Polycystic ovarian syndrome, or PCOS, is a common condition associated with underlying hormone imbalances, which affects how a woman’s ovaries work and causes a range of symptoms.

Yet, it can often go undiagnosed for years, and general awareness of the condition is still relatively low.

So, with World PCOS Day on September 1, which also marks the start of PCOS Awareness Month, we asked some women’s health and hormone specialists to help demystify the topic. Here are some key facts every woman, partner and family member needs to know about PCOS…

1. PCOS is a syndrome“PCOS is not a disease but a syndrome, meaning it is a collection of specific symptoms that can vary significantly from one individual to another,” says Hannah Alderson, hormone specialist and registered nutritionist.

“The syndrome is characterised by issues with hormonal production, particularly an overproduction of testosterone, cortisol and insulin, and an underproduction of oestrogen and serotonin.”

2. The Rotterdam criteria is used to diagnose PCOS

There isn’t one single test doctors can perform in order to determine whether someone has PCOS. Jodie Relf, a dietitian specialising in PCOS and spokesperson for supplement brand MyOva, explains that in order to be diagnosed with PCOS, people generally need to meet two of the following three criteria:

Elevated androgens – this can be diagnosed based on blood tests and/or physical signs of androgen excess such as excess facial hair and acne.

Ovulatory dysfunction – indicated by irregular or absent periods.

The presence of polycystic ovaries – diagnosed using an internal scan.

“As part of diagnosing PCOS, it is also important to test other parameters to rule out any other conditions (such as premature ovarian failure, hypothyroidism and hyperprolactinaemia) that may be causing the ‘PCOS like’ symptoms,” adds Relf.

3. How it affects people can vary

Although common symptoms of PCOS include facial acne, excess hair growth, weight gain, anovulation or irregular cycles, women affected can experience the condition differently, Relf explains.

“It’s really important to remember that the symptoms show up differently for everyone, which is why PCOS requires a personalised approach to be managed effectively,” she says. “Yes, some with PCOS will struggle with their weight and ‘abdominal obesity’, however there is large percentage of those with PCOS who are in smaller bodies and don’t have issues with their weight.”

Some of the symptoms may be more vague, such as headaches, mood changes, sleep problems and depression. Fatigue and tiredness are also common.

4. PCOS can make managing weight tricky

“One of the biggest misconceptions about PCOS is that overweight women with PCOS are lazy and just need to eat less, which is not true,” says Alderson. “Due to the metabolic nature of PCOS, it can be extremely difficult to lose weight, and very easy to gain it.

“Another myth is that losing weight will solve PCOS, but solely losing weight does not address the root cause.”

5. It is still possible to get pregnant with PCOS

“It is incorrect to believe that women with PCOS cannot fall pregnant; while it may be more challenging, it is possible to have a family with PCOS,” says Alderson.

“PCOS can impact fertility because if you’re not ovulating, you won’t naturally fall pregnant, making PCOS a leading cause of infertility,” explains Alderson. “However, it is not a definitive sentence of infertility. By addressing the root causes of PCOS, a woman’s chances of falling pregnant can be positively impacted.”

6. PCOS is manageable

Managing PCOS can vary for each person, but a combination of medication and lifestyle measures – such as dietary changes and exercise – can help decrease the intensity of the symptoms.

“There are a number of ways in which PCOS can be treated. These include making lifestyle changes to lose weight (if necessary) and eating more high-fibre foods to address insulin resistance, whilst reducing consumption of refined carbs and sugar,” says women’s health expert Dr Shirin Lakhani. “Exercising daily can also help, as can taking steps to reduce stress.

“People with PCOS can also be prescribed medication to help regulate periods and decrease insulin resistance, as well as to address excessive facial hair and acne. If you’re concerned that you may have PCOS, it’s important to seek medical advice and support.”