Confronting the underdiagnosed condition affecting millions of women

Mr Ahmed Abdelbar, Consultant Gynaecologist at Guy’s and St Thomas’ Specialist Care explains how earlier diagnosis of PCOS could change women’s lives 

Many women first learn about polycystic ovary syndrome (PCOS), also known as polyendocrine metabolic ovarian syndrome (PMOS), only when they start trying for a family. They may already have spent years living with symptoms they did not fully understand: irregular periods, acne, weight changes, excessive hair growth, hair thinning or difficulties with mood and confidence.

One of the biggest challenges with PCOS is that it often develops gradually during a woman’s teens and twenties.  Symptoms can easily be dismissed as stress, hormonal fluctuations or simply ‘one of those things’.  Many women normalise what they are experiencing because they have lived with it for so long.  Others feel embarrassed discussing symptoms such as facial hair growth or fertility concerns.

As clinicians, we see the consequences of this delayed diagnosis every day.  Women often arrive at specialist clinics having spent years searching for answers, moving between appointments and treating symptoms individually without anybody joining the dots.  By the time they receive a diagnosis, they may already be facing fertility difficulties or wider metabolic complications associated with the condition.  This is why earlier awareness and diagnosis are so important.

PCOS affects around one in ten women of reproductive age, making it one of the most common hormonal conditions we see in women’s health.  Yet awareness remains surprisingly low.  Many women do not realise that absent or irregular periods are not something they should simply ‘put up with’.  Others are unaware that symptoms such as persistent acne, oily skin or unexplained weight gain may have an underlying hormonal cause.

We need to change the conversation around PCOS so that women recognise symptoms earlier and feel empowered to seek help in their twenties, long before they begin thinking about having children.  Each woman will present with a different set of symptoms.  However, it’s important to remember that we are not treating the symptoms; we are treating women and our goal is to improve the quality of their lives and improve their health risks.

Fertility is only one part of the story.  PCOS can also affect long-term health, increasing the risk of insulin resistance, type 2 diabetes, cardiovascular disease and mental health challenges.  Early diagnosis gives women the opportunity to manage these risks proactively rather than reactively.

Importantly, PCOS does not look the same in every patient.  Some women experience severe symptoms, while others may only have mild irregularities that become more significant over time.  This variability is one reason diagnosis can sometimes be delayed in primary care settings where symptoms may initially appear unrelated.

But women know when something does not feel right in their bodies, and listening carefully to those concerns matters enormously.  A young woman who has never had regular periods should not simply be reassured without further investigation.  Likewise, somebody struggling with symptoms affecting their confidence and self-esteem deserves proper assessment and support, not just symptom management in isolation.

The GSST private Women’s Health service  

At Guy’s and St Thomas’ Specialist Care, we are increasingly seeing the value of a more joined-up approach to PCOS management.  The condition sits at the intersection of gynaecology, endocrinology, fertility care, nutrition and mental wellbeing.  Treating it effectively therefore requires collaboration across specialties rather than viewing it purely as a reproductive health issue.

My own clinical work focuses on both general gynaecology and minimally invasive surgery, with a particular interest in supporting women with complex and often life-changing conditions.  Working within Guy’s and St Thomas’ gives us access to a broad multidisciplinary network, allowing patients to benefit from expertise that extends beyond traditional gynaecological care alone.

For women with PCOS, this support can include endocrinologists, fertility specialists, dietitians and psychologists depending on their individual needs. As PCOS has some genetic components, with a lot of metabolic factors coming into play, a multidisciplinary approach is essential because we are not simply treating symptoms.

One of the most rewarding aspects of women’s health is the ability to make a meaningful difference to somebody’s everyday life.  PCOS can affect confidence, relationships, body image and emotional wellbeing in profound ways, particularly for younger women.  We should never underestimate that impact.

At the same time, there is reason for optimism.  Earlier recognition and better awareness can transform outcomes.  Lifestyle interventions, nutritional support and medical treatment can all significantly improve symptoms and reduce long-term risks when introduced early enough.  In many cases, women finally receiving a diagnosis describe a sense of relief simply from understanding what has been happening to their bodies.

Raising awareness  

There is also an important public health dimension to this discussion.  Healthcare systems are increasingly focused on prevention and early intervention, and PCOS is a clear example of where that approach matters.  Diagnosing the condition earlier allows clinicians to support women before more serious complications emerge later in life.

For this reason, awareness campaigns and education are vital, not only among healthcare professionals but among young women themselves.  We need to encourage women to seek advice earlier and reassure them that these symptoms are both common and treatable.

Ultimately, PCOS care should never begin only when fertility becomes a concern.  By that stage, many opportunities for earlier intervention may already have been missed.  Instead, we should be focusing on identifying the condition earlier and supporting women holistically, helping them take control of their health. The earlier we recognise PCOS, the greater the opportunity we have to improve the lives of those who suffer with it.

Mr Ahmed Abdelbar is a consultant gynaecologist who sees private patients at Wimpole Street Consulting Rooms and Diagnostic Centre.

gstt.privatepatientenquiries@nhs.net

Tel: +44 203 131 6858