The essentials

  • It is a common hormonal disorder that also affects metabolism12.
  • Its signs vary from person to person and can change over time3.
  • It comes with increased health risks, which can be monitored and are not inevitable4.
  • Pregnancy is often possible, naturally or with medical help5.
  • No particular diet or sport has been shown to be better than others6.

Signs that vary a great deal

The syndrome can show itself in several ways: infrequent, unpredictable or absent periods, sometimes heavy or painful; more noticeable hair growth on the face or body; hair loss or thinning; acne or oily skin; difficulty conceiving7. These signs are not always present together and can change over the years3.

Having one or other of these signs does not mean that you have PCOS: only a medical assessment can confirm it8. Conversely, hair growth or hair loss that bothers you deserves to be taken seriously, even if it seems minor to other people9.

Hormones and metabolism

Androgens, which include testosterone, are hormones that everyone has. In PCOS, their levels are often higher than normal, which can explain some of the signs1.

The syndrome also affects the way the body uses insulin, the hormone that moves sugar into cells. This “insulin resistance” is recognised as an important feature, but it is not measured routinely with a blood test, because the tests available are of little use in practice2.

What is still unknown

The exact cause of PCOS is not known. Having family members with PCOS or type 2 diabetes is associated with a higher risk10. The origin is very probably multiple, genetic and environmental, and several hypotheses, such as endocrine disruptors, remain unproven to date11.

Over time: long-term health

PCOS does not stop when plans for pregnancy come to an end: it is a long-lasting condition12. It is associated with certain increased risks:

  • blood sugar problems and type 2 diabetes, whatever your age and weight13;
  • a higher cardiovascular risk, which remains low overall before menopause14;
  • more frequent sleep apnoea15;
  • a higher risk for the lining of the womb (endometrium) before menopause, with a low absolute risk16.

An increased risk does not mean that these problems will happen4. That is precisely why simple follow-up is recommended: blood sugar, cholesterol and blood pressure, at intervals suited to each person17. See what happens after the diagnosis.

Your mood matters too

Symptoms of depression and anxiety are common in people with PCOS, and the guidelines ask clinicians to pay attention to them18. Your relationship with food, your body image and your quality of life can also be affected, whatever your weight19.

You can talk about this at an appointment, even if nobody asks you about it.

Fertility: important nuances

PCOS is the most common cause of absent ovulation and a major cause of infertility20. Even so, pregnancy can often be achieved, naturally or with medical help5.

The opposite is true too: pregnancy is still possible even with irregular cycles. If you do not want to become pregnant, contraception is still useful21. And if you do become pregnant, it is recommended that you tell the team caring for you that you have PCOS, so that monitoring can be adapted22.

Whether you want a pregnancy, want one later, never want one, or do not know yet, your plans matter when choosing your follow-up care.

Weight: moving beyond shortcuts

PCOS affects people of all weights. There is no consistent evidence that people with PCOS eat or move differently, and the mechanisms that promote weight gain remain poorly understood23.

Many people with PCOS experience weight stigma, including in healthcare24. The guidelines encourage clinicians to ask for your consent before weighing you, to explain why, and to offer an approach that is not necessarily focused on weight loss25.

A balanced diet and physical activity are beneficial for everyone with PCOS, even without weight loss26.

Treatment and care: the broad outlines

To date, no treatment makes the syndrome go away. Treatments target symptoms, fertility and the prevention of complications, and they are tailored to each person27.

As general information, the international guideline places the combined contraceptive pill as the first-line option for irregular cycles and signs of excess androgens, and reserves metformin mainly for metabolic aspects28. These pointers are not advice: choices are discussed with a healthcare professional, taking your priorities into account29.

Common misconceptions

  • “You have to have cysts.” No: the “cysts” of the old name are not really cysts, and they are not needed for the diagnosis30.
  • “It's a question of weight.” No: the syndrome affects people of all weights, and the risk of diabetes is increased whatever your weight13.
  • “A blood test is enough to make the diagnosis.” No: no test, including the AMH test, is enough on its own31.
  • “You can't have children.” No: pregnancy can often be achieved, naturally or with medical help5.
  • “There is an anti-PCOS diet.” No type of diet has been shown to be better than another6.
  • “The new name changes the diagnosis.” No: only the name is changing32.

Sources for this page

Each number leads to a neutral statement and to the documents that support it. We summarise these sources in our own words; the links open the original documents.

  1. 1

    The WHO describes a common hormonal disorder in which higher-than-normal androgen levels can lead to irregular periods, ovulation disorders, infertility, excessive hair growth and/or acne.

    Established fact · checked on 18 October 2026

    Back to the text
  2. 2

    Insulin resistance is recognised as an important feature of the syndrome, but the insulin tests available in practice are not recommended routinely.

    Recommendation · checked on 18 October 2026

    Back to the text
  3. 3

    The signs and symptoms vary from one person to another, are not always present at the same time and can change over time.

    Established fact · checked on 18 October 2026

    Back to the text
  4. 4

    An increased risk does not mean that these complications will occur.

    Established fact · checked on 18 October 2026

    Back to the text
  5. 5

    Pregnancy can often be achieved, naturally or with medical help.

    Recommendation · checked on 18 October 2026

    French-language sources word this point differently (see research notes): the wording used here follows the international guideline.

    Back to the text
  6. 6

    No type of diet, and no type or intensity of physical activity, has been shown to be superior to another.

