PCOS – irregular periods, weight and fertility

Polycystic ovary syndrome is a common hormonal condition. The ovaries do not release an egg regularly, which causes irregular or absent periods, and there is often a higher level of male-type hormones, which causes extra hair growth on the face or body, acne, or thinning hair on the scalp. Many women with it also have insulin resistance, which links it to weight and to type 2 diabetes.

There is no single treatment, because the aim differs from person to person: regular periods, controlling hair or acne, reducing diabetes risk, or getting pregnant. Say which of those matters most to you — the treatment follows from the goal.

• Weight, activity and diet have a real effect here, and a modest loss can restore ovulation in some women. This is not a brush-off; it is one of the few things that works on several symptoms at once.
• Hormonal contraception is used to regularise periods and improve acne and unwanted hair growth in women who are not trying to conceive.
• Metformin is used where there is insulin resistance or to reduce diabetes risk.
• Medicines that induce ovulation are used when the goal is pregnancy.
• Hair removal methods and acne treatment address the visible symptoms directly.

• PCOS is a common cause of difficulty conceiving, and it is one of the more treatable ones.
• Irregular ovulation does not mean no ovulation. Contraception is still needed if you do not want to become pregnant.
• If you are trying to conceive, start folic acid before you conceive rather than after.
• Ovulation-inducing medicines increase the chance of twins and need supervision, including monitoring. They are not something to obtain informally.

• PCOS raises the risk of type 2 diabetes, including in pregnancy, so periodic glucose testing is part of care.
• Blood pressure and cholesterol are worth checking too.
• Depression and anxiety are more common with PCOS, partly because of the symptoms themselves. That is worth raising rather than absorbing.