Polycystic Ovary Syndrome: Symptoms & Diagnosis

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects women of reproductive age. It’s a complex condition, but understanding it is the first step toward managing it and taking control of your health.

This guide breaks down the essentials of PCOS, from its symptoms and diagnosis to the various ways you can manage the condition and improve your quality of life.

What is Polycystic Ovary Syndrome?

PCOS is an endocrine disorder (a problem with the body’s hormone system). The name “polycystic ovaries” refers to the small, benign cysts that can form on the ovaries, visible during an ultrasound. These “cysts” are actually follicles (fluid-filled sacs) that haven’t matured enough to release an egg.

The key hormonal imbalance in PCOS often involves:

• Androgens (Male Hormones)

  Women with PCOS often have higher-than-normal levels of androgens, such as testosterone. This excess can interfere with ovulation and cause symptoms like excess hair growth and acne.

• Insulin

  Many women with PCOS have insulin resistance. This means their body doesn't use insulin effectively, which then signals the ovaries to produce more androgens.

• Luteinising Hormone (LH) and Follicle-Stimulating Hormone (FSH)

  The balance between these hormones is often disrupted, leading to irregular or absent ovulation.

In simple terms: PCOS is a hormonal mix-up that prevents the ovaries from working normally, leading to irregular periods and other symptoms.

PCOS Symptoms: What To Look Out For

PCOS symptoms can vary wildly from one woman to the next. You may have one or two mild symptoms, or you might experience several that are more severe. Symptoms often become noticeable around the time of puberty but can develop later in life.

PCOS Symptoms Checker

Try our free PCOS symptom quiz. Simply select yes or no for the symptoms you’re experiencing and we’ll help you understand if PCOS might be the cause.

Note: This quiz is for educational purposes only and will not diagnose perimenopause.

Please enable JavaScript in your browser to complete this form.

Are your periods irregular or infrequent (more than 35 days between periods)? *

• Yes
• No

2. Do you have unwanted hair growth? (excessive hair growth around the face, chest, back or buttocks) *

• Yes
• No

3. Do you have hair loss or thinning on your head? *

• Yes
• No

4. Do you have consistently bad skin? (oily skin or acne) *

• Yes
• No

5. Do you have difficulty controlling your weight? *

• Yes
• No

6. Are you experiencing fertility issues? (difficulty conceiving) *

• Yes
• No
• Not trying to conceive

Submit results

Results from our PCOS Quiz

Data from our PCOS quiz shows that nearly 60% of women are struggling with the outward, metabolic indicators of the condition. The two most frequently reported symptoms were Unwanted Hair Growth (59.5%) and Difficulty Managing Weight (59.0%), highlighting the prominence of these issues.

Following closely behind, a significant portion of respondents—between 43% and 45%—reported classic hormonal and menstrual indicators:

• Hair Loss (45.2%)
• Bad Skin (45.2%)
• Irregular or Infrequent Periods (42.9%)

The least reported symptom was Fertility Issues at 19.0%. While this is a common concern associated with PCOS, the high percentages across all other categories confirm that PCOS is a condition characterised by a wide range of hormonal and metabolic issues, not solely fertility challenges.

Getting a PCOS Diagnosis

Getting a definitive PCOS diagnosis can sometimes be a frustrating journey. Your doctor will likely use a set of criteria and rule out other causes of your symptoms.

Most doctors in the UK use the widely accepted Rotterdam Criteria. To be diagnosed with PCOS, you must have at least two out of the following three conditions:

1. Irregular or absent periods (Oligo- or Anovulation)

   Indicating that you aren't ovulating regularly (fewer than 8 periods per year).

2. Clinical or biochemical signs of excess androgens (Hyperandrogenism)

   Clinical: Observable signs like hirsutism (excess hair) or severe acne or Biochemical: High levels of androgens (like testosterone) found in a blood test.

3. High Anti-Müllerian Hormone (AMH) levels OR Polycystic Ovaries (PCO) on scan

   A high AMH level in the blood is now often used as an alternative marker for the numerous small follicles characteristic of PCOS. Historically, this was confirmed by pelvic ultrasound, which looks for 12 or more follicles in one or both ovaries.

