Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions in women of reproductive age, affecting around 1 in 10. It involves hormonal imbalances that can affect periods, fertility, metabolism, skin and mood. Medical management is the primary intervention, but lifestyle, dietary and complementary approaches have good evidence for improving symptoms alongside medical care.
See therapies that may helpPCOS is a hormonal condition characterised by a combination of features: polycystic ovaries (ovaries containing many small follicles), irregular or absent periods, and signs of elevated androgens (male hormones) such as acne, excess hair or hair thinning. Not all of these features need to be present for a diagnosis.
The underlying mechanism involves insulin resistance in many women — cells are less responsive to insulin, leading to elevated insulin levels that stimulate androgen production. This disrupts follicle development and ovulation, producing the characteristic irregular cycle.
PCOS has significant health implications beyond reproductive function: it is associated with increased risk of type 2 diabetes, cardiovascular disease, endometrial cancer (related to irregular periods) and mental health difficulties including anxiety and depression.
PCOS symptoms vary considerably. Common features include:
Lifestyle approaches are central to PCOS management alongside medical treatment:
If you have irregular periods, signs of high androgens or difficulty conceiving, a GP assessment is the appropriate starting point. PCOS is diagnosed through clinical assessment, blood tests and ultrasound. A referral to a gynaecologist or endocrinologist may be appropriate for complex presentations or fertility concerns.
Verity (the PCOS charity) and the PCOS Association offer support and resources. A dietitian with PCOS expertise is a valuable adjunct for the metabolic aspects of PCOS management.
Showing 12 therapies linked to PCOS support (adjunct).
| Therapy | Evidence | Notes |
|---|---|---|
| Cognitive Behavioural Therapist |
strong
|
CBT helps address the low mood, anxiety and body-image distress that often accompany PCOS, and supports lasting lifestyle change. |
| Dietitian |
strong
|
A dietitian can tailor eating patterns to improve insulin sensitivity and support weight and menstrual regularity in PCOS. |
| Nutritional Therapist |
strong
|
Nutritional therapy looks at diet and lifestyle to help steady blood sugar and ease PCOS-related weight and cycle concerns. |
| Clinical Pilates Practitioner |
moderate
|
Clinical Pilates offers structured, low-impact exercise that aids weight management and insulin sensitivity in women with PCOS. |
| Counsellor |
moderate
|
Counselling gives space to process the emotional impact of PCOS, including fertility worries and changes to self-image. |
| Herbal Medicine Practitioner |
moderate
|
Some herbal preparations are used to support menstrual regularity in PCOS, though evidence is limited and this should complement medical care. |
| Hydrotherapist |
moderate
|
Hydrotherapy may provide gentle, supportive exercise for women with PCOS, but evidence is limited and it is not a substitute for medical care. |
| Mindfulness Practitioner |
moderate
|
Mindfulness can reduce the stress and emotional eating linked to PCOS, supporting wellbeing alongside appropriate medical care. |
| Physiotherapist |
moderate
|
Physiotherapy can guide safe, sustainable activity that improves fitness and insulin sensitivity for women managing PCOS. |
| Pilates Practitioner |
moderate
|
Pilates provides gentle strengthening exercise that supports weight management and insulin sensitivity in women with PCOS. |
| Psychotherapist |
moderate
|
Psychotherapy can help work through the deeper emotional effects of living with PCOS, such as anxiety and changes to identity. |
| Sex Therapist |
moderate
|
Sex therapy can support intimacy and confidence affected by PCOS symptoms, complementing rather than replacing medical care. |
PCOS is a common cause of ovulatory dysfunction and accounts for around 80% of anovulatory infertility. However, many women with PCOS conceive naturally or with relatively straightforward fertility treatment. Lifestyle approaches, particularly weight management in overweight women, can restore ovulation. Speak to your GP or a fertility specialist about options.
There is no cure for PCOS, but symptoms can be very effectively managed. For many women, symptoms improve significantly with lifestyle changes — particularly weight management and dietary approaches that improve insulin sensitivity. Symptoms may also improve after menopause as androgen levels naturally decline.
Yes significantly. Dietary approaches that improve insulin sensitivity — including lower glycaemic index eating, reducing refined carbohydrates, adequate protein and anti-inflammatory foods — can improve hormonal profile, cycle regularity, acne and weight management in PCOS. A dietitian with PCOS expertise can provide personalised guidance.
Yes — the name is somewhat misleading. 'Polycystic' ovaries refers to an appearance on ultrasound (multiple small follicles) rather than true cysts. Not all women with PCOS have this appearance on ultrasound, and it can be present in women without PCOS. Diagnosis is based on a combination of features, not ultrasound appearance alone.
PCOS is associated with insulin resistance, which promotes fat storage and makes weight loss more difficult. However, PCOS does not inevitably cause weight gain, and many women with PCOS are not overweight. When weight gain does occur, targeted dietary and lifestyle approaches that specifically address insulin resistance are more effective than generic calorie restriction.