Tag: pcos treatment

Managing Polyendocrine Metabolic Ovarian Syndrome (PMOS) (formerly Polycystic Ovary Syndrome, PCOS) starts with a simple question: which symptoms matter most to you right now? There’s no single treatment, because the condition affects everyone differently. The right approach depends on your symptoms, your wider health, whether you need contraception and whether you’re trying to conceive. Living with PMOS can mean juggling several symptoms at once: irregular periods, acne, unwanted facial hair, thinning hair, fatigue, or changes to your weight and metabolism. Or it might be just one or two that really bother you. Either way, PMOS rarely needs to be tackled all at once. Here, Dr Yewande, a Women’s Health GP at Hertility, shares practical, evidence-based ways to manage some of the most common PMOS symptoms, and the treatments and support that can help. For a full overview of the condition, read our guide to everything you need to know about PMOS (PCOS). Quick facts 1. Keep track of your periods, even if they have always been irregular If your periods have always been unpredictable, it’s tempting to accept long gaps as normal for you. But with PMOS (PCOS), how often you bleed matters as much as how predictable your cycle is. A typical cycle lasts 21 to 35 days. With PMOS (PCOS), periods often come less frequently, stop altogether (amenorrhoea) or arrive erratically, because PMOS can disrupt ovulation. Why frequency matters. After you ovulate, your body makes progesterone. If you rarely ovulate, your womb lining is exposed to oestrogen without that regular progesterone. Over time, this can make the lining thicken too much, a condition called endometrial hyperplasia. The relative risk of endometrial cancer is also higher with PMOS, although the absolute risk stays low meaning that even though the chance of developing endometrial cancer with PMOS is higher than if you didn’t have PMOS the actual risk of it occurring is low. That’s why long gaps in periods are still worth acting on rather than ignoring. What can help? If you regularly go several months without a period, speak to your GP. Depending on your history and whether you need contraception, options may include hormonal contraception like the pill, a hormonal coil such as the Mirena, or intermittent courses of a progestogen to bring on a withdrawal bleed. If you’re trying to conceive, your options will be different, because the focus shifts to understanding and supporting ovulation. Don’t wait for your cycles to settle before mentioning them. Keep a record for 2-3 months before your appointment of your cycle length (first day of one period to first day of the next), how long bleeding lasts, how painful it is, and flow (light, medium, heavy), so you can tell your doctor exactly how often you’re bleeding.  Want to understand what’s happening with your hormones? Hertility’s Advanced Hormone and Fertility Test helps you build a clearer picture of your hormones and cycle, with results reviewed alongside your symptoms and health history. 2. Stop searching for the perfect “PCOS diet” There’s no single diet proven to be best for PMOS (PCOS). Low-carb diets, keto, intermittent fasting and other eating plans are often promoted for PMOS (PCOS)., but the international guidelines doesn’t recommend one diet over another. Rather than following strict rules, focus on an eating pattern that supports your health and that you can realistically keep up. For many people, that means: If insulin resistance is a concern, eating carbohydrates alongside protein, fibre and healthy fats can make meals more filling and help keep your blood sugar steady. But eating well with PMOS (PCOS), shouldn’t mean constant dieting or feeling guilty about food. The best approach fits your health, culture, budget, preferences and relationship with food. Read our guide on There a Best Diet for PMOS (PCOS)?. If nutrition feels confusing, a Hertility Nutrition Consultation can help you build a plan around you, rather than another generic PMOS (PCOS)  meal plan. 3. Exercise for your health, not just the number on the scales Exercise is one of the most useful tools for managing PMOS (PCOS)., even if your weight doesn’t change. Regular activity supports insulin sensitivity, heart health, sleep, mood and metabolic health. There’s no single “best exercise for PCOS”: current recommendations suggest around 150-300 minutes of moderate activity a week (or 75-150 minutes of more vigorous activity). Either way, add muscle-strengthening activity on at least two days a week. This is in line with UK physical activity guidelines. That doesn’t have to mean intense workouts. Walking, cycling, swimming, Pilates, resistance training or a combination of these are all good options, and the best type is the one you’ll actually keep doing. If you’re currently doing very little, jumping straight to 10,000 steps and five gym sessions a week can make exercise feel impossible. Start smaller. A 15 to 20 minute walk most days is better than an ambitious plan you give up on after a fortnight. 