Polycystic ovary syndrome (PCOS):
What’s really going on?
Is this normal?
Irregular periods? Stubborn acne that won’t budge? Extra hair in places you don’t expect—or hair loss where you do? If you’ve noticed changes in your cycle or your body that just don’t feel right, it could be PCOS.
It’s one of the most common hormonal conditions affecting people with ovaries yet many people don’t know they have it.
Let’s talk about what it really means to live with PCOS, and what you can do if this sounds like you.
Understanding
What is PCOS, exactly?
Polycystic ovary syndrome (PCOS) is a hormonal condition that affects how the ovaries work. Despite the name, it doesn’t always involve actual cysts. The word “polycystic” refers to the appearance of the ovaries on ultrasound, which often show many small follicles.
What’s really going on is an imbalance in hormones, especially higher levels of androgens (commonly called “male” hormones), which can affect ovulation, skin, hair growth, and metabolism.
PCOS can start at any time after puberty and often continues through the reproductive years. It affects around 1 in 10 women and people assigned female at birth, although many go undiagnosed for years.
What causes PCOS?
There’s no single cause, but research suggests that genetics, insulin resistance, and inflammation all play a role.
PCOS tends to run in families, and it’s more likely if other relatives also have hormone or metabolic conditions. High insulin levels (a sign of insulin resistance) can increase androgen production and disrupt ovulation, which is why PCOS is often linked to weight gain or difficulty losing weight but not always.
PCOS symptoms
What does PCOS feel like?
PCOS can look and feel different for everyone. Some people have obvious signs; others only discover it while investigating irregular cycles or fertility issues.
Common symptoms include:
- Irregular, infrequent, or missing periods
- Acne or oily skin (often persistent past the teenage years)
- Excess hair growth on the face, chest, stomach or thighs
- Thinning hair or hair loss on the scalp
- Weight gain or difficulty losing weight
- Trouble conceiving
- Fatigue or low mood
- Darkened skin patches (often under the breasts, neck or armpits)
You don’t need to have all of these to have PCOS. Some people only have one or two.
Why does it take so long to get diagnosed?
Because PCOS symptoms overlap with lots of other things like teenage hormone changes, stress, or thyroid conditions. It can be easy to miss.
Some people are told their symptoms are “just normal teenage stuff” or blamed on lifestyle. Others go years without a diagnosis, especially if they’re not trying to conceive.
If you’ve ever felt brushed off or like you had to “push” for answers, you’re not imagining it. You’re not alone.
How is PCOS diagnosed?
There’s no single test. A diagnosis is usually made based on:
- Your symptoms and medical history
- A physical exam (including skin, hair and weight)
- Blood tests to check hormone levels
- An ultrasound to look for the “polycystic” appearance of the ovaries
You don’t need to tick every box to be diagnosed. Your GP may refer you to a gynaecologist to confirm the diagnosis and work out the best management plan.
How can PCOS be managed?
There’s no “cure” for PCOS, but symptoms can be managed often quite effectively. The right plan depends on your goals, such as regulating periods, improving skin, managing weight, or planning for pregnancy.
Management options may include:
Hormonal treatments
Such as the oral contraceptive pill, progesterone tablets, or hormonal IUDs to regulate cycles and reduce androgens.
Insulin-sensitising medication
Metformin may help reduce insulin resistance and improve ovulation.
Lifestyle changes
For some, gentle regular exercise and balanced nutrition can improve insulin levels and hormone balance.
Fertility support
If you're trying to conceive, there are medications and assisted reproductive options that can help.
Mental health care
Anxiety, low mood, and body image concerns are common. Support from a psychologist or counsellor can be very valuable.
The goal isn’t to “fix” you. It’s to support your body in the way it works best, whatever that looks like for you.
What people are saying
Here are some anonymous reflections from people living with PCOS:
- “I went years without a diagnosis because I was on the pill. I only found out when I came off it to try for a baby.”
- “My periods were all over the place, and I thought the fatigue was just me being unfit or lazy.”
- “The hair on my chin really affected my confidence. I used to plan my day around whether I’d shaved.”
- “It was only when I saw a specialist that someone finally connected all the dots.”
These are common experiences and nothing to be ashamed of.
PCOS treatment plan
What now?
If you think PCOS could be part of what you’re experiencing, here’s what you can do today:
Track your symptoms:
Keep note of your cycle, skin changes, mood, fatigue, and any hair growth or weight shifts.
Talk to your GP:
Ask if PCOS could be a factor, and whether blood tests or an ultrasound might help clarify things.
Be clear about your goals:
Whether it’s cycle regulation, fertility, skin care or energy, your goals help guide your options.
Don’t go it alone:
If you’d like support or a second opinion, I’m here. There are strategies we can explore together.
PCOS Specialist Perth
Let’s take the pressure off
You don’t have to tick every box. You don’t have to do this alone. PCOS can be overwhelming, but it can also be managed with the right care, support, and information.
- Follow me on Instagram for educational content and women’s health conversations.
- Book a consultation if you’d like to talk things through
- Download a symptom tracker to bring along to your GP or specialist appointment. As a founder of Charli.health, I’ve worked on a symptom tracker designed to help you log your cycle and symptoms. It’s a simple tool you can use to support conversations with your healthcare team.