Polycystic ovary syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS): Understanding Symptoms, Diagnosis, and Management

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal conditions affecting women — it affects 1 in 10 women of childbearing age. Despite how common it is, it’s often misunderstood, misdiagnosed, or left untreated for years.

At Happiher, we believe every woman deserves personalised, compassionate care for PCOS — not a one-size-fits-all approach. As a private gynaecologist in London, I help women manage PCOS with evidence-based treatments, lifestyle support, and clear, expert guidance.

What is Polycystic Ovary Syndrome (PCOS)?

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that affects how the ovaries work. PCOS affects women during their childbearing years, leading to various hormonal imbalances and reproductive health issues. Women with PCOS may have:

• Irregular or absent periods

• High levels of androgens (male hormones)

• Multiple small fluid-filled sacs (follicles) in the ovaries (seen on ultrasound)

Not all women with PCOS have cysts on their ovaries, and not all ovarian cysts mean you have PCOS — diagnosis is based on a combination of features.

Introduction to PCOS

Symptoms of PCOS: Irregular Menstrual Periods

PCOS can look different for every woman, but common signs include:

• Irregular, infrequent, or absent periods

• Missed periods

• Excess body hair growth (hirsutism), especially on the face, chest, or back

• Unwanted hair growth on other parts of the body

• Acne or oily skin

• Thinning hair on the scalp

• Difficulty losing weight or unexplained weight gain

• Fertility challenges (difficulty ovulating)

• Mood swings, low mood, or anxiety

Because symptoms vary, PCOS is often missed, especially if women don’t fit a “typical” profile. Many women have PCOS but are undiagnosed, and up to 70 percent have not been diagnosed in some studies.

What Causes PCOS? Insulin Resistance

The exact cause of PCOS isn’t fully understood, but several factors play a role:

• Insulin resistance (where the body’s cells don’t respond properly to insulin, leading to elevated insulin levels)

• Hormonal imbalance (higher levels of luteinising hormone or male hormones called androgens)

• Genetic factors (PCOS tends to run in families)

The pituitary gland regulates ovulation and hormone levels by producing follicle-stimulating hormone (FSH) and luteinising hormone (LH). Imbalances in the pituitary gland can contribute to PCOS.

These imbalances can disrupt normal ovulation, leading to irregular cycles and other symptoms.

How Is PCOS Diagnosed?

At Happiher, we diagnose PCOS using a holistic approach, looking at the full picture.

Diagnosis may include:

• Detailed consultation about periods, symptoms, family history, and lifestyle

• Pelvic ultrasound uses sound waves to assess ovaries and check for multiple follicles

• Blood tests to check hormone levels (androgens, LH, FSH, insulin, thyroid function)

• Blood tests to check cholesterol and triglyceride levels

• Physical exam to assess symptoms related to PCOS

Diagnosis is based on the Rotterdam criteria, meaning two of the following three must be present:

1. Irregular periods or no ovulation

2. High androgen levels (symptoms or blood test evidence)

3. Multiple follicles in the ovaries (polycystic appearance)

It’s important to rule out other causes of symptoms before confirming PCOS.

Is PCOS Serious?

PCOS is manageable, but without treatment, it can lead to serious health problems such as:

• Infertility

• Type 2 diabetes

• High blood pressure

• High cholesterol and cardiovascular risk

• Sleep apnoea

• Endometrial cancer (due to prolonged unopposed oestrogen)

Women with PCOS are also at greater risk for miscarriage and pregnancy complications.

• Infertility

• Type 2 diabetes

• High blood pressure

• High cholesterol and cardiovascular risk

• Sleep apnoea

• Endometrial cancer (due to prolonged unopposed oestrogen)

That’s why early diagnosis and ongoing support matter so much.

Health Conditions Related to PCOS

Polycystic Ovary Syndrome (PCOS) is often linked with several health conditions that can significantly impact the overall well-being of women with the condition. One of the primary concerns is insulin resistance, where the body’s cells don’t respond effectively to insulin, leading to higher blood glucose levels. This can increase the risk of developing type 2 diabetes. Additionally, women with PCOS are more likely to experience high blood pressure and metabolic syndrome, a cluster of conditions that elevate the risk of heart disease and stroke.

