Originally Posted On: https://sloanestreetsurgery.co.uk/articles/pcos-what-you-need-to-know-about-this-common-hormonal-condition/

PCOS: What You Need to Know About This Common Hormonal Condition

What is polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions affecting women, yet many remain undiagnosed. Initially thought to be a gynaecological issue, we now understand that PCOS is a metabolic disorder that happens due to a mix of hormonal imbalances, high androgens (such as testosterone), and insulin resistance. The exact cause of PCOS is unknown, but it is thought to have a genetic element.

It is inaccurately named after the appearance of the ovaries on an ultrasound scan, which rather than being cysts are actually immature follicles that have not developed properly due to disrupted ovulation.

What are the symptoms of PCOS?

PCOS usually starts during adolescence or early adulthood and is very common as it is thought to be present in 5-10% of women. Mild PCOS can often show no symptoms and remain undiagnosed.

PCOS symptoms vary from person to person, but the most common ones include:

1. Irregular periods

• Infrequent, very long, or missed periods (due to irregular ovulation).

2. Excess androgen symptoms (high male hormones)

• Hirsutism – excessive hair growth on the face, chest, back, or abdomen.
• Acne – often severe and persistent.
• Scalp hair thinning (female-pattern baldness).

3. Weight gain and metabolic issues

• Many with PCOS struggle with weight gain, especially around the abdomen.
• Insulin resistance can lead to difficulty losing weight and increased risk of type 2 diabetes, high blood pressure, and raised cholesterol.

4. Fertility problems

• PCOS is one of the most common causes of infertility due to irregular ovulation.

5. Mood changes

• Higher risk of anxiety, depression, and mood swings.

6. Skin changes

• Dark patches of skin (acanthosis nigricans) in the neck, armpits, or groin (linked to insulin resistance).
• Skin tags are also common.

How is PCOS diagnosed?

PCOS is diagnosed when 2 out of the 3 criteria below are met:

• Irregular or absent periods
• Polycystic ovaries seen on ultrasound scan
• The presence of typical symptoms or blood test results of raised androgens

What are the treatment options for PCOS?

Lifestyle changes are the first-line treatment for PCOS, with diet and exercise playing a crucial role in managing symptoms. Regular physical activity and a balanced diet help with weight management, improve insulin resistance, and promote overall hormonal balance. Even a small amount of weight loss, typically 5-10% of body weight, can significantly improve symptoms, regulate menstrual cycles, and improve ovulation.

Medications can help manage different aspects of PCOS, including hormone regulation, insulin resistance, and fertility.

For irregular periods and hormonal balance the combined oral contraceptive pill is often used to regulate periods. It can also help reduce acne and excess hair.

Metformin is often prescribed for insulin resistance. It improves insulin sensitivity and may help with weight loss and ovulation. More recently, GLP-1 agonists such as semaglutide (Ozempic) and tirzepatide (Mounjaro) have been shown to have a role in aiding weight loss and improving insulin resistance.

Anti-androgens (such as spironolactone) can be used to reduce hair growth and acne.

A variety of treatments can be used to aid fertility. Clomiphene is commonly used to stimulate ovulation and some women benefit from IVF treatment when struggling with conception.

If you’re experiencing symptoms of PCOS or want to explore management options, our doctors are here to help. Book an appointment here or call us on 0207 245 9333.