Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome (PCOS) is a common hormonal condition that can affect menstrual cycles, hormone balance, skin, weight and metabolic health. Symptoms vary widely between individuals, and not everyone with PCOS experiences the same concerns.
This page provides GP-reviewed information on PCOS, including common symptoms, how it is diagnosed, what blood tests may show, and how PCOS is managed in primary care.
These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help, please book an appointment with one of our GP’s.
What this page covers
This page explains:
- what PCOS is and how it presents
- common symptoms and patterns
- how PCOS is diagnosed
- blood tests and scans that may be used
- links between PCOS and metabolic health
- management and treatment options
- when to seek medical advice
What is PCOS?
Polycystic Ovary Syndrome is a hormonal condition characterised by a combination of:
- irregular or absent ovulation
- increased androgen (male-type hormone) activity
- changes seen on ovarian ultrasound in some cases
Despite the name, PCOS does not always involve ovarian cysts, and many people with PCOS have normal-looking ovaries on scan.
PCOS often begins in adolescence or early adulthood but may only be recognised later when symptoms become more noticeable.
Common symptoms of PCOS
Symptoms can vary significantly. Some people have mild symptoms, while others experience more pronounced effects.
Menstrual and reproductive symptoms
- irregular periods or missed periods
- infrequent ovulation
- difficulty predicting cycles
Hormonal and skin-related symptoms
- acne
- increased facial or body hair (hirsutism)
- thinning hair or scalp hair loss
Metabolic and general symptoms
- weight gain or difficulty losing weight
- fatigue
- insulin resistance
- increased appetite
Not everyone with PCOS has all of these features.
How PCOS is diagnosed
There is no single test for PCOS. Diagnosis is based on a combination of symptoms, blood tests and sometimes ultrasound findings.
Most UK clinicians use the Rotterdam criteria, which require two of the following three features:
- irregular or absent ovulation
- clinical or biochemical signs of excess androgens
- polycystic ovaries on ultrasound
A GP will also exclude other conditions that can cause similar symptoms.
Blood tests that may be used
Blood tests help assess hormone patterns and exclude alternative causes. These may include:
- total and free testosterone
- sex hormone binding globulin (SHBG)
- LH and FSH
- prolactin
- thyroid function tests
- HbA1c or fasting glucose
- lipid profile
Results are interpreted in context, not in isolation.
Ultrasound scans and PCOS
Pelvic ultrasound may show ovaries with multiple small follicles. However:
- ultrasound findings alone do not diagnose PCOS
- some people with PCOS have normal scans
- polycystic ovarian appearance can be normal in younger individuals
Ultrasound is used as part of an overall assessment, not as a standalone test.
PCOS and metabolic health
PCOS is associated with an increased risk of:
- insulin resistance
- type 2 diabetes
- raised cholesterol
- cardiovascular risk over time
Not everyone with PCOS develops these issues, but awareness allows for early monitoring and prevention.
A GP may recommend periodic checks of blood sugar, cholesterol and blood pressure.
Management and treatment options
There is no single treatment for PCOS. Management focuses on individual symptoms and long-term health.Lifestyle measures
Lifestyle measures
Lifestyle support is often first-line and may include:
- balanced nutrition
- regular physical activity
- weight management where appropriate
- sleep optimisation
Even modest changes can improve symptoms and hormone balance.
Hormonal treatments
Depending on symptoms and goals, a GP may discuss:
- combined hormonal contraception to regulate cycles
- treatments to manage androgen-related symptoms
Fertility considerations
Many people with PCOS conceive naturally. If fertility is a concern, referral for further assessment may be appropriate.
When to seek medical advice
You should consider a GP review if you experience:
- persistent irregular or absent periods
- new or worsening acne or excess hair growth
- difficulty managing weight despite lifestyle measures
- concerns about fertility
- symptoms affecting mental wellbeing
Early assessment can help guide appropriate support.
Further Reading and Hub Links
Visit our Women’s Health hub or browse more health topics in the AccessGP Knowledge Base.
If you would like to discuss symptoms of PCOS, hormone testing or metabolic health, you can book an online GP appointment with AccessGP.
Last reviewed by Dr Zamiel Hussain, GMC registered GP
Clinical contributor: Dr Tasnimah Miah, Women’s Health Advocate
Updated: 15 December 2025