    Recommendation · checked on 18 October 2026

    Back to the text
  7. 7

    Possible signs and symptoms include: infrequent, unpredictable or absent periods (sometimes heavy, long or painful), difficulty conceiving, excessive hair growth on the face or body, hair loss or thinning, and acne or oily skin.

    Established fact · checked on 18 October 2026

    Back to the text
  8. 8

    Having some of these signs does not mean having PCOS: only a medical assessment can confirm the diagnosis.

    Established fact · checked on 18 October 2026

    Back to the text
  9. 9

    The guideline asks healthcare professionals to consider reported unwanted hair growth or hair loss as important, whatever its apparent severity, because of its possible psychological impact.

    Recommendation · checked on 18 October 2026

    Back to the text
  10. 10

    The exact cause remains unknown; a family history of PCOS or type 2 diabetes is associated with a higher risk.

    Established fact · checked on 18 October 2026

    Back to the text
  11. 11

    The origin is very probably multifactorial (genetic, epigenetic, environmental); the predisposing genes identified explain only a small proportion of cases, and the role of endocrine disruptors has not been proven to date.

    Uncertain · checked on 18 October 2026

    Back to the text
  12. 12

    The WHO describes a chronic condition that continues beyond the fertile years, and the guideline considers that the diagnosis can be enduring, or even lifelong.

    Established fact · checked on 18 October 2026

    Back to the text
  13. 13

    Regardless of age and body mass index, the risk of blood sugar disorders and type 2 diabetes is increased.

    Recommendation · checked on 18 October 2026

    Back to the text
  14. 14

    Cardiovascular risk is considered to be increased, while remaining low overall before menopause.

    Recommendation · checked on 18 October 2026

    Back to the text
  15. 15

    Obstructive sleep apnoea is more common, independently of BMI; snoring with waking up unrefreshed, or sleepiness or tiredness during the day, are reasons to bring it up.

    Recommendation · checked on 18 October 2026

    Back to the text
  16. 16

    Before menopause, the risk of endometrial hyperplasia and endometrial cancer is higher, but the absolute risk remains low: routine screening is not recommended.

    Recommendation · checked on 18 October 2026

    Back to the text
  17. 17

    After diagnosis, the guideline provides in particular for a blood glucose check at diagnosis and then every 1 to 3 years depending on risk factors, a lipid profile at diagnosis, and a blood pressure measurement every year.

    Recommendation · checked on 18 October 2026

    Back to the text
  18. 18

    Depressive and anxiety symptoms are common; the guideline provides for screening for depression in adults and adolescents, and for anxiety in adults, at diagnosis and then according to the situation and life events.

    Recommendation · checked on 18 October 2026

    Back to the text
  19. 19

    Eating disorders should be considered whatever the person's weight, and the features of the syndrome can affect body image and quality of life.

    Recommendation · checked on 18 October 2026

    Back to the text
  20. 20

    According to the WHO, it is the most common cause of absent ovulation and a major cause of infertility.

    Established fact · checked on 18 October 2026

    Back to the text
  21. 21

    A spontaneous pregnancy is still possible even with irregular ovulation: contraception is therefore useful when no pregnancy is planned.

    Established fact · checked on 18 October 2026

    Back to the text
  22. 22

    Pregnancies are considered to be at higher risk of complications; it is recommended that PCOS be flagged during pregnancy care so that monitoring can be adapted.

    Recommendation · checked on 18 October 2026

    Back to the text
  23. 23

    There is no consistent evidence that people with the condition eat or move differently; the mechanisms that promote weight gain remain poorly understood.

    Recommendation · checked on 18 October 2026

    Back to the text
  24. 24

    Many people with the condition experience weight stigma, including in healthcare; professionals are encouraged to recognise their own biases.

    Recommendation · checked on 18 October 2026

    Back to the text
  25. 25

    The guideline encourages asking permission before weighing and explaining the reason, and offering an approach that is or is not focused on weight loss according to each person's goals.

    Recommendation · checked on 18 October 2026

    Back to the text
  26. 26

    A balanced diet and physical activity are beneficial for everyone with the condition, even without weight loss.

    Recommendation · checked on 18 October 2026

    Back to the text
  27. 27

    To date, no treatment makes the syndrome go away; treatments target symptoms, fertility and the prevention of complications, and are tailored to each person.

    Established fact · checked on 18 October 2026

    Back to the text
  28. 28

    Medicines are chosen according to symptoms and plans: the international guideline places the combined contraceptive pill as first-line treatment for irregular cycles and signs of excess androgens, and reserves metformin mainly for metabolic aspects.

    Recommendation · checked on 18 October 2026

    Practices and marketing authorisations may differ in Switzerland and France: to be reviewed as a priority.

    Back to the text
  29. 29

    The guidelines emphasise shared decision-making: choices take into account each person's values and preferences.

    Recommendation · checked on 18 October 2026

    Back to the text
  30. 30

    The “cysts” suggested by the old name are not a feature of the syndrome: the appearance of the ovaries on ultrasound corresponds to follicles whose development has stopped, and cysts are not needed for the diagnosis.

    Established fact · checked on 18 October 2026

    Back to the text
  31. 31

    The AMH test should not be used as the only test for the diagnosis, and it is not done in addition to an ultrasound, in order to limit overdiagnosis.

    Recommendation · checked on 18 October 2026

    Back to the text
  32. 32

    According to the team that coordinates the international guideline, the name change does not alter the content of the 2023 recommendations, the diagnostic criteria or the approach to care.

    Established fact · checked on 18 October 2026

    Back to the text