Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is the most common hormonal condition affecting women.

The main problems experienced may include:

Irregular or absent periods
Difficulty getting pregnant (infertility)
Problems managing weight (often weight gain)
Skin issues such as acne
Unwanted hair growth on the face and body

Not everyone with PCOS will have all of these symptoms. However, symptoms can become more noticeable or worsen if weight continues to increase.

Losing weight often helps improve symptoms. It can also help to regulate periods and may restore fertility.

How can you diagnose polycystic ovary syndrome?

If you have more than one of the symptoms listed above and PCOS is suspected, your healthcare professional will take a blood test to check your reproductive hormone levels.

An ultrasound scan to look at the appearance of your ovaries can also help confirm the diagnosis.

Does PCOS mean I have abnormal cysts on my ovaries?

Despite the name, polycystic ovary syndrome (PCOS), does not mean you have abnormal ovarian cysts.

The ovaries naturally contain many small cyst‑like sacs called follicles, which hold immature eggs. These small follicles do not cause pain or problems by themselves.

In women without PCOS, one follicle becomes the “leading follicle” each month. It grows gradually until ovulation, when the egg is released.

Women with PCOS have many small follicles on the surface of each ovary. Because of the hormone imbalance, these follicles do not grow and develop in the normal monthly cycle.

If you are trying to get pregnant, this can cause difficulties because ovulation may not happen regularly, or may not happen at all. As a result, your periods may be irregular or infrequent.

Is PCOS dangerous to my health?

The follicular cysts in PCOS are very small, less than 5 mm in size. They do not need to be removed and they do not increase the risk of ovarian cancer.

However, women who have infrequent or absent periods are at risk of the lining of the womb (the endometrium) becoming too thick.

If the endometrium is not shed regularly, abnormal cells can develop over time. These changes may eventually become pre‑cancerous.

To reduce this risk, women with PCOS who do not have periods should take a tablet called medroxyprogesterone two or three times a year. This helps ensure that the lining of the womb is shed occasionally. Your healthcare professional will advise you about this.

If you are overweight or obese, it is very important to try to lose weight by eating a healthy diet and taking regular exercise. Weight loss can help reduce many unwanted symptoms of PCOS and also lower your risk of developing conditions such as diabetes, heart problems and high blood pressure, which are more common in overweight women with PCOS.

Is PCOS hereditary?

PCOS often runs in families, and there is some evidence that it may have a genetic cause. Symptoms usually appear after puberty or after weight gain, although not all women with PCOS gain weight or are overweight.

Slim women can also have PCOS and may still experience the other symptoms of the condition, such as irregular or absent periods and difficulty getting pregnant.

Is there any treatment for PCOS?

PCOS itself cannot be “cured,” but some medications can help improve certain symptoms, such as:

excess body hair
acne

These medicines cannot be prescribed if you are trying to get pregnant because they may harm a developing baby.

If you are having difficulty conceiving then a number of options may be available to you, usually starting with simple (but effective) medication. Your healthcare professional will be able to advise which is the most appropriate for you.