PATIENT RESOURCE

PCOS: Symptoms, Diagnosis & Treatment

Polycystic ovary syndrome is common. It can affect periods, skin and hair, fertility, and long-term health - but there are effective ways to manage it.

Patient information from the Verra Health Clinic team · Last reviewed August 2026

A note about PCOS: You do not need to have every symptom, and PCOS can occur at any body size. Your care should be based on your symptoms, health, and goals - not on weight alone.

What is PCOS?

PCOS is a hormonal condition that can affect menstrual cycles, ovulation, skin and hair, fertility, mood, and blood sugar regulation. The name can be confusing. You can have PCOS without having ovarian cysts, and seeing small follicles on an ultrasound does not by itself mean that you have PCOS.

Common symptoms

Periods that are irregular, infrequent, very heavy, or absent
Difficulty predicting ovulation or getting pregnant
Increased facial or body hair, or scalp hair thinning

Acne or oily skin, especially after adolescence
Weight changes or difficulty managing weight
Darkened, thickened skin folds, sometimes linked with insulin resistance

Symptoms vary from person to person, and some people have few visible symptoms. Depression, anxiety, poor sleep, and sleep apnea are also more common in people with PCOS and should be discussed as part of your care.

How is PCOS diagnosed?

There is no single test for PCOS. In adults, your clinician will usually look for at least two of the following, after ruling out other causes: irregular or absent ovulation, signs or blood-test evidence of higher androgen levels, or polycystic-appearing ovaries on ultrasound. Your medical history is an important part of the diagnosis.

Depending on your symptoms, tests may include thyroid and prolactin levels, androgen hormones, glucose or A1C, and cholesterol. An ultrasound is not always needed. Your clinician may also check for other conditions that can cause irregular periods, acne, or excess hair.

Health checks that matter

People with PCOS have a higher chance of insulin resistance and type 2 diabetes, high blood pressure, abnormal cholesterol, sleep apnea, and depression or anxiety. At follow-up, your clinician may check your blood pressure, glucose or A1C, and cholesterol, and ask about your sleep and mood. The timing of these checks depends on your health and family history.

Treatment options

Treatment is chosen according to the symptoms and health concerns that matter most to you. You may need treatment for one issue, or several treatments at the same time.

Periods, acne, and excess hair

Combined hormonal contraception can make bleeding more predictable and may improve acne and excess hair.
Progestin may be prescribed from time to time to protect the lining of the uterus if periods are very infrequent.
Acne treatment, laser or other hair-removal methods, and sometimes anti-androgen medication may help. Anti-androgens are not safe in pregnancy, so reliable contraception is important.

Blood sugar and general health

Regular physical activity, balanced meals, adequate sleep, and support for stress can improve health and symptoms. There is no single diet or exercise plan that works best for everyone with PCOS.
Metformin may be useful for some people, particularly when blood sugar or insulin resistance is a concern.
If weight loss is one of your goals, your clinician can help you choose a safe and sustainable approach. Weight is not the only measure of health or treatment success.

PCOS and fertility

PCOS can make ovulation less predictable, but many people with PCOS become pregnant. If you are not trying to conceive, contraception is still needed because ovulation can happen unexpectedly. If you are trying to conceive, your clinician can review your medications, check for other fertility factors, and discuss treatment to help you ovulate. Letrozole is often the first medication discussed when PCOS is the only cause of difficulty ovulating.

Planning a pregnancy? Make an appointment before trying to conceive so your medications and health conditions can be reviewed. Folic acid, blood pressure and glucose checks, and support with sleep, mood, nutrition, and activity may also be recommended.

When to make an appointment

Make an appointment if your periods have become irregular, you have new excess hair or acne, you are concerned about blood sugar, or you have been trying to conceive without success. Seek urgent care for severe pelvic pain, fainting, or very heavy bleeding—for example, soaking through a pad or tampon every hour for several hours.