Polycystic Ovarian Syndrome, or PCOS, is a health condition that affects about one in ten women of reproductive age, making it one of the most common hormonal disorders among women. In this article we’ve put together a detailed look at what PCOS is, including the symptoms, causes, ways to manage and even what PCOS looks like in real life.

What is PCOS?

PCOS is a gynaecological condition in women characterised by a hormonal imbalance that leads the ovaries to produce abnormally high levels of androgens, male sex hormones typically present in women in smaller amounts. 

Due to these high androgen levels, women with PCOS often have cysts on their ovaries, too.


What are the symptoms of PCOS?

  • Irregular periods (or non at all!)
  • Being overweight or suffering from obesity
  • Excessive hair growth (Hirsutism)
  • Thinning hair around the hair line, or suffering from female pattern hair loss 
  • Acne
  • Poor mental health (anxiety and depression)
  • Poor body image 
  • Infertility or trouble getting pregnant
  • Low or no sex drive
  • Painful periods
  • Moon face

The first sign of PCOS tends to be a problem with your menstrual cycle. 

Women with PCOS tend to have menstrual cycles longer than normal, they do not ovulate and often have very painful periods.


What causes PCOS?

The direct cause of PCOS is unknown. Scientists and hormone experts are still trying to figure that out.

However, it is thought that Polycystic Ovarian Syndrome has some genetic influence. So if your Mother or another female in your family has PCOS, there is a chance that you may have it too. 

Women with PCOS struggle with the regulation of their insulin levels…it is not uncommon for them not to know this either!

Insulin is released and spikes whenever we eat, this is a completely normal and healthy process. For women with PCOS, their insulin levels spike higher or more than what is considered normal; which then causes a disruption to hormone levels and higher levels of androgens.

This tends to be why people who suffer from this condition are overweight, suffer from obesity, and struggle to lose weight.


How is PCOS diagnosed?

It can be challenging to get a PCOS diagnosis.

You need to speak to your Doctor, and many cases require a referral to a gynaecological specialist. 

Generally speaking, you need to have a blood test, an ultrasound scan, and your symptoms assessed. Many Doctors have different ways of diagnosing polycystic ovarian syndrome.

However, PCOS is typically diagnosed by using the Rotterdam Criteria:

  1. Elevated testosterone levels – Established by blood test
  2. Ferriman–Gallwey score assessed – This looks at how severe your hirsutism is
  3. Number of follicles, or cysts, in your ovaries – Assessed by ultrasound
  4. Length of your menstrual cycles
Whilst many women who suffer from PCOS are overweight or obese, it is not uncommon for someone slim or of average size to have the condition.

What does PCOS look like?

Weight gain


It isn’t uncharacteristic for PCOS weight gain to happen very fast, and even with no change to the food you eat or the exercise that you do. 


Stretch marks

With rapid weight gain typically comes stretch marks. 

New stretch marks can red or darker in tone, whereas old stretch marks fade to the normal colour of your skin. 

It isn’t uncommon for women with PCOS to have stretch marks on their stomach, breasts, bottom, inner and outer thighs, and arms.



Due to the excess in androgens, women with PCOS tend to have oily skin and can struggle with acne. 

The acne is typically around the chin, jaw and cheeks. This is due to a hormonal imbalance.



One of the first symptoms of PCOS is excessive hair growth.

This can be along the bikini line, buttocks, legs, arms, hair on the chest and nipples, lower belly button, and in some cases on the chin and face; similar to that of a beard.


How is PCOS treated?

There is no cure for PCOS, it is only your symptoms that can be treated. 

You can treat and manage your symptoms with medical intervention, lifestyle changes, or both. 



Your Doctor may recommend you to take the contraceptive pill, or some form of hormonal contraception as a way to regulate your hormones. 

This can be the pill (combined or progesterone only), an implant, IUD (the coil), patches, or injections. 

There are other medical treatments to help women with PCOS when trying to conceive or manage acne for example. Please visit the NHS website and speak to your Doctor 

*It is important that you research and thoroughly discuss the options available, including the risks of the medications you are to take, if the medical route is what you pursue.  


Lifestyle Changes

PCOS isn’t dangerous on its own, but when a woman with PCOS is overweight or obese, it has the potential to be. 

The first recommendation a Doctor will typically give a woman who has PCOS and is overweight or suffering with obesity is to lose weight. The general recommendation is to lose 5-10% of their body weight.

Whilst this advice is not suitable for everyone, it is a very important step to managing PCOS and reducing the risk of developing any other medical conditions. 

The recommendation to lose weight is great, but how do you do it?

  • Eat a healthy, balanced diet
  • Walk more day-to-day
  • Find a type of exercise that you enjoy and build up to doing it frequently enough to meet the NHS recommended 150-minutes of exercise weekly
  • Drink more water


What about the long term?

You don’t need to lose weight forever.

…but you do need to manage your PCOS on an on-going basis.

That is why recommend women with PCOS find healthy habits that work for them, and focus on making these healthy habits a permanent change. 

An example of this is following a low glycaemic index diet as much as possible. 

Supplements may also help in the long term. This is something you need to discuss with your Doctor by organising a blood test, and potentially then speaking to a naturopath. 


Louise’s Experience

I lived with Polycystic Ovarian Syndrome (PCOS) for over seven years before I was finally diagnosed.

Even though my PCOS is considered relatively mild, I’ve experienced all the symptoms over the years.

Following my doctor’s advice, I took the pill, but my lifestyle choices made things worse. I was under-eating, over-exercising, and putting my body under a lot of stress, which made my symptoms so much worse.

In this photo, you can see I had a “moon face,” a common PCOS symptom caused by inflammation.

Thankfully, once I got my diagnosis, I began making lifestyle changes. Now, I rarely deal with moon face, and I’ve adopted daily habits to keep my hormones balanced and excessive androgens under control.

It requires constant effort, but it’s so worth it. I am now in control and my life has changed for the better.


Where we got some of our information for this article

Alur-Gupta, S., Chemerinski, A., Liu, C., Lipson, J., Allison, K., Sammel, M. D., & Dokras, A. (2019). Body-image distress is increased in women with polycystic ovary syndrome and mediates depression and anxiety. Fertility and sterility, 112(5), 930-938.

Azziz, R., Carmina, E., Chen, Z., Dunaif, A., Laven, J. S., Legro, R. S., … & Yildiz, B. O. (2016). Polycystic ovary syndrome. Nature reviews Disease primers, 2(1), 1-18.

Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. A prospective study of dietary carbohydrate quantity and quality in relation to risk of ovulatory infertility. Eur J Clin Nutr. 2009;63(1):78–86

Hoeger, K. M., Dokras, A., & Piltonen, T. (2021). Update on PCOS: consequences, challenges, and guiding treatment. The Journal of Clinical Endocrinology & Metabolism, 106(3), e1071-e1083.

Peña, A. S., Witchel, S. F., Hoeger, K. M., Oberfield, S. E., Vogiatzi, M. G., Misso, M., … & Teede, H. (2020). Adolescent polycystic ovary syndrome according to the international evidence-based guideline. BMC medicine, 18, 1-16.

Witchel, S.F., Teede, H.J. & Peña, A.S. Curtailing PCOS. Pediatr Res 87, 353–361 (2020). https://doi.org/10.1038/s41390-019-0615-1

Wolf WM, Wattick RA, Kinkade ON, Olfert MD. Geographical prevalence of polycystic ovary syndrome as determined by region and race/ethnicity. Int J Environ Res Public Health. 2018;15(11):1–13.



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