What is PCOS (Polycystic ovary syndrome)?

🌸 PCOS : An overview

PCOS is a relatively common hormonal imbalance that affects women. It’s a condition that encompasses multiple factors: these include a disruption of hormones produced by the ovaries and the pituitary gland*, as well as changes in how the body functions. 

This condition was discovered in 1935 by Stein-Leventhal, hence the name "Stein-Leventhal Syndrome", which it is also sometimes referred to as. 

*The pituitary gland is a small gland located in the brain. Its main function is to produce hormones.

Symptoms of PCOS 

Here are the most common symptoms experienced : 

• Irregular menstrual cycles or no periods
• Acne
• Excessive hair growth in unusual places (chin, abdomen, etc.)
• Weight gain or difficulty losing weight
• Insulin resistance (which is also a contributing factor in PCOS)
• Chronic fatigue
• Hair loss
• Ovaries with a multifollicular appearance
• Difficulty conceiving
• Depression, stress, anxiety (our mental health article might help)
• Low sex drive

In terms of the symptoms mentioned by women afflicted with PCOS, this list is by no means exhaustive.

Diagnostic Criteria for PCOS

In the UK, the diagnosis of PCOS is based on a combination of medical history, blood tests, and imaging – usually an ultrasound scan of the ovaries (most often transvaginal for adults). Your GP will often refer you to a gynaecologist or sometimes an endocrinologist for further assessment.

Like most of Europe, the UK follows the Rotterdam criteria, recognised by the NHS and international health bodies.

According to these criteria, a diagnosis of PCOS can be made when two out of the following three signs are present:

1. Clinical or biological hyperandrogenism – this means either visible signs of high androgens (such as hirsutism, acne, or hair thinning) or raised androgen levels found on blood tests.
   
   

2. Irregular ovulation or anovulation – typically seen as irregular or absent menstrual cycles.

3. Polycystic ovaries on ultrasound – showing a multifollicular appearance (20 or more follicles in at least one ovary, or ovarian volume above 10ml).

📝 Important: In the UK, an ultrasound is not recommended for teenagers unless they are more than 8 years past their first period, because multifollicular ovaries are very common during adolescence.

🖊 Examples of how a diagnosis might look in practice:

●   Marie, 26 years old, suffers from acne (clinical hyperandrogenism) and hasn't had a period for 2 years (anovulation). However, her ovaries have a normal appearance during an ultrasound scan.

●   Jade has irregular cycles (irregular ovulation) and on the ultrasound scan there are 20 visible follicles (ovaries with a polycystic appearance). She does not have acne or any other visible signs of hyperandrogenism.

●   Zoé has not had an ultrasound scan, but she has 60-day cycles (irregular ovulation) and excessive hair growth (clinical hyperandrogenism).
 

💡 Did you know?
Other countries sometimes use different rules. For example, in the US, hyperandrogenism must be present for a PCOS diagnosis. But in the UK, any 2 of the 3 Rotterdam criteria are enough – as long as other conditions (like thyroid disorders or high prolactin levels) are ruled out first.

"Cysts" that are not really cysts

Vocabulary used to describe Polycystic Ovary Syndrome tends to revolve around the idea of "cysts," but we now know this is not the case.       

When the condition was first discovered, doctors believed that the small masses visible on ovarian ultrasound scans were cysts. Today, we know they are actually follicles.

Follicles are small pockets where eggs mature. When an egg is ready to be released, the "dominant" follicle (the largest one) ruptures to let it pass: this is what is commonly known as ovulation.

For women afflicted with PCOS, eggs take much longer to mature than normal. This results in an accumulation of follicles in the ovaries. In simple terms: there is no dominant follicle; as a result, eggs remain in their small pockets and are not regularly released.

This creates what can best be described as a "traffic jam" scenario and gives the ovaries a "multifollicular" appearance on ultrasound scans. A more accurate term would be "ovaries with a multifollicular appearance."

 *An egg cell is also known as a female gamete, as opposed to a sperm cell, which is the male gamete. If an egg cell is fertilised by a sperm cell, it becomes an "ovum." An egg cell is tiny, yet it is the largest cell in the human body !

The Different Types of PCOS

PCOS is often classified into four major categories. Please bear in mind that you may well fall into multiple categories. 

It's not necessarily essential to fit into one of these boxes; the key is to actually identify the source of the imbalance for personalised management. 

👉 If you want to discover the four types of PCOS, discover the 4 types of PCOS here!

If you’ve made it this far, congratulations! By now, you’re probably wondering: “What can I actually do to get this under control?”

Your gynaecologist will likely bring up the contraceptive pill as a first option. The pill works by “pausing” your menstrual cycle — no cycle means fewer hormonal symptoms to deal with. It’s quick, it’s convenient, and for many women, it’s an easy solution.

But more and more women are looking for alternatives. Some don’t tolerate the pill well. Others simply want to explore more natural options — not to reject medicine, but to feel more in control of their bodies.

That’s where a natural approach comes in. This means looking at your diet, your lifestyle, and yes — the right supplements.

✨ Supplements like Ovastart (rich in inositol and zinc) can help regulate cycles, balance hormones, and support your overall reproductive health.

✨ If insulin resistance or sugar cravings are part of your PCOS picture, Sugar Balance combines cinnamon, berberine, and green tea to help manage blood sugar levels.

✨ And for those who want an “all-in-one” start, the Balance Bundle brings both together — a simple way to cover the foundations.

The truth is, there’s no one-size-fits-all solution. You might choose a medical approach (the pill), a natural approach (diet, lifestyle, supplements), or a mix of both.

Whatever you choose, one thing is non‑negotiable: a healthy diet and lifestyle are the foundation for managing PCOS and feeling better in the long run.