PATIENT EDUCATION
Polycystic Ovary Syndrome (PMOS)
PMOS is a common hormonal condition that can affect menstrual cycles, ovulation, skin and hair, fertility and long-term metabolic health. Not everyone with PMOS has the same combination of symptoms.
Select a topic below to view more information.
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Irregular or Infrequent Periods
What you'll notice or feel
- Cycles more than several weeks apart or periods occurring unpredictably.
- Periods stopping for months at a time.
- Sometimes heavy bleeding when a period eventually occurs.
- Difficulty predicting ovulation.
Common causes
- Irregular ovulation associated with PMOS.
- Weight change, stress or major changes in exercise.
- Thyroid disease, high prolactin or other hormonal causes.
- Pregnancy must always be considered when periods are late.
What it could be
- PMOS after excluding other causes.
- Another endocrine or gynaecological condition.
- A temporary cycle disturbance depending on age and circumstances.
Initial self-care
- Keep a simple menstrual calendar.
- Take a pregnancy test when relevant.
- Avoid self-starting hormone products or herbal treatments.
- Seek review if periods are absent for several months.
When to see a doctor urgently
- Very heavy bleeding causing dizziness, fainting or marked weakness.
- Severe pelvic pain with a positive pregnancy test.
When to see a doctor
- Cycles remain irregular for several months.
- Periods are absent for 3 months or more and pregnancy is excluded.
- You are trying to conceive.
Excess Facial/Body Hair or Acne
What you'll notice or feel
- Coarser hair growth on the face, chest, abdomen or other androgen-sensitive areas.
- Persistent or severe acne.
- Symptoms developing gradually from adolescence or early adulthood.
- Occasionally scalp hair thinning at the same time.
Common causes
- Higher androgen activity associated with PMOS.
- Genetic tendency to increased body hair.
- Some medicines.
- Rarely, another ovarian or adrenal cause of androgen excess.
What it could be
- PMOS when symptoms are gradual and other causes are excluded.
- Idiopathic hirsutism with normal hormone tests.
- A separate androgen-excess disorder if symptoms develop very rapidly.
Initial self-care
- Cosmetic hair-removal methods can be used while evaluation is underway.
- Avoid unregulated androgen-blocking supplements.
- Record how quickly symptoms have progressed.
- Skin care may help acne while the hormonal cause is addressed.
When to see a doctor urgently
- Very rapid onset of coarse hair with voice deepening or marked increase in muscle bulk.
- Severe abdominal or pelvic pain with sudden hormonal changes.
When to see a doctor
- Hair growth or acne is distressing or progressing.
- Menstrual irregularity is present as well.
- Symptoms started rapidly or later in life.
Weight Gain or Insulin Resistance
What you'll notice or feel
- Weight gain, especially around the waist.
- Darkened velvety skin at the neck or other folds.
- Prediabetes or high glucose on screening.
- Difficulty losing weight despite sustained efforts.
Common causes
- Insulin resistance commonly accompanies PMOS.
- Genetic and lifestyle factors.
- Sleep problems or medicines that affect weight.
- Other metabolic conditions.
What it could be
- PMOS with metabolic risk.
- Prediabetes or Type 2 diabetes developing alongside PMOS.
- Another cause of weight gain if the clinical pattern is atypical.
Initial self-care
- Aim for sustainable nutrition and activity changes rather than extreme dieting.
- Screen for glucose, blood pressure and lipids as advised.
- Prioritise sleep and regular meal patterns.
- Medical treatment may be appropriate depending on metabolic risk.
When to see a doctor urgently
- Very high glucose with dehydration, vomiting or confusion.
- Chest pain or stroke-like symptoms.
When to see a doctor
- Weight or glucose is progressively increasing.
- There is a family history of diabetes.
- You want structured weight-management support.
Difficulty Conceiving
What you'll notice or feel
- Trying to conceive without success.
- Long or unpredictable cycles making ovulation difficult to identify.
- Few or no periods.
- Sometimes previous early pregnancy losses or fertility treatment.
Common causes
- Irregular or absent ovulation in PMOS.
- Age-related fertility factors.
- Male-factor or other reproductive causes may coexist.
- Thyroid and prolactin disorders can also affect ovulation.
What it could be
- Anovulatory infertility associated with PMOS.
- A fertility problem requiring broader couple-based assessment.
- Another endocrine cause if the PMOS diagnosis is uncertain.
Initial self-care
- Seek preconception review rather than waiting until pregnancy.
- Optimise diabetes, blood pressure and thyroid treatment before conception if relevant.
- Take standard preconception folic acid as advised by your clinician.
- Avoid unregulated fertility or hormone products.
When to see a doctor urgently
- Severe pelvic pain or heavy bleeding in early pregnancy.
- Symptoms of ectopic pregnancy such as one-sided pain, fainting or shoulder-tip pain need emergency assessment.
When to see a doctor
- You are planning pregnancy and cycles are very irregular.
- You have been trying to conceive and are concerned about delay.
- You have diabetes or other metabolic risks that need optimisation before pregnancy.
Scalp Hair Thinning or Other Hormonal Symptoms
What you'll notice or feel
- Gradual thinning of scalp hair.
- Increased hair shedding.
- Hair changes alongside irregular periods, acne or facial hair growth.
- Sometimes fatigue or thyroid-like symptoms.
Common causes
- Androgen-related hair thinning in PMOS.
- Iron deficiency, thyroid disease or nutritional factors.
- Stress-related shedding.
- Genetic-pattern hair loss unrelated to PMOS.
What it could be
- PMOS-related androgen effects.
- A separate thyroid, nutritional or dermatological cause.
- More than one condition occurring together.
Initial self-care
- Avoid unnecessary high-dose supplements until deficiencies are confirmed.
- Use gentle hair care and avoid traction hairstyles.
- Record menstrual and other hormonal symptoms.
- Arrange evaluation if hair loss is progressive.
When to see a doctor urgently
- Rapid hair loss with severe systemic illness.
- Rapid virilisation such as voice deepening or major muscle changes.
When to see a doctor
- Hair thinning continues for several months.
- There are associated menstrual or androgen symptoms.
- You want to discuss treatment options and likely causes.
YOUR CONSULTATION
What to Expect at Your Visit
- Review of menstrual pattern, weight history, skin/hair symptoms, fertility goals and medicines.
- Blood pressure and assessment for signs of androgen excess or insulin resistance.
- Blood tests are selected to exclude alternative causes and assess metabolic risk.
- Pelvic ultrasound may be useful in some situations but is not required for every patient.
- Treatment is tailored to the main goals: cycle control, skin/hair symptoms, fertility, weight or metabolic risk.
- Long-term follow-up may include screening for diabetes, lipids and other cardiometabolic risks.
* IMPORTANT: A Note Before You Go
PMOS is a heterogeneous condition. The diagnosis should not be based on a single symptom or an ultrasound report alone; alternative causes of irregular cycles or androgen excess may need to be excluded.
This page provides general educational information and cannot replace an individual medical assessment. If symptoms are persistent, worsening or concerning, arrange appropriate medical review.
NEED AN ASSESSMENT?
Arrange an Endocrinology Consultation
For non-emergency assessment or follow-up, appointments are booked through the hospital’s central appointment desk on 0422 432 4433. For severe or rapidly worsening symptoms, seek urgent medical care rather than waiting for a routine appointment.