Could my irregular periods or acne be PCOS, and what can help?

What does PCOS mean?

Polycystic ovary syndrome is commonly called PCOS in India. You may also encounter the newer name polyendocrine metabolic ovarian syndrome, or PMOS, endorsed by ASRM in May 2026. This describes the broader hormonal and metabolic effects; it does not mean that you have developed a different illness. This guide uses PCOS because it remains a familiar search term.

The small follicles described on a scan are not the same as an ovarian cyst that might need an operation. Some people with PCOS have no polycystic appearance on ultrasound. Others have that appearance without having the syndrome.

Which symptoms are worth discussing?

Periods that are infrequent or unpredictable, increased facial or body hair, troublesome acne and scalp hair thinning can prompt assessment. Symptoms vary, and PCOS can occur at any body size. Difficulty becoming pregnant may be related to irregular ovulation, but it should not automatically be attributed to PCOS alone.

Tell your doctor how symptoms affect sleep, mood, confidence, work and relationships. These concerns deserve attention alongside blood tests. A period diary and a list of medicines, including supplements, are often more useful than buying a large screening package before your appointment.

How is the diagnosis made?

In adults, diagnosis generally requires two of three features after other causes have been excluded: irregular ovulation, evidence of higher androgen activity, and a characteristic ovarian appearance. In selected adults, AMH can be used instead of ultrasound to assess the ovarian feature; AMH alone cannot diagnose PCOS.

Pregnancy, thyroid problems and other hormone conditions may need consideration. Adolescents require a different approach: persistent menstrual irregularity and androgen excess are assessed together, and ultrasound or AMH should not be used to establish the diagnosis. An early label based only on a scan can be misleading.

How can treatment be tailored to me?

There is no single treatment that everyone needs. When pregnancy is not currently desired, a suitable hormonal contraceptive or prescribed progesterone may help manage bleeding and protect the uterine lining. Acne and excess hair can need separate treatment. Metformin may be considered for metabolic indications or selected menstrual concerns; it is not automatically needed by everyone.

Treatment choices should account for your medical history, other medicines, side effects and preferences. Do not start hormone tablets, anti-androgen medicines or fertility medicines from an online recommendation. If periods are very far apart, ask specifically whether the uterine lining needs protection rather than waiting indefinitely for bleeding to return.

What can I do day to day?

Regular movement, adequate sleep and sustainable meals support health even when weight does not change. An Indian eating pattern can include familiar foods such as dal, vegetables, fruit, whole grains and appropriate protein; an expensive restrictive “PCOS diet” is not essential. Choose changes you can keep up with and ask for nutrition support if needed.

Discuss blood pressure, glucose and cholesterol assessment with your doctor. The frequency depends on your circumstances. A useful follow-up plan includes both symptoms and general health, with space to discuss anxiety, low mood or difficulties with eating. Progress should not be judged by a weighing scale alone.

What if I want a pregnancy?

Many people with PCOS become pregnant, sometimes with help to achieve ovulation. The plan should also consider age, semen findings and whether the fallopian tubes need assessment. When anovulation from PCOS is the only identified fertility factor, supervised letrozole is commonly a first-line medicine; treatment still needs individual prescribing and monitoring.

Before trying, review medicines and preconception needs with your doctor. An irregular cycle is a reason to seek advice earlier rather than waiting a full year. See our fertility service and fertility-evaluation guide for the broader assessment of both partners.

What should I ask at my consultation?

Questions to ask at your consultation

• Which findings support my diagnosis, and what else has been excluded?
• Do I need protection for my uterine lining?
• Which treatment fits my pregnancy plans and medical history?
• What health checks and follow-up would be useful?

What else do patients ask?

Related care: Gynaecology consultations.

Read also: When to seek fertility evaluation.