What is PCOS?

Polycystic ovarian syndrome (PCOS) is a common hormonal condition that affects how your ovaries work. It can start as early as the teenage years and may lead to:

• disruptions to your menstrual cycle
• skin and hair changes

PCOS is one of the most common causes of infertility in females. Many people don't know they have it, as PCOS is often not diagnosed.

While PCOS can't be cured, you and your doctor can manage many of its symptoms.

What are the symptoms of PCOS?

PCOS affects the ovaries and hormones in your body. This can lead to a wide range of symptoms that can affect your skin, menstrual cycle and overall health.

The condition can look different for each person. Some symptoms are visible, while others may not be as noticeable.

Symptoms you can see

PCOS can lead to visible changes in your appearance and skin. These symptoms may include:

• excess hair growth on your face, chest, stomach or back (hirsutism)
• thinning hair or baldness (alopecia)
• acne or oily skin on your face and body
• weight gain or difficulty losing weight
• dark, velvety patches of skin in areas such as your neck, underarms or groin

Symptoms you cannot see

Some symptoms of PCOS are inside your body. They may be more difficult to notice but can affect your health and wellbeing. These symptoms may include:

• irregular periods or missed periods for many months (amenorrhea)
• difficulty conceiving
• enlarged ovaries with multiple small follicles (fluid-filled sacs), called polycystic ovaries
• tiredness or low energy levels
• mood changes, such as depression, anxiety or mood swings

What causes PCOS?

The exact cause of PCOS is unknown. It is thought to happen due to a mix of genetic (inherited), hormonal, lifestyle and environmental factors.

Genetic and hormonal factors

• Hormonal problems — high levels of androgens (male hormones) and insulin may interfere with ovulation.
• Family history — if a close family member has PCOS or a similar condition, your risk may be higher.
• Inflammation — ongoing inflammation can disrupt your hormone levels.

Lifestyle and environmental factors

• Diet and weight — an unhealthy diet or living with obesity can make hormone issues worse.
• Pollution — certain chemicals and air pollution may upset your balance of hormones.
• Gut health — changes in gut bacteria may affect your metabolism and inflammation. This can make PCOS worse.

These causes often combine, making PCOS different for everyone.

When should I see my doctor?

It's important you see a doctor if you think you might have PCOS. Early diagnosis and treatment can help you feel better and lower your risk of long-term health issues.

You should see your doctor if:

• you notice any symptoms of PCOS, even if your symptoms are mild
• you have PCOS and your symptoms are getting worse
• you have PCOS and are planning a pregnancy

Talk to your doctor if you need help to manage your weight. They can refer you to the right health professional, such as a dietitian or exercise specialist.

How is PCOS diagnosed?

To diagnose PCOS, your doctor may ask about your symptoms and medical history. They may also refer you for tests. They may also try to rule out other conditions that could cause similar symptoms.

Diagnosing PCOS may be difficult because symptoms can vary widely. You don't need to have all the symptoms to be diagnosed with the condition.

Your doctor may use specific criteria to diagnose PCOS. At least 2 of the following must be present:

• irregular periods or no periods
• signs of high androgen levels (male hormones), such as excess facial hair, or high hormone levels found in a blood test
• the appearance of at least 20 partly formed eggs per ovary (fluid filled sacks called follicles) seen on an ultrasound

To confirm PCOS and rule out other conditions, your doctor may refer you for tests such as:

• blood tests to check your hormone levels, blood sugar and cholesterol
• an ultrasound scan to look for multiple cysts (fluid-filled sacs) in the ovaries
• screening for other conditions that could cause similar symptoms, such as thyroid disease

How is PCOS treated?

Treatment for PCOS focuses on:

• managing symptoms
• improving your quality of life
• reducing long-term health risks

Treatment options may include lifestyle changes and medicines. Shaving, waxing, laser therapy or electrolysis may help you to remove unwanted body hair.

Lifestyle changes

A healthy lifestyle is important to manage PCOS. Here are some tips that may help:

• Eat a healthy diet to improve symptoms such as irregular periods and weight gain.
• Try to lose even a small amount of weight if you live with overweight or obesity. This can make a big difference and reduce your symptoms, improve fertility and lower your risk of complications.
• Regular exercise may help your body use insulin better, which can lower the effects of PCOS.

Medicines

There are several different medical therapies to help manage PCOS symptoms. These therapies include:

• hormone treatments, such as the oral contraceptive pill or anti-androgen medicines
• ovulation inducers to encourage your ovaries to release eggs, if you are planning a pregnancy
• probiotics to support gut health, reduce inflammation and balance hormones
• skin lotions with medicines or antibiotics to treat acne
• insulin-sensitising medicines
• weight loss medicines and interventions

Living with PCOS

Living with PCOS means managing both physical and emotional challenges. With the right care, you can lead a normal life. Treatments and lifestyle changes, such as staying active and eating well, can help improve your symptoms.

It's also important to seek support for emotional concerns, such as anxiety or depression. Speak with your doctor to make sure you're getting the support you need for both your physical and emotional well-being.

What are the complications of PCOS?

PCOS can affect your long-term health if left untreated. It may increase your risk of health problems such as:

• type 2 diabetes
• high cholesterol and heart disease
• endometrial cancer
• sleep apnoea
• infertility
• pregnancy complications, such as a higher risk of gestational diabetes, preeclampsia or miscarriage
• uterine problems, such as endometrial hyperplasia (a thickened uterine lining)

Can PCOS be prevented?

PCOS cannot be completely prevented. This is because its exact causes are not fully understood and factors that you cannot change, such as genetics, may play a role.

Maintain a healthy lifestyle to help lower your risk of developing complications. Manage your symptoms and attend regular follow up appointments with your doctor. This may help reduce your chance of developing complications or help you recognise them early.

Resources and support

• Pregnancy Birth and Baby has information about PCOS and pregnancy.
• Jean Hailes for Women's Healthoffers a fact sheet on PCOS.
• Hormones Australia offers information about PCOS.
• Ask PCOS by National Health and Medical Research Council, Monash Health and Monash University provides high quality information on PCOS to help you manage it.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Other languages

Jean Hailes for Women's Health offers PCOS fact sheets in multiple languages.

Looking for information for Aboriginal and/or Torres Strait Islander people?

Jean Hailes for Women's Health provides a booklet for Aboriginal and/or Torres Strait Islander people.