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Everything you should know about PCOS

PCOS is one of the most common causes of female infertility, affecting six per cent to 12 per cent of US women of reproductive age but, according to the CDC, it’s a lot more than that. This lifelong health condition continues far beyond the child-bearing years. Here, we look at everything you should know about it.
What is PCOS?
PCOS is a condition in which the ovaries produce an abnormal amount of androgens, male sex hormones that are usually present in women in small amounts. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form in the ovaries. However, some women with this disorder do not have cysts, while some women without the disorder do develop cysts.
Polycystic ovaries contain a large number of harmless follicles that are up to 8mm (approximately 0.3in) in size.
The follicles are underdeveloped sacs in which eggs develop. In PCOS, these sacs are often unable to release an egg, which means ovulation does not take place.
The three main features of the condition are:
- irregular periods
- excess androgen
- polycystic ovaries
If you have at least two of these features, you may be diagnosed with PCOS.
What are the symptoms of PCOS?
The symptoms may include:
- Missed periods, irregular periods, or very light periods
- Ovaries that are large or have many cysts
- Excess body hair, including the chest, stomach, and back
- Weight gain, especially around the abdomen
- Acne or oily skin
- Male-pattern baldness or thinning hair
- Infertility
- Small pieces of excess skin on the neck or armpits (skin tags)
What causes PCOS?
The exact cause of PCOS is not clear. Many women with the condition have insulin resistance. This means the body can’t use insulin well. Insulin levels build up in the body and may cause higher androgen levels. Obesity can also increase insulin levels and make PCOS symptoms worse.
PCOS may also run in families. It’s common for sisters or a mother and daughter to have it.
Genes, insulin resistance and inflammation have all been linked to excess androgen production.
What are the complications of PCOS?
Women with PCOS are more likely to develop certain serious health problems. These include type 2 diabetes, high blood pressure, problems with the heart and blood vessels, and uterine cancer.
Women with the condition also tend to have difficulty getting pregnant.
How is PCOS treated?
There’s no cure for PCOS, but the symptoms can be treated.
According to the NHS website, if you have PCOS and you are overweight, losing weight and eating a healthy, balanced diet can make some symptoms better. Medicines are also available to treat symptoms such as excessive hair growth, irregular periods and fertility problems.
If fertility medicines are not effective, a surgical procedure called laparoscopic ovarian drilling (LOD) may be recommended.
This involves using heat or a laser to destroy the tissue in the ovaries that’s producing androgens, such as testosterone. With treatment, most women with PCOS are able to get pregnant.
When should I seek help?
Experts recommend to see your doctor if your body has skipped periods, or you have other symptoms like hair growth on your face or body. Also, you should see a doctor if you’ve been trying to get pregnant for 12 months or more without success.
News
Jill Biden visits Imperial on women’s health and AMR mission

Former US first lady Dr Jill Biden visited Imperial College Healthcare NHS Trust and Imperial College London to explore work on women’s health and antimicrobial resistance.
The visit was hosted by professor the Lord Darzi of Denham, who chairs the Fleming Initiative and directs Imperial’s Institute of Global Health Innovation.
Dr Biden, chair of the Milken Institute’s Women’s Health Network, spoke about the impact scientists, clinicians, innovators and investors can have on improving women’s healthcare.
Dr Biden stressed the importance of “collaboration, prevention and education” in improving women’s health globally.
At the museum, Dr Biden and Esther Krofah, executive vice-president of health at the Milken Institute, heard about the worldwide significance of the discovery and the contribution of women who, during wartime Britain, grew penicillin in bedpans to support early experimentation.
The discussion also explored how AMR is a key women’s health issue, with women disproportionately affected in low and middle-income countries, and in high-income settings where women are more likely than men to be prescribed antibiotics.
Dr Biden was shown an architectural model of the Fleming Centre in Paddington, which will bring together research, policy and public engagement to address AMR worldwide.
The second part of the visit brought together Imperial clinicians, researchers and innovators for a roundtable on women’s health priorities, including improving diagnosis, equity in maternity care and support during the menopause transition.
Participants highlighted wide variation in the quality of care for conditions affecting women and called for fairer access to services, with the postcode lottery named as a priority to address.
Professor Tom Bourne, consultant gynaecologist and chair in gynaecology at Imperial’s Department of Metabolism, Digestion and Reproduction, described how AI could improve diagnostic accuracy for conditions such as endometriosis.
Equity emerged as a central theme.
Professor Alison Holmes, professor of infectious diseases at Imperial College London and director of the Fleming Initiative, highlighted persistent gaps in women’s representation in clinical trials, including antibiotic studies, which limits the ability to optimise care and treatments.
Dr Christine Ekechi, consultant obstetrician and gynaecologist at Imperial College Healthcare NHS Trust, drew on national maternity investigations to underline the importance of valid data, meaningful engagement with affected communities and rebuilding trust.
Menopause and midlife health were also identified as priorities for clinical research.
Professor Waljit Dhillo, consultant endocrinologist and professor of endocrinology and metabolism in Imperial’s Department of Metabolism, Digestion and Reproduction, described a new treatment for hot flushes, including for women unable to take hormone replacement therapy, such as those with a history of breast cancer.
The discussion then turned to bringing innovation into health systems. Innovators shared how data and technology are being used to close gaps in women’s health, while noting challenges in accessing funding to grow and scale.
Dr Helen O’Neill and Dr Deidre O’Neill, co-founders of Hertility Health, described predictive algorithms using self-reported data to help diagnose gynaecological conditions at scale.
Embedded into clinical workflows, the technology could reduce waiting times, identify conditions earlier and improve outcomes. They noted how “we have cures for the rarest genetic conditions but don’t even have the answers to common women’s health issues.”
Dr Lydia Mapstone, Dr Tara O’Driscoll and Dr Sioned Jones, co-founders of BoobyBiome, outlined work creating products that harness beneficial bacteria found in breast milk to support infant health.
By isolating and characterising key microbial strains, BoobyBiome has created synbiotics, combinations of beneficial bacteria and the food that nourishes them, to make these benefits accessible to all babies.
Speakers throughout the visit stressed the need to reduce variation in care quality and outcomes for women, strengthen prevention and education, and address power and equity in women’s health.
Professor the Lord Ara Darzi said: “It was a privilege to welcome Dr Biden and the Milken Institute to Imperial to meet some of the outstanding researchers, clinicians and innovators advancing women’s health.
“Imperial’s unique combination of clinical excellence and world-leading research positions us at the forefront of tackling the biggest health challenges facing society and the UK’s ambition for innovation demands nothing less.
“For too long, the health needs of women and girls across their life course have not received the attention they deserve.
“By working together across borders and disciplines, we can transform equitable access to care, accelerate the detection and treatment of disease, and ultimately improve health outcomes for millions of women in the UK and around the world.”
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