Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions affecting women of reproductive age, with estimates suggesting it affects 1 in 10 women in the UK. Despite its prevalence, PCOS remains poorly understood by many women — and sometimes by the healthcare professionals treating them.
What is PCOS?
PCOS is a condition characterised by a combination of hormonal imbalance, metabolic dysfunction, and ovarian changes. To receive a diagnosis, you typically need at least two of the following three criteria (known as the Rotterdam criteria):
- Irregular or absent periods
- Clinical or biochemical signs of excess androgens (e.g., acne, excess hair growth, hair thinning)
- Polycystic ovaries on ultrasound
It's important to understand that having polycystic ovaries on a scan alone does not mean you have PCOS. The condition is a syndrome — a collection of features — not defined by a single finding.
The metabolic dimension
PCOS is increasingly understood as a metabolic condition, not simply a reproductive one. Women with PCOS have a higher risk of insulin resistance, type 2 diabetes, cardiovascular disease, and fatty liver disease. This is why long-term management matters, even if your immediate concern is irregular periods or skin changes.
What actually helps?
Management of PCOS should be holistic and tailored to your individual symptoms and priorities:
- Nutrition: A balanced, anti-inflammatory dietary pattern (rather than restrictive dieting) that stabilises blood sugar. Focus on whole foods, adequate protein at each meal, fibre-rich carbohydrates, and healthy fats.
- Movement: Regular physical activity improves insulin sensitivity independent of weight loss. Both resistance training and moderate cardiovascular exercise are beneficial.
- Sleep and stress management: Poor sleep and chronic stress worsen insulin resistance and hormonal imbalance. Prioritise sleep hygiene and find sustainable stress-management strategies.
- Medical treatment: Depending on your symptoms and goals, options include the combined oral contraceptive pill (for menstrual regulation and skin symptoms), anti-androgen medications, metformin (for insulin resistance), and ovulation induction if you are trying to conceive.
- Regular monitoring: Women with PCOS benefit from periodic checks of blood glucose, lipids, blood pressure, and endometrial health — particularly if periods are infrequent.
PCOS is a lifelong condition, but with the right support and management plan, most women can manage their symptoms effectively and protect their long-term health.
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