According to the NHS, it is estimated that 1 in 5 women in the UK have polycystic ovary syndrome (PCOS), a gynaecological condition that prevents the ovaries from working properly.
"The condition is thought to be caused by incorrect hormone levels," explains Dr Prudence Knight, online doctor at Push Doctor. "It is usually comprised by at least 2 out of 3 irregular or absent periods, cysts on the ovaries on ultrasound and abnormally high testosterone levels (male hormones) in the blood. Aside from absent or irregular periods, another symptom could be a difficulty becoming pregnant due to absent or infrequent ovulation," adds Dr Prudence, but PCOS can also manifest in many other physicalities, such as hirsutism (excess hair growth, typically on the face and also on the chest, buttocks and back), head hair thinning or loss, acne and weight gain.
For those living with PCOS, these skin-deep symptoms can be debilitating. According to support group PCOS UK, the condition affects women in different ways, so not all women will have these features, but for those who do, research has shown that acne, hair loss and excess hair growth in particular can have a profound psychological impact, affecting quality of life for many and even worsening anxiety and depression in some cases. While there is no cure for PCOS, a lot can be done to treat the symptoms.
"For example, acne may be more likely to respond to specific pills that reduce or block the amount of testosterone in the body," says Dr Prudence. Contraceptive pills are popular among those with PCOS, as is anti-androgen (male hormone-blocking) oral medication, spironolactone, for treating both acne and hair issues. "Off-label, spironolactone can help with both types of hair problem," says dermatologist and author of The Skincare Bible, Dr Anjali Mahto. "It can potentially improve both scalp hair growth and hirsutism. However, in this context it should only be prescribed by a consultant dermatologist with experience in its use as it is an unlicensed treatment." Excess hair growth can also be treated with the usual removal techniques, explains Dr Prudence, such as laser hair removal or IPL (intense pulsed light). "Special creams may also help, although it is important to remember that hair can grow back on stopping treatment."
A lot of the time, dealing with the traits of PCOS is a never-ending battle. Ahead, six women talk about the effects of the condition on their body, appearance and self-esteem over the years, and how they've learned to manage it.
I had acne when I was a teenager, I have naturally fairly heavy periods and I'm a little hairier than some people, but honestly, it's hard to know what's PCOS and what's just me. I've never known a time I definitely didn't have PCOS, so it's hard to tell if things like the hair on my arms is a genetic trait I've inherited or a symptom of PCOS, but my doctor told me there's some evidence that PCOS tends to run in families.
I have another chronic illness, and by the time I found out I had PCOS, I had come to terms with having symptoms you just have to live with. Am I maybe a little heavier because I have PCOS? A little hairier? I'll never know how much heavier or how much hairier. I can spend my life waxing and dieting or I can accept that this is just me. Maybe I would still have a little 'tache and a little belly without the cysts. But I don't really consider those physical signs as symptoms because that would drive me crazy. I just try and love my body for what it is.
I was slightly concerned about my fertility, which is why I switched from the implant to the pill. My doctor told me it would help if I wanted to get pregnant later in life. I also spoke to my GP who was really supportive. She wasn't overly concerned – after all fertility is a spectrum with or without PCOS. Maybe I'll need some fertility treatments later down the line, maybe I'll take a while to get pregnant, but maybe I'll get knocked up without trying. Again, worrying about that would just drive me crazy.
I am pretty open about having PCOS and I'm lucky my symptoms aren't debilitating. My family all know and I told my partner pretty early on. If it comes up, I'll mention it to my friends. I sometimes come up against the same frustrations I have with telling people about any chronic illness – they want to fix you but there isn't a cure and more importantly, I shouldn't be made to feel that I'm broken. The cysts on my ovaries are as much part of me as the moles on my skin. All you can do is try to appreciate all the things your body can do, not focus on the very few things it might have difficulty doing.
Rachel*, 26
I've always been hairy – a fluffy upper lip, arm fuzz, a snail trail on my stomach – but I used to put it down to my Greek heritage. I never knew excess hair was a symptom of PCOS until my periods stopped for an entire year, which prompted me to push for a scan.
I went along to the ultrasound and I remember the nurse counting the cysts on my ovaries before taking me into a room to explain the condition. She said it was nothing to worry about, and that lots of women have it, but that it explains my irregular cycle and why my body hair had been going into overdrive. A year after my diagnosis, I started to develop excess facial hair. I'm not talking a few whiskers, but a full-on lady beard. Shaving, plucking and waxing weren't working for me and I was left with a thick 5 o'clock shadow that not even heavy concealer would cover. I cancelled plans with friends, missed two big family weddings and ghosted dates all because I was so embarrassed to show my stubbly face. I virtually became a recluse and would shut myself away and cry and cry.
I decided to give IPL (intense pulsed light) hair removal a go but the laser technician explained that due to my condition I would need nine to 11 sessions instead of the average six, and that top-up treatments would be needed every few months to keep my hair under control. After nearly a year of regular treatments, my facial hair became much less noticeable. I'm still going with it and use the Philips Lumea between treatments. It's pricy, but worth it, because I feel much less self-conscious.
