Health Insights · Women's Health
PCOS: symptoms, diagnosis and management
PCOS affects around one in ten women and is the commonest cause of irregular periods and of difficulty conceiving. Despite the name, it is not really about cysts — it is a hormonal and metabolic condition, and treating it as purely gynaecological misses most of what matters long term.
Arrange assessment if you have
- no periods for three months or more, or fewer than four a year
- heavy or prolonged bleeding after a long gap without periods
- rapid onset of severe excess hair growth, a deepening voice or male-pattern balding
- signs of diabetes — thirst, frequent urination, unexplained weight change
- difficulty conceiving after 12 months, or 6 months if you are over 35
Going many months without a period allows the womb lining to thicken unopposed, which over years increases the risk of endometrial cancer. Prolonged absent periods should be managed rather than ignored, even if you are not trying to conceive. Rapid virilising symptoms need prompt investigation for other causes.
How it is diagnosed
Two of the following three, with other causes excluded:
- Irregular or absent ovulation — usually irregular or absent periods
- Excess androgen — either on blood testing, or clinically as excess hair growth, acne or scalp hair thinning
- Polycystic ovaries on ultrasound — many small follicles, which are not cysts and are not harmful
An ultrasound alone does not diagnose PCOS — around a fifth of women have polycystic-appearing ovaries with no other features and no condition. Equally, you can have PCOS with entirely normal ovaries on scan.
Insulin resistance is the engine
Most women with PCOS have some degree of insulin resistance, independent of weight — slim women get PCOS too. Higher insulin drives the ovaries to produce more testosterone, which disrupts ovulation and causes the hair and skin changes. This is why the condition carries a substantially raised long-term risk of type 2 diabetes, and why the metabolic side deserves as much attention as the periods.
Managing the symptoms
- Irregular periods — the combined pill regulates cycles and protects the womb lining. Alternatives include cyclical progestogen or the hormonal coil. Aim for at least four bleeds a year if not on continuous protection.
- Excess hair growth — the combined pill helps over six to twelve months; topical treatment, and laser or electrolysis, are effective. Expect slow progress; hair cycles are long.
- Acne — responds to standard acne treatment and often to the combined pill.
- Hair thinning — treatable, and worth addressing early.
- Weight — losing even 5% improves ovulation, cycles and insulin sensitivity measurably. It is also genuinely harder with PCOS, which is a reason for support rather than for blame.
- Metformin may be used where there is insulin resistance or glucose intolerance.
Fertility
Most women with PCOS can conceive, though it may take longer and often needs help with ovulation. Treatments to induce ovulation are effective. Do not assume you cannot conceive — contraception is still needed if you are not trying, because cycles are unpredictable rather than absent.
The long-term checks that matter
PCOS raises the risk of type 2 diabetes, gestational diabetes, high blood pressure, sleep apnoea, fatty liver and cardiovascular disease. It is also associated with higher rates of anxiety and depression, which are under-recognised and worth raising. Regular monitoring is the part of PCOS care most often neglected.
Book an appointment if you have irregular periods, unwanted hair growth or acne, difficulty conceiving, or a PCOS diagnosis that has never been followed up. We offer hormone profiles, pelvic ultrasound, metabolic screening and women's health consultations on site.
Private PCOS assessment in London
PCOS can cause irregular periods, acne, unwanted hair, weight change and fertility concerns, and diagnosis brings together symptoms, blood tests and often an ultrasound scan. Our private women’s health clinic in London — or a private GP in East London to start — can assess you, arrange the right investigations on site, and put together a management plan covering periods, skin, metabolic health and fertility as needed. PCOS is assessed at our private women's health service in Whitechapel, East London, with patients coming from Canary Wharf, the City and Bethnal Green.
PCOS: diagnosis, symptoms and long-term care
How is PCOS diagnosed?
Through a combination of symptoms, hormone blood tests, and an ultrasound of the ovaries — we can arrange all of these.
Can I get an ultrasound privately for PCOS?
Yes — we provide private pelvic ultrasound on site, with results discussed by a clinician.
Does PCOS affect fertility?
It can affect ovulation, but many women with PCOS conceive, sometimes with support. We can advise and refer where appropriate.
Do I need a referral?
No — you can book directly with our women's health team or start with a private GP.
Where can I get PCOS assessed near me in East London?
Our private women’s health clinic in London at Whitechapel, near Canary Wharf, can arrange hormone blood tests in London and pelvic ultrasound in London to diagnose PCOS.
Can PCOS affect fertility?
It can affect ovulation, but many women conceive with the right support; our fertility assessment can help if you are trying to conceive.
Hormone testing and ultrasound on site
Women's health appointments 7 days a week on Whitechapel Road.