4. If you’re constantly exhausted, don’t automatically blame PCOS Fatigue is common with PMOS (PCOS), but it has many possible causes. Depending on your symptoms, your doctor may check for: PMOS (PCOS) is also linked with a higher rate of obstructive sleep apnoea, regardless of your weight. So if you snore heavily, wake up unrefreshed, get morning headaches or feel unusually sleepy during the day, mention it to your doctor. Sleep apnoea is treatable, and it’s often missed. 5. Your skin symptoms might be hormonal, and topical treatment may not be enough Persistent acne or oily skin can be a visible sign of the hormonal changes linked to PMOS (PCOS). Higher androgen activity (including testosterone) can increase oil production and contribute to acne. This is particularly likely when it appears alongside irregular periods, excess facial or body hair, or scalp thinning. Topical treatments. These can still be very effective. Depending on severity, options include benzoyl peroxide, azelaic acid, topical retinoids or other prescription treatments. When acne keeps coming back. If your acne keeps returning or isn’t improving despite the right treatment, that’s a clue […]

Can GLP-1s like Ozempic or Mounjaro help with PCOS? Our experts explain how they work, safety rules before pregnancy, and what to know about long-term use. Thank you to everyone who joined our recent webinar, “GLP-1 RAs: The PCOS Game Changer?”with Dr. Helen O’Neill and Dr. Paul Hardiman. The overwhelming response (over 600 attendees) confirmed the critical need for transparent, evidence-based information regarding these new therapies and their role in managing Polycystic Ovary Syndrome. We know the session generated significant interest and, crucially, many complex questions about everything from long-term safety and fertility planning to navigating the NHS and finding effective alternatives. This document serves as our expert-synthesised FAQ, acting as a crucial next step in your journey. It consolidates the questions we received into a concise, actionable resource. This FAQ will help you understand: By providing these clinically-vetted answers, we aim to empower you to have confident, informed conversations with your own healthcare providers, ensuring your PCOS management pathway is truly personalised and effective. Understanding PCOS and How GLP-1 Medications Fit In What does an irregular period mean in PCOS? According to the 2023 International Evidence-Based Guidelines (Teede et al., 2023), for women 3 years post-menarche up to the perimenopause stage, irregular menstrual cycles are defined as: OR Does everyone with PCOS have insulin resistance, even if my test results (such as glucose) have always been negative? No, not everyone with PCOS has insulin resistance (IR), but it is a critical part of the syndrome’s pathogenesis, documented in approximately 75% of women with PCOS (Cleveland Clinic, 2024).It is important to know that in the early stages of IR, standard tests like fasting glucose or HbA1c may appear normal because the pancreas is compensating by overproducing insulin (hyperinsulinemia). Therefore, monitoring glucose levels alone will not reliably detect the onset of IR. If my BMI is within the normal range (lean PCOS), would GLP-1 RAs still help with my symptoms (like skin, mood, or central adiposity)? Yes, GLP-1 RAs primarily target insulin sensitivity, which is thought to be a core driver of the syndrome, not just weight loss. Preclinical studies indicate that GLP-1 RAs can directly improve reproductive endocrinopathy by reversing high Luteinising Hormone (LH) levels and reducing serum testosterone and the Free Androgen Index (FAI) (Bednarz et al., 2022). These hormonal improvements offer a potential treatment strategy to manage hyperandrogenism-related symptoms regardless of BMI. What are the non-pill treatment options for managing acne and irregular periods in women with lean PCOS? For women with a normal BMI who wish to avoid the contraceptive pill, management focuses on lifestyle and targeted therapies: Ensure you consult a doctor or sexual health specialist before taking any supplements, vitamins or starting new treatments.  . At Hertility, we provide diagnostic testing with clinical grade results into your hormonal health. Get actionable insights into your reproductive health and egg count, and screen for up to 18 conditions such as PCOS. Receive in-depth insights, a comprehensive Doctor-written report, a clinically recommended Care Plan, and a complimentary Clinical Result Review Call. My GP is reluctant to diagnose or treat me for PCOS; what steps can I take to get appropriate care? PCOS diagnosis in the UK is guided by International Evidence-based Guidelines, typically using the Rotterdam Criteria (2 out of 3 features: irregular periods, hyperandrogenism, or polycystic ovarian morphology) (NICE, 2025; Teede et al., 2023). If you are struggling to get a diagnosis, ensure you have documented evidence of your symptoms (irregular periods, clinical signs like acne or hirsutism, and any relevant blood test or ultrasound reports). The Hertility Advanced Hormone & Fertility Test is a diagnostic test with clinical grade results into your hormonal health. Get actionable insights into your reproductive health and egg count, and screen for up to 18 conditions such as PCOS. Receive in-depth insights, a comprehensive Doctor-written report, a clinically recommended Care Plan, and a complimentary Clinical Result Review Call. We also provide fast referrals to leading UK private fertility clinics and treatment centres for comprehensive onward care. GLP-1 for PCOS: Safety, Effectiveness and Long-Term Use If I achieve my weight and symptom goals on a GLP-1 RA, will I regain the weight and symptoms if I stop taking it? Is this medication necessary long-term? GLP-1 RAs should generally be viewed as a long-term management strategy for a chronic metabolic condition. Clinical data does indicate a considerable likelihood of weight regain upon cessation, with weight often returning toward the pre-treatment baseline within about a year (Budini et al., 2025). However, the outlook is not universally negative; some evidence suggests that more than half of patients are able to maintain the achieved weight loss one year after discontinuing the medication (Szczesnowicz et al., 2023). Are there any known long-term health risks associated with taking GLP-1 RAs? While GLP-1 RAs are generally well-tolerated, rare but serious adverse events can occur, including acute pancreatitis and gallbladder issues (Szczesnowicz et al., 2023). Furthermore, long-term safety, particularly regarding combination therapy (e.g. with Metformin) in women with PCOS is an area that requires further research. It is crucial to obtain these prescriptions only from a doctor and fill them at a pharmacy, as unapproved or compounded versions have not been reviewed for safety or quality. If hair loss or fatigue occurs while taking a GLP-1 RA, what steps or supplements can help manage these side effects? Hair thinning or increased shedding (telogen effluvium) reported while on GLP-1 RAs is typically considered temporary and is usually attributed to the physiological stress of rapid weight loss or significant dietary changes, rather than the drug itself (Healthline, 2025). Management involves consulting your healthcare provider to assess your overall health and ensuring adequate nutritional intake, as inadequate consumption of key vitamins and minerals can impede the hair growth cycle. Vitamin D, iron and zinc are common deficiencies that can cause hair loss, but ensure you contact your doctor before taking any vitamins or supplements.  Through targeted dietary and lifestyle advice, Hertility works alongside you to help manage your symptoms of PCOS or help you […]

Polyendocrine metabolic ovarian syndrome (PMOS) is the condition you may still know as polycystic ovary syndrome (PCOS). It’s one of the most common hormonal conditions, affecting around 1 in 8 women. But despite the old name, it has never been just about the ovaries. PMOS can affect your periods, ovulation, skin, hair, metabolism, fertility, sleep and mental health. It can also look completely different from one person to another. One person may have very irregular periods and excess facial hair, while another has acne, fairly regular cycles and no obvious symptoms until they start trying to conceive. That variation is one of the reasons PMOS can be difficult to recognise and why diagnosis is sometimes delayed. Whether you have recently been diagnosed, think your symptoms could be linked to PMOS, or have been living with the condition for years, this guide covers PCOS symptoms, diagnosis, fertility, treatment, nutrition and long-term health. Quick facts:  If you are wondering whether your symptoms could be linked to PCOS, Hertility’s Advanced Hormone and Fertility Test can help build a clearer picture of your hormones, cycle and symptoms to help you understand what’s going on. Why was PCOS renamed PMOS? On 12 May 2026, the international PCOS community officially adopted the name polyendocrine metabolic ovarian syndrome, or PMOS. The previous name, polycystic ovary syndrome, could be misleading for several reasons. Firstly, the “cysts” associated with PCOS are not typical ovarian cysts. They are usually