What is polycystic ovary syndrome (pcos)?
Polycystic ovary syndrome is a hormonal condition in which the ovaries contain many small follicles and may not release eggs regularly, alongside higher levels of androgens ('male' hormones). Despite the name, the follicles are not true cysts. PCOS affects roughly one in ten women of reproductive age and often runs in families. It is also linked with insulin resistance, which raises the longer-term risk of type 2 diabetes and makes weight management harder.
There is no single test for PCOS. Diagnosis is based on having at least two of three features: irregular or absent ovulation, signs or blood-test evidence of excess androgens, and polycystic-appearing ovaries on ultrasound — once other hormonal conditions have been ruled out with blood tests.
Common symptoms
- Irregular or absent periods
- Excess facial or body hair (hirsutism)
- Acne or oily skin
- Weight gain or difficulty losing weight
- Thinning hair on the scalp
- Difficulty getting pregnant
- Low mood or anxiety
How long will you wait?
PCOS is often managed by GPs, but referrals to gynaecology or endocrinology for diagnosis confirmation, symptom control or fertility problems face routine waits of several months, with fertility pathways adding further stages after that.
Privately, you can typically see a consultant within 3–7 days, with blood tests and a pelvic ultrasound completed within 1–2 weeks.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Lifestyle changes. Weight loss of even 5–10% can restore ovulation, improve symptoms and reduce long-term diabetes risk.
- Combined contraceptive pill. Regulates periods and improves acne and excess hair for women not trying to conceive.
- Metformin. Improves insulin sensitivity and can help restore regular cycles, particularly in women with insulin resistance.
- Ovulation induction. Letrozole or clomifene stimulate ovulation for women trying to conceive, with fertility specialist support.
- Hair and skin treatments. Prescription creams, laser hair removal and acne treatments manage the cosmetic effects of excess androgens.
What does private treatment cost?
As a guide, a private assessment including consultation, hormone blood tests and a pelvic ultrasound typically costs £500–£900, with follow-up consultations around £150–£250.
Does health insurance cover polycystic ovary syndrome (pcos)?
PCOS occupies a grey area for private medical insurance. Initial investigation of symptoms such as irregular periods is usually covered if the condition is not pre-existing, but PCOS is a long-term condition, so ongoing management typically falls under chronic-condition exclusions. Fertility treatment arising from PCOS — including ovulation induction and IVF — is almost never covered by standard UK policies.
Frequently asked questions
Does PCOS mean I have cysts on my ovaries?
Not in the usual sense. The 'cysts' in PCOS are actually many small, immature follicles — egg sacs that have paused in development — rather than true cysts needing removal. They are harmless in themselves. You can also have polycystic-appearing ovaries on a scan without having the syndrome, which is why diagnosis relies on symptoms and blood tests as well as ultrasound.
Can I get pregnant with PCOS?
Most women with PCOS can conceive, though it may take longer because ovulation is irregular. Lifestyle changes alone restore ovulation for some women, and ovulation-induction tablets such as letrozole help many others. Only a minority need IVF. If you have been trying for a year — or six months if you are over 35 — ask for a fertility assessment.
What are the long-term health risks of PCOS?
PCOS is associated with insulin resistance, which increases the risk of type 2 diabetes, and with higher rates of high blood pressure and abnormal cholesterol. Very infrequent periods can also slightly raise the risk of womb-lining thickening over time. Regular health checks, maintaining a healthy weight and ensuring you have at least a few periods a year all substantially reduce these risks.
Related guides
- Endometriosis
- Fertility Problems
- Heavy Periods (Menorrhagia)
- Ovarian Cysts
- Pelvic Organ Prolapse
- Uterine Fibroids