Common Diagnostic Tests

PCOS and Fertility

One of the most concerning aspects of PCOS for many women is its impact on fertility.

PCOS is a leading cause of anovulatory infertility (infertility due to a lack of ovulation). Because the high levels of androgens disrupt the usual hormone cycle, the eggs often don’t mature fully and aren’t released. If an egg isn’t released, conception can’t happen.

Managing Fertility with PCOS

If you are struggling to conceive, there are several effective options available:

• Lifestyle Changes

  Achieving a healthy weight through diet and exercise can significantly improve ovulation for many women.

• Medication to Induce Ovulation

  Drugs like Clomiphene or Letrozole are commonly prescribed to stimulate the ovaries and trigger the release of an egg.

• Metformin

  Although primarily a diabetes drug, Metformin can help improve insulin sensitivity, which in turn can lower androgen levels and potentially restore regular ovulation.

• IVF (In Vitro Fertilisation)

  If medication isn't successful, IVF may be an option, where eggs are retrieved and fertilised outside the body.

Treatment Options and Lifestyle Changes

While there is no “cure” for PCOS, the condition can be effectively managed by tackling the underlying hormonal imbalances and the specific symptoms you experience.

1. Diet and Exercise

This is often the most important area to focus on, as it directly addresses insulin resistance, which is a core driver of PCOS for many women.

• Focus on Low Glycaemic Index (GI) Foods

  Low-GI foods release sugar slowly into the bloodstream, helping to stabilise blood sugar and reduce the demand for insulin. Think whole grains, oats, non-starchy vegetables, and legumes.

• Balance Your Meals

  Include a source of lean protein (fish, chicken, beans) and healthy fats (avocado, nuts, seeds) with every meal to keep you feeling full and manage blood sugar.

• Regular Exercise

  Aim for a combination of cardio (like walking or running) and strength training. Exercise improves your body’s sensitivity to insulin, making it more effective.

• Aim for Sustainable Weight Loss

  Even a modest weight reduction of 5-10% of your body weight can significantly improve symptoms like menstrual regularity and ovulation.

2. Medical Treatments for Symptoms

3. Key Supplements for PCOS Support

While supplements are not a direct replacement for lifestyle changes or prescribed medication, recent research highlights that specific micronutrients can play a crucial role in supporting the body’s hormonal and metabolic balance^[1].

• Inositols (Myo- and D-Chiro-Inositol

  These are perhaps the most well-researched supplements for PCOS. They act as "insulin sensitizers" by helping your cells use insulin more effectively. This can significantly reduce androgen levels, which may help regulate ovulation and improve symptoms like acne and hair growth.

• Vitamin D

  Many women with PCOS are deficient in Vitamin D. Adequate levels are vital for immune function and have been linked to improvements in metabolic markers and menstrual regularity in women with the syndrome.

• Magnesium

  Often recommended to help with blood sugar regulation, as it plays a role in insulin signalling. It may also assist with mood and sleep quality.

• Omega-3 Fatty Acids (Fish Oil)

  These are great for reducing chronic, low-level inflammation often associated with PCOS and can help improve insulin sensitivity and cholesterol levels.

Long-Term Health Risks of PCOS

PCOS isn’t just a collection of symptoms; it’s a chronic condition that, if left unmanaged, can increase the risk of other health problems later in life. Knowing these risks is crucial for proactive management.

A Note on Mental Health and Emotional Wellbeing

Living with PCOS can be incredibly challenging. The physical symptoms, like weight gain, acne, and excess hair, can deeply impact self-esteem and body image. The uncertainty of fertility struggles adds significant stress.

• Talk to others: Connect with support groups, either online or in person. Sharing experiences can be incredibly validating.

• Seek professional help: A counsellor or therapist can provide strategies for coping with anxiety, depression, or body image issues.

• Practice self-compassion: Remember that PCOS is a medical condition, not a failure of will. Be kind to yourself as you navigate your journey.

Frequently Asked Questions