Polycystic Ovary Syndrome: What To Do
A common hormonal condition involving irregular ovulation, raised androgens and metabolic features.
Last revised
It is the commonest cause of irregular periods, and its metabolic consequences matter as much as its fertility ones.
Key takeaways
- Diagnosis: two of three: irregular ovulation, raised androgens, polycystic ovaries on scan
- Associated with: insulin resistance and raised type 2 diabetes risk
- Most useful single change: Ask for metabolic screening as well as hormonal assessment.
- Commonest mistake: Treating it as only a fertility issue.
- See a doctor if any of the signs under "When to get help" below apply to you.
Do
- Ask for metabolic screening as well as hormonal assessment
- Address weight and activity, which improve both cycles and metabolic risk
- Ask about endometrial protection if you have very infrequent periods
- Discuss fertility plans early rather than after difficulty arises
Do not
- Treating it as only a fertility issue
- Assuming a scan alone makes or excludes the diagnosis
- Ignoring very infrequent periods
The figures behind the list
Each item above follows from these, published in the guidance named at the foot of the page.
| Measure | Figure |
|---|---|
| Diagnosis | two of three: irregular ovulation, raised androgens, polycystic ovaries on scan |
| Associated with | insulin resistance and raised type 2 diabetes risk |
| Screening | periodic HbA1c or glucose testing recommended |
| Weight loss of 5-10 per cent | can restore ovulation in many |
| Fewer than 4 periods a year | warrants assessment for endometrial protection |
Where to go next
- What Polycystic Ovary Syndrome Is, and Why It Matters
- Polycystic Ovary Syndrome: What to Do, in Order
- Polycystic Ovary Syndrome — the reference entry
- The Evidence on Hormones and Mood, Without the Hype
- Cortisol and Stress Hormones: What the Evidence Actually Says
When to get help
See a GP if you have fewer than four periods a year, which can allow the womb lining to thicken and needs managing. Report any bleeding between periods, after sex, or unusually heavy bleeding. Seek assessment for rapid onset of male-pattern hair growth, voice deepening or clitoral enlargement, which suggests another cause.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.