth
• Early onset of body odor
• Oily skin and acne
• Irregular or late-starting periods
• Rapid weight gain that seems out of line with normal growth

Symptoms in older adults

• PCOS symptoms may change after menopause, but people may still have health risks linked to the condition, such as high blood sugar and heart disease.
• Menstrual symptoms no longer occur after menopause, but unwanted hair growth and metabolic issues may continue or even worsen.
• Older adults with PCOS may have a higher chance of type 2 diabetes and high blood pressure and should stay in regular care.

Causes

Main causes

• The exact cause of PCOS is not fully understood, but it is linked to a combination of genetic and environmental factors.
• Many people with PCOS have insulin resistance, meaning the body's cells are less responsive to insulin. This causes the body to produce extra insulin, which can boost androgen production.
• Low-grade inflammation is common in PCOS and can contribute to hormone imbalance and insulin resistance.
• Hormonal signals from the brain that control ovulation may be disrupted, causing irregular periods.

Risk factors

• Family history – having a mother, sister, or aunt with PCOS increases the risk
• Being overweight or having obesity, especially with extra fat around the waist
• Insulin resistance or type 2 diabetes
• Metabolic syndrome (high blood pressure, high blood sugar, and unhealthy cholesterol)
• Being born to a mother with gestational diabetes
• Early puberty before age 12

When to see a doctor

See a doctor urgently if:

• If you have severe belly or pelvic pain, call your local emergency number immediately.
• If you are bleeding heavily and feel faint, dizzy, or short of breath, seek urgent care.
• If you have sudden swelling, pain, or redness in one calf, get same-day medical attention.
• If you have diabetes and your blood sugar is very high with vomiting, nausea, or confusion, seek urgent care.

Book a routine appointment if:

• See your healthcare provider if you have irregular periods, especially if they come less often than every 35 days, if you have gone more than 3 months without a period, or if you have trouble getting pregnant.
• Talk to a doctor if you notice excess hair growth, severe acne, or unexplained weight gain.
• Even if you feel fine, if you have PCOS, it is important to have regular check-ups to monitor for long-term risks like diabetes and heart disease.

Diagnosis

There is no single test for PCOS. A doctor usually makes the diagnosis after asking about your symptoms, performing a physical exam, and checking your hormone levels. The condition is often diagnosed if you have at least two of these three signs: irregular periods, high androgen levels (shown by symptoms or blood tests), and polycystic ovaries on an ultrasound.

Tests that may be done

• A detailed discussion of your menstrual history, symptoms, and family history
• A physical exam to check for excess hair, acne, weight gain, and other physical signs
• Blood tests to check hormone levels, including testosterone and other androgens
• Blood sugar and cholesterol tests to check for insulin resistance or risk of diabetes
• An ultrasound of the pelvis to look for cysts in the ovaries and to see the thickness of the lining of the uterus
• Some doctors may recommend a pregnancy test if periods have stopped

What to expect at your appointment

If your doctor recommends an ultrasound, you may be asked to arrive with a full bladder for one type of scan, or have an internal (vaginal) ultrasound that uses a small probe. You may also be asked to fast for 8 to 12 hours before a blood test for blood sugar and cholesterol. Before any procedure, your care team will give you clear instructions. It is a good idea to ask about preparation steps, such as fasting, in advance, and to let them know about any medicines you take, your allergies, and if you might be pregnant.

Treatment

Treatment for PCOS depends on your main concerns — such as regulating periods, managing symptoms like acne or hair growth, improving fertility, or reducing long-term health risks. Most treatment plans include a mix of lifestyle changes and medicines. Your healthcare provider will help you set goals and adjust your plan over time. If a procedure or surgery is needed, your care team will explain the steps to prepare, including any fasting or medication adjustments.

Self-care at home

• Keep a calendar or phone app to track your periods, symptoms, and weight changes.
• Build a regular eating and sleeping routine to help steady your blood sugar.
• Try stress-reducing activities like walking, deep breathing, yoga, mindfulness, or talking with friends.
• Write down questions and symptoms before your doctor visits so you can make the most of the appointment.
• If you are having a procedure, ask a friend or family member to accompany you and take notes on what the doctor says.