I also suffer with acne. After months of going back and forth to my GP and being palmed off with OTC creams that burned my skin, I visited a dermatologist, who assessed my hormonal condition as well as my skin and prescribed me a course of spironolactone. The female-only oral pill is an off-label treatment for acne. It's main use is to lower blood pressure, but it has anti-androgen effects, so it blocks the male hormone testosterone, which is responsible for oily skin and spots. At higher doses, it also helps reduce my unwanted hair. The only thing is, it's a water tablet, so it makes me pee all the time!
Jacqueline, 25
I have patches of pigmentation on my neck and underneath my armpits, which my GP said is a well-known symptom of polycystic ovary syndrome. An ultrasound scan confirmed I had the condition when I was 22, after I noticed my periods were becoming few and far between.
I'm Indian and have quite dark skin, so the patches are pretty noticeable. The area just underneath my chin almost looks like a birthmark. When I was younger I did everything I could to minimise the appearance: avoiding the sun at all costs and even sleeping in skin-lightening creams that contained hydroquinone, which we all know is harmful on skin. At times, I overdid it and it just made my skin super sensitive and sore.
The crease at the back of my neck is also very pigmented and the skin feels slightly thicker in that area, but I rarely notice it when my hair is down. My main concern is my weight, which I find quite difficult to keep down. My GP told me that it's both an effect and contributor to PCOS. I now speak to a nutritionist regularly and visit my GP for check-ups every month because I'd like children in the next year or so and I want to be as healthy as possible to make it happen.
Priya, 33
Most women think excess hair is the only hair-related symptom of PCOS but not very many know that it can also cause hair thinning on the scalp. Over the past few years, I've noticed a loss in volume around my hairline and the older I become, it gets me down more and more.
In my quest for lush hair, I found out that you can now buy minoxidil – which is a pretty potent hair loss treatment – over the counter at the pharmacy. The product I purchase is a foam, which I rub into my scalp every day. I've noticed little baby hairs coming through but they don't tend to grow any thicker or longer than that. As long as it masks the bald patches, I'm happy.
I recently looked into having hair extensions because my hairdresser told me that there are some really great ones out there, such as invisible tapes that aren't noticeable and don't pull at the hair, as well as really good quality wefts so no one will notice that the hair isn't my own, but I'm scared I'll become dependent on them and they're really expensive to maintain. I'd actually like to book an appointment with a trichologist, but I can't afford to see one as regularly as I'd like.
Marina, 31
I first found out I had PCOS when I was 26. I was really stressed out at work and stopped having periods for around five months. I put it down to working too much until my friend persuaded me to go to the doctors to get it checked out.
In terms of symptoms, excess hair is my main thing. I'm lucky that I don't get acne, just a hell load of inappropriate hair in really inappropriate places. The hair thing has been getting me down ever since I was a teenager and I secretly used to shave my arms and stomach to avoid being bullied. Surprise, surprise, shaving made my hair feel so much worse over the years. I was badly teased for having sideburns as a kid and I've been on dates with guys before where they've actually commented on how hairy I am. It's safe to say they got dumped pretty quickly.
Aside from the body and facial hair, my main worry is always: Can I have children? Sometimes when I don't have a period for a few months it makes me feel weirdly less female.
I went on the pill when I was diagnosed to keep them regular, which helped a lot, but nine months ago decided to stop taking it because I didn't want it in my system anymore.
If I didn't have PCOS, I'd be less hairy for a start! But I don't think my life would be dramatically different. Perhaps when I was growing up it would have been different, as I was very insecure, but now I've learned to love my body and my poorly ovaries! If I could give advice to any women who have recently been diagnosed with PCOS, I'd say: Do your research but try not to read and believe too many horror stories as they really start to scare you after a while. I also try and be open about it to my friends as so many women have it and it's nice to know you're not alone.
Cassie*, 28
When I was 15, I went to the doctors because I had very heavy and painful periods as well as excessive hair growth, and that's when I discovered I had PCOS. The excessive hair growth hasn't slowed down and I still get awful periods – I also struggle with my weight.
When I was younger, I would feel so depressed about the symptoms, especially my excess facial hair. I would have to wax every two weeks and I tried bleaching and threading, too. I remember when I was 14 I was so depressed and anxious about going to school in case someone noticed and made a comment, but thankfully, I've learned to deal with it as I've got older. Although, I do gain weight easily and can never really keep it in check.
I was on the pill until 21, which helped, but my GP took me off it at 21 as DVT (deep vein thrombosis) runs in my family and the medication put me at risk of developing it. In regard to my excess facial hair, I opt for laser now, which has improved it slightly. In all honesty, I can’t imagine my life without PCOS as it’s all I have ever known, but to not constantly worry about my facial and body hair as well as my weight would be dreamy!
My suggestion to anyone who has just found out that they have PCOS is to read up on it and to find PCOS communities – yep, they exist. Also, don’t bottle it up.
Freya*, 23
*Some names have been changed
Like what you see? How about some more R29 goodness, right here?
We Asked Our Mums Their Greatest Regrets & The Answers Got Us Emotional
What Is Honeymoon Cystitis? (It Has Nothing To Do With Getting Married)
A Mood Board For Your Sign, In Case You Don't Have One Already