Another serious concern is the increased risk of endometrial cancer due to prolonged periods without ovulation, which can lead to a buildup of the uterine lining. Pregnancy complications such as gestational diabetes and hypertension are also more common in women with PCOS. Given these risks, it’s crucial for women with PCOS to work closely with their healthcare providers to manage these related health conditions and mitigate long-term complications.

Mental Health and PCOS

The emotional and psychological impact of PCOS is significant and often underappreciated. Many women with PCOS struggle with depression and anxiety, partly due to physical symptoms like excess hair growth, acne, and weight gain. The hormonal imbalance inherent in PCOS can also lead to mood swings and emotional distress, further affecting mental health.

It’s essential for women with PCOS to seek comprehensive support, which may include counseling, therapy, or joining support groups. Lifestyle changes such as adopting a healthy diet and engaging in regular exercise can also play a crucial role in improving mental health and reducing the risk of depression and anxiety. Addressing these mental health concerns is a vital part of managing PCOS and improving overall quality of life.

Metabolic Syndrome and PCOS

Metabolic syndrome is a collection of conditions that significantly increase the risk of heart disease and stroke, and women with PCOS are at a higher risk due to the hormonal imbalance and insulin resistance associated with the condition. Symptoms of metabolic syndrome include high blood pressure, elevated cholesterol levels, and increased insulin resistance.

Managing metabolic syndrome involves making lifestyle changes such as following a healthy diet and maintaining a regular exercise routine. These changes can help lower blood pressure, improve cholesterol levels, and enhance insulin sensitivity. In some cases, medications like metformin may be prescribed to help manage insulin resistance and reduce the risk of long-term complications. Lifestyle changes like weight loss can also improve PCOS symptoms and increase fertility. Proactive management of metabolic syndrome is crucial for women with PCOS to maintain their overall health.

Treatment Options for PCOS

Polycystic ovarian syndrome (PCOS) is a common health issue related to hormonal imbalances affecting the ovaries and the menstrual cycle. It can lead to irregular menstrual periods and other significant concerns for those affected.

There’s no single cure for PCOS, but symptoms can be well-managed with a combination of lifestyle adjustments, medication, and supportive therapies to improve symptoms.

• Birth control pills or other hormonal birth control to regulate cycles and manage symptoms

• Laser hair removal for managing excess hair growth

• Hair removal treatments can also help manage excessive hair growth in women with PCOS

At Happiher, treatment is tailored to your goals — whether that’s regulating periods, managing symptoms, or supporting fertility, we offer various options to treat PCOS symptoms.

Lifestyle Management

• Nutrition advice focused on blood sugar regulation

• Exercise programmes to improve insulin sensitivity

• Weight management (even a modest weight loss of 5–10% of body weight can restore ovulation and lower blood glucose levels)

• Losing just 5 to 10 percent of body weight can also help regulate menstrual cycles in women with PCOS

Medical Treatments

Medical treatments can help improve symptoms and manage PCOS effectively.

• Hormonal birth control to regulate cycles and protect the uterine lining

• Anti-androgen medications to reduce excess hair and acne

• Insulin-sensitising drugs (like metformin) if insulin resistance and elevated insulin levels are present

• Ovulation induction therapies (if fertility is a goal)

• Clomiphene, a fertility drug, can help women with PCOS ovulate to improve chances of pregnancy

Surgical Options

In rare cases, laparoscopic ovarian drilling may be offered if medical ovulation induction isn’t successful. This surgical procedure can improve fertility in women with PCOS.

At Happiher, Dr Kaur’s expertise in minimally invasive gynaecology ensures safe, advanced surgical care when needed.

Alternative Therapies

While there is no cure for PCOS, alternative therapies such as acupuncture, herbal supplements, and mind-body therapies may help manage symptoms. Some women with PCOS find that practices like yoga and meditation reduce stress and improve overall well-being. However, it is essential to consult with a healthcare provider before starting any alternative therapies, as some may interact with medications or have adverse effects. Alternative therapies should complement, not replace, conventional medical treatment, offering a holistic approach to managing PCOS symptoms.

PCOS and Fertility

While PCOS is a leading cause of ovulatory infertility, many women with PCOS conceive naturally or with minimal support. Effective treatment plans, including lifestyle changes and medical interventions, can enhance the chances of achieving a healthy pregnancy.

