WOMEN’S HEALTH
PCOS — Symptoms, Testing and Treatment Options
How polycystic ovary syndrome presents, how it is assessed, and why a clear explanation and practical management plan make a real difference.
Polycystic ovary syndrome, or PCOS, is one of the more common hormonal conditions affecting women of reproductive age. It can present in different ways, which is one reason it is often misunderstood. Some women attend because of irregular periods. Others are more concerned about acne, excess hair growth, weight gain, difficulty losing weight, or fertility questions.
PCOS is best approached as a medical condition that may affect cycle pattern, metabolic health, and fertility rather than as a one-dimensional label. The broader women’s health hub covers the wider service.
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Common symptoms of PCOS
PCOS can present with any combination of irregular or absent periods, prolonged cycles over 35 days, acne particularly along the jawline and lower face, excess facial or body hair, scalp hair thinning, weight gain concentrated around the abdomen, difficulty losing weight despite effort, and fertility concerns. Some women have several of these features. Others have only one or two. Many feel frustrated because their symptoms have been present for years without a clear diagnosis or coherent management plan. PCOS also carries longer-term metabolic implications — including increased risk of type 2 diabetes, cardiovascular disease, and endometrial thickening — which is why proper assessment matters beyond the immediate symptoms.
Diagnosis
How PCOS is assessed
Diagnosis is based on the Rotterdam criteria, requiring two of three features: irregular or absent ovulation, clinical or biochemical signs of excess androgens, and polycystic ovaries on ultrasound. Blood tests commonly include testosterone, SHBG, DHEA-S, LH and FSH, thyroid function, prolactin, HbA1c or fasting glucose, and lipid profile. The aim is both to confirm the likely diagnosis and to assess metabolic risk.
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Management
Treatment and management
Management depends on which symptoms matter most. For cycle regulation, the combined oral contraceptive pill is commonly used. For acne and hirsutism, anti-androgen medication may be discussed. For insulin resistance and metabolic risk, lifestyle intervention is the cornerstone, with metformin sometimes considered. For fertility, ovulation induction may be discussed, usually in coordination with specialist referral. Weight loss of even 5–10% can meaningfully improve cycle regularity, fertility outcomes, and metabolic markers — which is one reason the condition often benefits from a broader approach through health screening alongside gynaecological management.
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