small ovarian follicles containing immature eggs. Secondly, you can have the condition without having polycystic-looking ovaries at all. Most importantly, the old name placed the emphasis on the ovaries when the condition can affect much more than reproductive health, including metabolism, hormones, mental wellbeing and long-term health. The new name was developed through an international process involving healthcare professionals, researchers and people living with the condition. If you already have a PCOS diagnosis, you do not need to be diagnosed again. Your diagnosis has not changed. You will also continue to see the term PCOS in medical records, research and online searches, which is why we use both PCOS and PMOS throughout this guide. Read more: PCOS has been renamed PMOS — here’s what that means for you. How common is PCOS? The World Health Organization estimates that PMOS affects up to 13% of women of reproductive age, making it one of the most common hormonal conditions worldwide, and that up to 70% of those affected may not know they have it. In the UK, the NHS estimates it affects about 1 in every 10 women. Part of the problem is that there’s no single way it presents. Diagnosis can also take time. In one international study, over a third of people with PCOS waited more than two years for a diagnosis, and almost half saw three or more health professionals before getting one. What are the common symptoms of PCOS? PCOS symptoms can affect your menstrual cycle, skin, hair, metabolism, sleep, mood and fertility. You do not need to have every symptom to have the condition. Menstrual cycle-related symptoms One of the most common features is irregular ovulation. which can make periods longer, unpredictable or absent for months, sometimes with heavier or prolonged bleeding after a long gap.  You may ovulate later, less often, or not at all in some cycles (an anovulatory cycle). In adults more than three years past their first period, cycles shorter than 21 days, longer than 35 days, or fewer than eight a year are considered irregular. Having regular periods don’t completely rule out PCOS, though more on that below.  If you want to understand your own cycle, see our guide Menstrual Cycle 101: Your Complete Guide to How Your Cycle Works Skin and hair-related symptoms Higher androgen activity (androgens include hormones like testosterone) can contribute to acne, oily skin, excess facial or body hair (known as hirsutism), often on the chin, upper lip, chest, abdomen or back, and scalp hair thinning, often noticed as a widening parting.  Hair-growth patterns vary a lot between individuals and ethnic groups, which matters when symptoms are assessed. Some people also develop acanthosis nigricans, darker, thicker, velvety-looking skin around the neck or underarms, which can be linked to insulin resistance. To find out more about how hormones affect your skin, read our guide to skin and hair changes. Weight gain or difficulty losing weight Some people experience weight gain or find weight harder to manage, but you don’t need to be overweight to have PCOS. It affects people across all body sizes, and insulin resistance can occur in people who aren’t overweight. Fatigue and sleep problems Significant tiredness is common, although fatigue has many causes and shouldn’t automatically be blamed on hormones. Obstructive sleep apnoea is more common in PMOS, even after taking BMI into account. So if you snore, wake up unrefreshed or feel tired all day, it’s worth talking to a healthcare professional. Mental health-related symptoms PCOS isn’t only physical. Depression and anxiety are more common, and symptoms like acne, unwanted hair growth, fertility difficulties, body-image concerns and weight stigma can all affect quality of life. Current guidance recommends that psychological wellbeing forms part of PMOS care, including screening and support for depression, anxiety and eating disorders. Difficulty conceiving PCOS is a leading cause of irregular ovulation and anovulatory infertility. If ovulation happens less often, there are fewer chances for egg and sperm to meet. But that’s very different from saying everyone with PCOS is infertile; many conceive naturally, and effective treatments exist when ovulation needs support. What causes PCOS? There is no single known cause of PCOS. Instead, it appears to develop through a combination of genetics, hormone signalling, ovarian function, metabolism and environmental factors. Two factors that are particularly important are androgens and insulin. High levels of Androgens Androgens are a group of hormones, the most common being testosterone. They are produced mainly by the ovaries and adrenal glands and have roles in reproductive health, bone and muscle health, sexual function and wider physiology. […]