Polycystic Ovary Syndrome
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What are the symptoms of PCOS?
Symptoms of PCOS often start during your late teens or early 20s. Symptoms can vary but can include:
- Excess hair growth (hirsutism), which is usually on the face, chest, buttocks or back
- Weight gain
- Hair loss on the scalp or thinning hair
- Acne
- Oily skin
- Irregular periods or no periods
- Challenges with getting pregnant because of absent or irregular ovulation
- Tiny flaps of skin (skin tags) in the armpits or neck
- Areas of darker, thickened skin in body folds
If you have PCOS, you might have all or just some of the above symptoms. Your symptoms can range from mild to severe. If you have any of the above symptoms or think you have PCOS, make sure to speak to your GP.
What are the features of PCOS?
Irregular periods
Irregular periods mean that your ovaries don’t release eggs regularly (this is called ovulation). This can make it hard to predict when your period will come.
Excess androgens
High levels of ‘male’ hormones in your body, called androgens, can cause physical signs like extra hair on your face or body.
Polycystic ovaries
Polycystic ovaries mean your ovaries are larger than normal and have many small fluid-filled sacs called follicles surrounding the eggs. Despite the name, these aren’t actual cysts. These follicles are underdeveloped sacs where eggs develop. In PCOS, these sacs often can’t release an egg, so ovulation doesn’t happen.
If you have at least 2 of these features, you might be diagnosed with PCOS. It’s hard to know exactly how many women have PCOS, but it’s thought to be very common, affecting about 1 in every 10. More than half of people with PCOS don’t have any symptoms, so they might not even know they have it.
What causes PCOS?
The exact cause of PCOS isn’t fully understood, but it’s thought to be related to a combination of hormonal imbalances and genetic factors. Many women with PCOS have imbalances in certain hormones.
Insulin resistance
Insulin is a hormone that helps control the amount of sugar in your blood. When your body doesn't respond well to insulin, it makes extra insulin. This extra insulin can cause the ovaries to produce more testosterone, a hormone that can affect how your ovaries work and stop normal ovulation (when your body releases eggs).
Prolactin
Some women with PCOS have higher levels of prolactin, a hormone that helps make milk during pregnancy.
These hormone changes might start in the ovaries, other hormone-producing glands or the brain.
Genetic factors
PCOS can run in families. If your mother, sister or aunty has PCOS, you might be more likely to get it too. Research is still ongoing into the exact genes that cause PCOS.
High testosterone
Women with PCOS often have higher levels of testosterone, which can cause problems like extra hair growth and acne.
Sex hormone-binding globulin (SHBG)
This protein binds to testosterone and lowers its effect. Having low levels of SHBG can cause more symptoms of PCOS.
Luteinising hormone (LH)
LH hormone helps with ovulation, but too much of it can affect the ovaries.
Getting diagnosed with PCOS
If you think you might have PCOS, it’s important to speak to your GP. Here’s how the diagnostic process works:
Diagnosis criteria
To be diagnosed with PCOS, your doctor will look for at least two out of these three signs:
- Irregular periods
- High levels of ‘androgens’ like testosterone which could be shown by a blood test or by physical signs like excess hair growth
- Polycystic ovaries which could be shown on an ultrasound scan
You don’t need to have an ultrasound scan to be diagnosed with PCOS if you have the other two signs.
Hormone tests
Your doctor may arrange some hormone tests. These tests can help to see if there are any hormonal imbalances and if they’re caused by PCOS or another condition. You might also be offered a blood test to check for diabetes or high cholesterol.
Talking to your doctor
Your GP might ask about your symptoms, and rule out other possible causes of your symptoms.
Being referred to a specialist
If you’re diagnosed with PCOS, your GP might offer you treatment or refer you to a specialist like a gynaecologist (a doctor who treats female reproductive system conditions) or an endocrinologist (a doctor who treats problems with hormones).
Ultrasound scan
In some cases, your doctor might suggest an ultrasound scan. This scan can show if you have a high number of follicles in your ovaries. Follicles are small fluid-filled sacs where eggs develop.
Treating PCOS
PCOS can’t be cured, but there are many ways to manage the symptoms. Lifestyle changes, medicines and support from your doctor can help you to control PCOS.
Medicines
There are different medicines available which can help to treat the symptoms of PCOS.
Being a healthy weight
Losing 5% of your body weight can make a difference to your PCOS symptoms. Eating a balanced diet with fruit, vegetables, whole grains, lean meats and fish can help. Doing regular exercise is also important.
Irregular periods or absent periods
Some oral contraception pills or progesterone-only tablets can help with making your periods regular. These can also reduce the risk of developing cancer of the womb lining.
In vitro fertilisation (IVF)
If medicines don’t help you to get pregnant, you might be offered IVF. This involves fertilising eggs outside the womb and then placing them back in.
Hair loss & unwanted hair growth
Some oral contraception pills can help with excess hair growth and hair loss. There are also creams available that can slow down unwanted facial hair.
It’s important to let your doctor know if you’re trying to get pregnant as some medicines won’t be suitable for you.
Difficulties with fertility
There are medicines that can help you ovulate if you’re trying to get pregnant. You can speak to your doctor for more advice if you want to get pregnant.
Surgery
For fertility problems that don’t respond to medicine, a surgery called laparoscopic ovarian drilling might help. This surgery uses heat or a laser to destroy the tissue in the ovaries that produce male hormones. This can help to restore normal ovary function.
PCOS related products
Living with PCOS
Living with PCOS can be challenging, but with advice and support, you can manage it well. PCOS can cause changes in your body and how you feel about yourself. It can also make getting pregnant harder. These things can lead to stress and feeling down.