At Happiher, we support women through:

• Natural cycle monitoring

• Ovulation induction therapies

• Referral to fertility specialists if needed

• In vitro fertilisation (IVF) as a potential assisted reproductive technology

We believe fertility discussions around PCOS should be hopeful and proactive — not fearful, and options like vitro fertilisation can be part of a comprehensive treatment plan.

Living with PCOS

PCOS affects more than just physical health — it can impact self-esteem, mental health, and body image. Many women with PCOS struggle with depression and anxiety, partly due to physical symptoms like excess hair growth, unwanted hair, acne, and weight gain. Unwanted hair growth can also contribute to emotional distress and impact self-esteem.

At Happiher, we offer not just medical treatment but emotional and psychological support too — helping women feel empowered, understood, and in control. Additionally, some treatments for PCOS can cause side effects like pelvic pain, which should be managed with the help of healthcare providers.

Preventing Complications

Women with PCOS are at a higher risk of developing complications such as metabolic syndrome, high blood pressure, and endometrial cancer. To prevent these complications, it is essential to maintain a healthy weight, engage in regular physical activity, and eat a balanced diet. Losing even a small amount of weight can improve insulin sensitivity and reduce the risk of complications. Regular check-ups with a healthcare provider are crucial for monitoring potential complications and ensuring prompt treatment of any issues that arise.

Latest Research on PCOS

Research on PCOS is ongoing, with new studies continually being published. Recent research has focused on the role of insulin resistance and androgen excess in the development of PCOS. Other studies have explored new medications and therapies, such as in vitro fertilisation, to help women with PCOS conceive. Additionally, researchers are developing new diagnostic tools and treatments, including genetic testing and personalised medicine. Staying up-to-date with the latest research can help women with PCOS better understand their diagnosis and make informed decisions about their treatment.

Preparing for Your Appointment

Before visiting a healthcare provider, it is essential to prepare by writing down any symptoms, medications, and medical conditions. Women with PCOS should be ready to discuss their menstrual periods, weight changes, and other symptoms. A physical exam, including a pelvic exam, may be performed to check for signs of PCOS, such as ovarian cysts and excess hair growth. Blood tests, including blood glucose and cholesterol tests, may also be ordered to check for insulin resistance and other health conditions. Being well-prepared for the appointment ensures that women with PCOS receive the best possible care and treatment for their condition.

Pelvic Exam and PCOS

A pelvic exam is a fundamental part of diagnosing and managing PCOS. During this exam, a healthcare provider will check for abnormalities in the reproductive organs, including the ovaries and uterus. The exam may also involve a blood test to measure hormone levels such as follicle stimulating hormone (FSH) and luteinising hormone (LH), which can provide insights into the hormonal imbalances characteristic of PCOS.

Additionally, an ultrasound may be performed to look for ovarian cysts and other abnormalities. This comprehensive approach helps in accurately diagnosing PCOS and identifying any related health conditions. Regular pelvic exams are essential for monitoring the condition and adjusting treatment plans as needed.

Why Choose Happiher for PCOS Care?

If you’re looking for a PCOS specialist in London, Happiher offers:

• Private, thoughtful consultations

• Expert hormone and ultrasound assessments

• Personalised lifestyle and medical management plans

• Holistic support addressing physical and emotional health

• Locations across London at Chelsea & Westminster, The Lister, and The Wellington Hospital

You deserve a care plan that fits your body, your goals, and your life — not a one-size-fits-all approach.

Conclusion and Next Steps

In conclusion, PCOS is a complex condition that affects women of reproductive age and can have a profound impact on their overall health and well-being. Symptoms such as irregular menstrual periods, excess hair growth, and weight gain can be effectively managed through a combination of lifestyle changes and medications. It’s crucial for women with PCOS to collaborate with their healthcare providers to develop personalised treatment plans that address their unique needs and health concerns.

Understanding the causes and symptoms of PCOS empowers women to take control of their health and reduce the risk of long-term complications. The next steps for women with PCOS include scheduling regular check-ups with their healthcare provider, making lifestyle changes to manage symptoms, and seeking support from therapists or support groups to address mental health concerns. With the right treatment and support, women with PCOS can manage their symptoms and improve their overall health and well-being.

Final Thoughts

PCOS may be common, but your experience is unique — and so is the care you deserve. Whether you’re managing symptoms, planning for fertility, or simply seeking answers, Happiher is here to guide you with expertise, empathy, and personalised support.