Medical treatments

Medicines are used to manage individual symptoms and long-term risks. For example, some medicines help regulate menstrual cycles or reduce excessive hair growth. Doctors may also recommend medicines that improve the body's response to insulin, which can help with many PCOS symptoms. Hormonal contraceptive methods are often used to regulate periods and protect the lining of the uterus, but they are not right for everyone. Fertility medicines may be considered if you are trying to conceive. All of these options should be discussed with your healthcare provider, who will explain possible benefits and risks. Your provider can also tell you whether any routine preparation is needed before starting a new medicine.

When is surgery considered?

Surgery is rarely the first treatment for PCOS. A minor surgical procedure called laparoscopic ovarian drilling may be used in some cases to help restore regular ovulation when medicines are not effective. This is done under general anesthesia through small incisions in the belly. Your surgical team will give you specific instructions on how to prepare, including fasting and stopping certain medicines, and what to expect during recovery.

Living with this condition

Living with PCOS involves building routines that support balanced hormones and overall health. This means keeping regular appointments, taking any prescribed medicines as directed, and being patient with yourself because symptoms can take time to improve. Structuring your days with consistent meal times, physical activity, and enough sleep can make a big difference. It is also helpful to track how you feel so you can discuss patterns with your doctor.

Lifestyle tips

• Move your body regularly – aim for 30 minutes of moderate exercise most days, like brisk walking, cycling, swimming, or dancing.
• Make small, lasting changes to your eating habits rather than trying a strict diet.
• Prioritize sleep and try to go to bed and wake up at the same time each day.
• Limit alcohol and sugary drinks, as they can affect blood sugar and hormone levels.
• Quit smoking if you smoke – ask your pharmacist or local health service for help.

Diet and exercise

There is no single 'PCOS diet,' but a balanced, whole-food approach is often recommended. Eating plenty of vegetables, fruits, lean proteins, whole grains, and healthy fats can help control blood sugar and improve insulin sensitivity. Try to pair carbohydrates with protein and fiber to slow down sugar absorption. Regular exercise, especially a mix of aerobic activity (like walking or jogging) and strength training, can lower insulin levels and help with weight management. Even a small weight loss of 5% to 10% of body weight may improve periods and other symptoms. Always check with your doctor before starting a new exercise routine, especially if you have other health conditions.

Mental health and emotional wellbeing

Living with PCOS can affect your mental health. Many people experience frustration, sadness, anxiety, low self-esteem, or depression because of symptoms like irregular periods, weight changes, unwanted hair, and difficulty getting pregnant. It is completely normal to have these feelings, and you deserve support. Talk with your healthcare provider about mood changes, and consider seeing a therapist or counselor. Stress management activities, support groups, and spending time with people who understand can all help. Remember that you are more than your diagnosis.

Prevention

PCOS itself is not completely preventable because it is linked to genetics and hormones. However, keeping a healthy body weight, staying physically active, and managing blood sugar can reduce the severity of symptoms and may lower the chance of developing long-term health problems like diabetes and heart disease. Early diagnosis and treatment can also prevent some complications.

Screening programmes

Screening is not used to diagnose PCOS, but if you have PCOS, your doctor will regularly screen you for related conditions. This includes checking blood pressure, blood sugar, cholesterol, and sometimes a test for sleep apnea or depression. Regular gynecological examinations may also be recommended to monitor the lining of the uterus, especially if you have infrequent periods. Ask your healthcare provider how often you should have these checks.

Complications

If left untreated

• Irregular periods can cause the lining of the uterus to grow thick, increasing the risk of endometrial cancer over time.
• Higher risk of type 2 diabetes and prediabetes due to insulin resistance.
• Higher risk of high blood pressure, high cholesterol, and heart disease.
• Increased likelihood of sleep apnea, a condition where breathing stops briefly during sleep.
• Difficulty getting pregnant and a higher chance of complications during pregnancy.
• A higher rate of depression and anxiety if symptoms are not managed.

Long-term outlook

With the right treatment and self-care, most people with PCOS can manage their symptoms well and greatly reduce long-term risks. Many people become pregnant with treatments, and you can live a full, healthy, and active life. There is no reason to feel hopeless. Regular check-ups, open conversations with your doctor, and support from loved ones can make a real difference. You are not alone.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.