Polycystic Ovary Syndrome
Polycystic ovary syndrome (PCOS) is a common hormonal condition that affects how the ovaries work. It can cause irregular periods, higher levels of certain hormones, and small fluid-filled follicles in the ovaries. PCOS often leads to symptoms such as acne, excess hair growth, difficulty losing weight, or challenges with fertility, though the condition can vary widely from person to person. With the right support and treatment, many people are able to manage symptoms effectively and improve their long-term health.
Overview | Symptoms & Causes | Diagnosis | Treatment Options
What is PCOS?
Polycystic ovary syndrome (PCOS) is a common hormonal condition that affects how the ovaries work. It is thought to affect around 1 in 10 people with ovaries and often begins during the teenage years or early adulthood.
The ovaries normally release an egg each month and produce hormones such as oestrogen and progesterone. In PCOS, the balance of these hormones becomes altered, and levels of androgen hormones (sometimes called “male hormones,” though everyone has them) may be higher than usual. This hormonal imbalance can affect ovulation, periods, skin, hair growth, and metabolism.
Despite the name, you don’t need to have ovarian cysts to have PCOS. When they are present, these “cysts” are not true cysts but small, harmless follicles that contain eggs which haven’t fully developed.
PCOS is a lifelong condition, but symptoms and severity vary widely. With the right support and treatment, most people are able to manage symptoms well and maintain good long-term health.
Understanding Polycystic Ovary Syndrome
PCOS can affect people differently - some experience only a few symptoms, while others notice many. Symptoms are caused by a combination of hormonal imbalance and irregular ovulation, and they can change over time.
Common symptoms include:
- Irregular or infrequent periods: Cycles may be shorter, longer, or unpredictable. Some people may have no periods for months at a time.
- Difficulty getting pregnant: Irregular or absent ovulation can make conception harder.
- Acne or oily skin: Often due to higher levels of androgen hormones.
- Excess hair growth (hirsutism): Typically on the face, chest, stomach, or back.
- Hair thinning on the scalp: Similar to male-pattern hair thinning.
- Weight gain or difficulty losing weight: Common but not universal.
- Darkened or thickened skin patches: Usually around the neck, armpits, or groin (known as acanthosis nigricans).
- Multiple small follicles on the ovaries: Seen on ultrasound, though not required for diagnosis.
- Mood changes: Anxiety, low mood, and body-image concerns can occur due to symptoms or hormonal effects.
Causes & Risk Factors
The exact cause of PCOS isn’t fully understood, but it is thought to result from a combination of hormonal and metabolic factors. These imbalances affect how the ovaries function, particularly ovulation.
| Hormonal imbalance | Higher androgen levels can disrupt ovulation and lead to symptoms such as acne or excess hair growth. |
| Insulin resistance | Reduced sensitivity to insulin increases insulin levels, which stimulates androgen production and contributes to irregular periods and difficulty ovulating. |
| Family history | PCOS often runs in families, suggesting a genetic influence. |
| Existing metabolic conditions | Insulin resistance and type 2 diabetes increase the likelihood of developing PCOS. |
| Higher body weight | Increased body weight can worsen insulin resistance and symptoms, though PCOS occurs in people of all body sizes. |
| Early hormonal patterns | Early puberty or long-standing irregular cycles may reflect underlying hormonal tendencies linked to PCOS. |
PCOS is a complex condition, and developing it is not your fault. Many of its risk factors are not within your control.
Diagnosing PCOS
PCOS is diagnosed based on a combination of symptoms, hormone levels, and imaging findings. Most clinicians use criteria similar to the Rotterdam criteria, which require two out of three key features to be present.
Symptoms & menstrual pattern
Your healthcare provider will ask about your periods and any symptoms that suggest ovulation is irregular. This includes:
- Infrequent, irregular, or absent periods
- Difficulty predicting your cycle length
- Symptoms such as acne or excess hair growth
A detailed medical history helps rule out other causes of irregular cycles.
Evidence of androgen excess
Higher-than-usual androgen levels are a common feature of PCOS. This can be identified in two ways:
Clinical signs, such as acne, increased facial or body hair, or hair thinning
Blood tests, which measure hormone levels to check for raised androgens and exclude other hormonal conditions
Your clinician may also order tests for thyroid function, prolactin, and general metabolic health.
Ultrasound appearance of the ovaries
An ultrasound scan, usually transvaginal for best detail, may show ovaries with:
- A higher number of small follicles
- Increased ovarian volume
These findings support the diagnosis but are not always required, especially in younger people where multifollicular ovaries can be normal.
Treatment Options
There is no single cure for PCOS, but symptoms can be effectively managed with a combination of lifestyle measures and medical treatments. The approach is tailored to your main concerns, whether that’s cycle regulation, skin or hair symptoms, metabolic health, or fertility.
| Lifestyle Factors | Lifestyle changes form the foundation of PCOS care and can improve insulin resistance, regulate menstrual cycles, and support long-term health. A balanced diet, regular physical activity, and maintaining a healthy weight (where relevant) can all play a role in reducing symptoms. |
| Regulating Periods | f your cycles are irregular, hormonal treatments may be recommended. - Combined oral contraceptives can regulate periods and improve acne and excess hair. - Progestogen-only options or intermittent progestogen courses help protect the womb lining if periods are infrequent. |
| Skin & Hair Symptoms | Androgen-related symptoms such as acne or excess hair growth may be treated with: - Hormonal contraceptives - Anti-androgen medications such as spironolactone (usually alongside contraception) - Dermatology treatments where needed |
| Fertility Support | If you are trying to conceive, ovulation can often be restored with: - Ovulation-induction medications such as letrozole (first-line) - Metformin, particularly if insulin resistance is significant - Assisted fertility treatments if other options are not effective |
Although PCOS is a long-term condition, most people are able to manage their symptoms very effectively with the right support. Periods can often be regulated, fertility can frequently be restored with treatment when needed, and skin or hair symptoms usually improve with targeted care. Long-term health risks such as diabetes or high cholesterol can be monitored and reduced through lifestyle measures and routine check-ups.
With personalised treatment and ongoing support, most people with PCOS lead healthy, active lives and experience significant improvement in their symptoms over time.
How can Lanthorn help?
Ultrasound Uterus & Ovaries - From £300
We provide high-resolution pelvic ultrasound to assess the appearance of your ovaries and endometrium. This helps confirm or rule out polycystic ovarian morphology and identify any other causes of irregular periods or pelvic symptoms.
PCOS Blood Test - £159
Our tailored hormone panels check key markers such as androgen levels, LH, FSH, and metabolic indicators. These tests help build a clear picture of how your hormones are functioning and support an accurate diagnosis.
Referral for further support
If you need additional care - such as dietetic support, endocrinology input, or fertility advice - we can guide you toward the right specialists. We ensure you have a clear plan and access to the services that best support your long-term health.
