Polycystic ovary syndrome (PCOS): symptoms and diagnosis
Polycystic ovary syndrome (PCOS) is a hormonal condition which, according to the NHS, can affect hair growth, periods, fertility and mood. Typical symptoms are irregular periods or long gaps between them, excess hair growth or hair loss, difficulty losing weight, acne and difficulty getting pregnant. It is diagnosed with blood tests for hormones and insulin resistance and an ultrasound scan of the ovaries. There is no cure, but medicines and lifestyle changes help.
- In 2026 the NHS renamed the condition PMOS (polyendocrine metabolic ovarian syndrome); the name PCOS remains in wide use.
- According to the NHS, symptoms usually start in puberty and continue until menopause, and can be mild, severe or absent altogether.
- Main symptoms: irregular periods, excess hair growth or hair loss, difficulty losing weight, difficulty getting pregnant, depression or anxiety, oily skin and acne, severe tiredness, dark thickened patches on the neck or armpits.
- Diagnosis involves blood tests for hormones and insulin resistance and an ultrasound scan of the ovaries – the NHS only does the scan in women over 18.
- Long-term risks according to the NHS: type 2 diabetes, high blood pressure, cardiovascular disease, non-alcoholic fatty liver disease and cancer of the womb – regular check-ups reduce them.
What is polycystic ovary syndrome and why is it now called PMOS?
According to the NHS, this is a hormonal condition that can affect hair growth, periods, fertility and mood. There is no treatment that removes it completely, but medicines and lifestyle changes help with the symptoms.
On the NHS page, reviewed in June 2026, the condition is now called PMOS – polyendocrine metabolic ovarian syndrome – with the note that it was previously known as polycystic ovary syndrome (PCOS). In this article we use both names, because PCOS is the name you will still come across most often in Bulgaria.
What are the symptoms of PCOS?
According to the NHS, symptoms usually start in girls and young women at puberty and continue until menopause, and can be mild, severe or absent. The main ones are:
- irregular periods or long gaps between cycles;
- excess hair growth (hirsutism) or hair loss;
- weight gain or difficulty losing weight;
- difficulty getting pregnant;
- mental health problems such as depression or anxiety;
- oily skin and acne;
- severe tiredness;
- thickened dark patches of skin on the neck or armpits (acanthosis nigricans).
The NHS notes that these symptoms are common and have many possible causes, so having them does not automatically mean PCOS – but they should be checked.
How is it diagnosed?
According to the NHS, if your GP suspects PCOS, they may arrange tests with a specialist in fertility or hormones – a gynaecologist or an endocrinologist. The tests include:
- blood tests for hormone levels and for insulin resistance;
- an ultrasound scan of the ovaries – according to the NHS, only in people over 18.
The cause of the condition is unknown. The NHS states that it may be linked to insulin and testosterone not working properly, and that it is more likely if a close relative has PCOS or if you are of Asian origin.
What should I ask the doctor at the appointment?
The NHS information gives a good basis for specific questions, so that the appointment is useful:
- Which blood tests will you do and will you check for insulin resistance?
- Do I need an ultrasound scan of the ovaries and which specialist are you referring me to – a gynaecologist or an endocrinologist?
- What is suitable for me for irregular periods – the combined pill, the progestogen-only pill or an intrauterine system?
- If I am planning a pregnancy – what are the options, for example clomifene?
- What can I do about the hair growth, acne and tiredness?
- What regular check-ups do I need for the long-term risks – diabetes, blood pressure, liver?
When should you see a doctor?
According to the NHS, you should book an appointment with a doctor if:
- you think you may have PCOS;
- the symptoms are affecting your daily life, work or relationships.
The NHS has no separate emergency guidance for this condition – the important thing is not to put off getting checked, because an early diagnosis allows the long-term risks to be monitored too.
What treatment is there and what are the long-term risks?
According to the NHS, the medicines depend on the symptom: the combined or progestogen-only pill or an intrauterine system for irregular periods; clomifene for fertility; spironolactone or eflornithine for unwanted hair growth; metformin (a medicine for type 2 diabetes) for tiredness and weight problems; creams or tablets for acne; weight-loss medicines if you are overweight. If other methods do not help with difficulty getting pregnant, laparoscopic ovarian "drilling" may be offered, which sometimes improves the chance of pregnancy.
As self-help, the NHS recommends a balanced diet, regular exercise, losing weight if you are overweight and talking therapy for depression or anxiety. Long-term risks according to the NHS include type 2 diabetes, high blood pressure, cardiovascular disease, non-alcoholic fatty liver disease and cancer of the womb – regular check-ups reduce them.
Frequently asked questions
Can I have PCOS without cysts on my ovaries?
According to the NHS, symptoms can be mild or absent, and the diagnosis is based on blood tests and an ultrasound scan together – this is exactly why the NHS moved to the new name PMOS, which does not include the word "polycystic".
Can I get pregnant if I have PCOS?
The NHS lists difficulty getting pregnant as a symptom, usually because the ovaries do not release an egg every month, but there are treatments – clomifene and, in some cases, a laparoscopic procedure on the ovaries.
Does PCOS go away with menopause?
According to the NHS, symptoms continue until menopause and some of them may stop or change after it, but the long-term health risks require regular monitoring.
Sources
- NHS – Polyendocrine metabolic ovarian syndrome (PMOS), previously called polycystic ovary syndrome (PCOS) – last reviewed by the NHS: 30 June 2026
Informational article retold in our own words from the sources listed. It does not replace a consultation with a doctor; in an emergency call 112. If you spot an inaccuracy, write to [email protected].