PCOS
Understanding PCOS
Polycystic Ovary Syndrome (PCOS) is a common hormonal condition affecting around 1 in 10 women in the UK. It involves an imbalance in reproductive hormones that can disrupt ovulation, cause irregular periods, and lead to symptoms like acne, excess hair growth, and fertility challenges.
Despite the name, not all women with PCOS have ovarian cysts. Diagnosis is usually based on a combination of symptoms such as irregular or absent periods, high levels of androgens (male hormones), and polycystic-appearing ovaries on ultrasound. Some women are diagnosed in their late teens or early 20s when symptoms like irregular cycles or skin changes first appear.
PCOS is closely linked with insulin resistance – a condition where the body struggles to respond properly to insulin. This can lead to weight gain, difficulty losing weight, and increased androgen production, which worsens symptoms. Many women with PCOS also have a family history of diabetes or hormonal conditions, suggesting a genetic component.
Common signs include:
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Irregular or missed periods
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Excess facial/body hair (hirsutism)
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Persistent acne
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Weight gain, especially around the belly
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Thinning hair on the scalp
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Fatigue or mood changes
PCOS can also impact long-term health. Left unmanaged, it increases the risk of type 2 diabetes, high cholesterol, and endometrial cancer due to irregular shedding of the womb lining. Mental health can be affected too – anxiety and depression are more common among women with PCOS.
Although there is no cure, PCOS is manageable. Treatment depends on your symptoms and goals. Lifestyle changes like a balanced diet, regular exercise, and maintaining a healthy weight can make a significant difference. Medication may be used to regulate periods, reduce androgens, or support fertility. If pregnancy is a goal, ovulation-inducing drugs or IVF may be considered.
Getting support early can reduce long-term risks and help you take control of your health. Whether it’s about skin, mood, periods or fertility, PCOS deserves attention – and treatment can help you feel more like yourself again.
Quick Facts, Big Impact
Prevalence in the UK
PCOS affects around 1 in 10 women in the UK, making it a leading cause of hormone-related health issues. Despite its prevalence, over half of women with PCOS may be undiagnosed, especially if their symptoms are mild or overlooked. It commonly emerges during the teenage years or early twenties and is a frequent cause of fertility challenges in young women. In total, it’s estimated that more than 3 million women in the UK are currently living with PCOS.
Diagnosis Delays
Because PCOS symptoms overlap with many other conditions, diagnosis is often delayed. Women may first seek help for individual concerns—like acne, irregular periods, or weight gain—before the link to PCOS is made. On average, it can take 1–2 years to receive a diagnosis, and some women may see several GPs or specialists before the condition is recognised. The NHS uses the “Rotterdam criteria” to diagnose PCOS, requiring at least two of the following: irregular periods, signs of high androgens (e.g. excess hair), or polycystic ovaries on ultrasound.
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Common Causes
The exact cause of PCOS is unclear, but it’s thought to involve a combination of hormonal imbalance, insulin resistance, and genetics. Women with PCOS often produce higher-than-normal levels of androgens (male hormones), which can disrupt ovulation. Obesity and family history may worsen the condition or increase risk.
Treatment Options
There’s no single cure, but many effective treatments exist. Lifestyle changes—such as balanced eating, weight management, and regular exercise—are first-line approaches and can significantly improve symptoms. To regulate periods and reduce androgen levels, GPs often prescribe the combined oral contraceptive pill. Metformin, a diabetes medication, is also used to improve insulin sensitivity and may help restore ovulation. For women trying to conceive, medications like clomifene or letrozole can stimulate egg release. In some cases, a keyhole surgery called ovarian drilling may be recommended. Long-term care includes monitoring for diabetes and cardiovascular risks. NHS care is typically coordinated between GPs, endocrinologists, and fertility or dermatology specialists.
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