Weight, extra hair & body image
Many women with PCOS gain weight, which can make them feel less confident about their bodies. It’s important to remember that this is common and you’re not alone. Eating healthy foods and exercising can help manage your weight and make you feel better. Talking to friends, and family, or seeking counselling can also help you feel more positive about your body.
Extra hair on the face or body can be another challenge of PCOS. This can affect how you feel about yourself. There are treatments to help manage extra hair, and it can be helpful to talk to a doctor about your options.
Sometimes, people with PCOS might feel judged because of symptoms like extra hair or weight gain. Learning more about PCOS and telling others about it can help reduce this judgment.
Feelings & social pressures
PCOS can make you feel anxious or sad.
It's important to talk about these feelings and not keep them to yourself.
Sharing your experiences with friends, and family, or seeking counselling can help you feel better.
Joining support groups can connect you with others who understand what you’re going through.
Complications of PCOS
Having PCOS can increase your chances of developing other health problems as you get older.
Women with PCOS who have very irregular periods (less than three or four periods a year) for many years have a higher risk of developing cancer of the womb lining (endometrial cancer). However, it’s important to know that the chance of getting this type of cancer is still small.
Treatments that help to regulate your periods can help to reduce this risk.
While having PCOS can increase the risk of certain health issues later in life, many of these risks can be managed with lifestyle changes and treatments.
PCOS can increase your chances of developing high blood pressure and high cholesterol.
Both of these conditions can lead to heart disease and stroke. Having a healthy diet and exercise can help keep your heart healthy.
If you’re diagnosed with PCOS, your doctor might suggest annual blood pressure checks to help make sure it’s staying within a healthy range.
Being pregnant with PCOS can come with some extra risks, but you are still able to have a healthy pregnancy with care and support. Women with PCOS have a higher chance of developing some conditions during pregnancy like:
- High blood pressure – this is also known as pregnancy-induced hypertension. This can be monitored and managed by your healthcare team
- Pre-eclampsia – this condition involves high blood pressure and can be serious, but regular check-ups can help to catch it early
- Type two diabetes – your doctor will screen for gestational diabetes by 20 weeks to help manage your blood sugars
- Premature birth – this means the baby is born before 37 weeks, but with prenatal care, the risks can be managed
If you’re pregnant and you have PCOS, your midwife and doctor will keep a close eye on you to help prevent and manage any complications.
Women with PCOS have a higher risk of developing type two diabetes. This is a long-term condition where your blood sugar levels become too high.
Managing your weight, eating a healthy diet and staying active can help to lower this risk.
The symptoms of PCOS, like weight gain, excess hair growth, and fertility issues, can affect your confidence and self-esteem, which might lead to low moods and mood swings.
It’s important to talk about your feelings with friends, family, or a healthcare professional. Support and treatment can make a big difference to how you feel.
If you’re overweight, you might be at risk of developing sleep apnoea, a condition that causes interrupted breathing while you’re asleep. This can lead to a reduced sleep quality and feeling tired during the day.
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Frequently Asked Questions
Symptoms of PCOS include:
- Irregular periods or having no period at all
- Difficulty getting pregnant. This could be because of irregular ovulation or not ovulating
- Excess hair growth, usually on the face, chest, back or buttocks
- Weight gain
- Thinning hair or hair loss from the head
- Oily skin
- Acne
Some people with PCOS may only experience a small number of these symptoms, and they can also vary from mild to severe. If you do notice any symptoms of PCOS, it’s likely to be during your late teens or early 20s, however PCOS can affect people at any point in their child-bearing age.
We’ve covered more on symptoms of PCOS in the ‘Symptoms’ section of the page.
Living with PCOS can bring about various physical and emotional experiences, but understanding what to expect can help you feel more in control and less alone. We’ve covered more on this in the ‘Symptoms’ section of the page.
PCOS is something you might have for a long time, and while there isn’t a cure, the great news is that many of the symptoms can be managed and improved with the right lifestyle changes and medications. With the right support and care, you can feel much better and live a healthy life despite having PCOS. We’ve covered more on this in the ‘Treating PCOS’ section of the page.
PCOS can usually be diagnosed after other possible causes of your symptoms have been ruled out. If you have at least 2 of the following 3 signs, your doctor might diagnose you with PCOS:
- Your periods are irregular or you don’t have them at all, which could mean that your ovaries aren’t releasing eggs regularly
- Blood tests show higher levels of "male hormones" like testosterone, or you have signs of these hormones being higher, even if your blood test looks normal
- Scans show polycystic ovaries
Remember, you only need to have 2 of these signs to be diagnosed with PCOS, so you might not always need an ultrasound scan. It's good to know that your doctor has several ways to help figure out what's going on and get you the right support.
We’ve covered more of this in the ‘Getting diagnosed with PCOS’ section of the page.
PCOS doesn’t usually go through “stages” like some other conditions. Instead, it shows up in different ways, and the symptoms can change over time. These symptoms might be severe or mild depending on things like your age, weight, how active you are, and what treatments you’re using.
It’s important to know that PCOS affects everyone differently, and with the right care, many of the symptoms can be managed well.
A ‘PCOS belly’ usually refers to weight gain that can happen around the midsection for some people with PCOS. This type of weight gain is sometimes called "abdominal" or "central" weight gain, and it might look like having extra fat around your belly area.
It's important to remember that everyone’s body is different, and not everyone with PCOS will have the same experience with weight. The good news is that with a healthy lifestyle, including balanced eating and regular exercise, managing this kind of weight gain is possible. You're not alone, and there are many ways to support your health if you're dealing with this.
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