Polycystic ovary syndrome
What is polycystic ovary syndrome? Polycystic ovaries (PCOS) is a women's health condition that affects the ovaries by preventing them from releasing eggs. The ovaries aren't actually covered in cysts, but they contain several follicles which are undeveloped sacs which eggs develop inside of. As the sacs are underdeveloped they don't always release eggs and therefore prevent ovulation. Wha
What it is
PCOS is diagnosed by the Rotterdam criteria — two of three: oligo-/anovulation, clinical or biochemical hyperandrogenism, and polycystic ovaries on ultrasound. It is associated with insulin resistance, type 2 diabetes, metabolic syndrome, NAFLD, sleep apnoea, endometrial hyperplasia and infertility — and is highly treatable.
Symptoms and signs
- Irregular or absent periods (oligomenorrhoea, amenorrhoea).
- Excess facial or body hair (hirsutism), acne, scalp hair thinning.
- Difficulty losing weight, or weight gain particularly central.
- Difficulty conceiving — PCOS is the commonest cause of anovulatory infertility.
- Acanthosis nigricans — dark velvety skin changes at the neck and axillae (insulin resistance).
How we investigate
Hormone profile (FSH, LH, oestradiol, testosterone, SHBG, free androgen index, prolactin, TSH, AMH, 17-OH progesterone where indicated), pelvic ultrasound, HbA1c, fasting lipids, liver function, oral glucose tolerance test where appropriate, blood pressure.
Treatment options at The Vesey
- Lifestyle intervention — structured weight management has the largest effect on every PCOS outcome.
- Combined hormonal contraception — cycle regulation, endometrial protection, androgen reduction.
- Metformin — insulin resistance, weight, ovulation; sometimes alongside GLP-1 receptor agonists for weight management.
- Anti-androgen therapy — for hirsutism and acne where contraception is not sufficient.
- Ovulation induction — letrozole first-line for PCOS-related infertility, coordinated with assisted conception centres.
- Cardiometabolic surveillance — annual review of weight, BP, HbA1c, lipids.
Does PCOS affect my chances of getting pregnant? +
PCOS is the commonest cause of anovulatory infertility. However, most women with PCOS can conceive with the right treatment. Letrozole is first-line for ovulation induction and has an excellent success rate. Where medication alone is insufficient, coordinated input with an assisted conception centre is arranged.
Can PCOS be cured, or is it a lifelong condition? +
PCOS is a long-term condition that cannot be cured, but every consequence — irregular cycles, excess hair, acne, infertility, and metabolic risk — can be treated effectively. Many women find symptoms improve significantly with weight optimisation, appropriate medication, and structured follow-up.
What blood tests are done to diagnose PCOS? +
A standard panel includes FSH, LH, oestradiol, testosterone, SHBG, free androgen index, prolactin, TSH, AMH and 17-OH progesterone where indicated. HbA1c, fasting lipids and liver function are checked for metabolic risk. Results are reviewed alongside a pelvic ultrasound.
Is weight loss the only treatment for PCOS? +
No, though lifestyle change has the largest impact across all PCOS outcomes. Treatment may include combined hormonal contraception (cycle regulation and androgen reduction), metformin (insulin resistance and ovulation), GLP-1 receptor agonists (weight management), anti-androgen therapy (hirsutism and acne), or ovulation induction for fertility.
Pricing at a glance
Initial gynaecology / endocrinology consultation £260. Hormone profile from £190. Pelvic ultrasound from £240. Metabolic workup from £150. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to see a specialist
Book if you have suspected PCOS that has never been formally worked up, an existing diagnosis without a structured management plan, or PCOS-related infertility.
Cost and pathway
Initial gynaecology / endocrinology consultation £260. Hormone profile from £190. Pelvic ultrasound from £240. Metabolic workup from £150.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our gynaecology team
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