PCOS is one of the most common hormonal conditions affecting women of reproductive age — and one of the most consistently under-diagnosed. Research suggests that up to 70% of women with PCOS remain undiagnosed for years, often because their symptoms have been normalised, minimised, or simply not recognised.
Why diagnosis is delayed
PCOS presents in many different ways. Some women have irregular or absent periods. Some have acne or excess hair growth. Some are overweight; many are not. Some have polycystic ovaries on ultrasound without any other symptoms. Because no single presentation defines the condition, it is easy for any one symptom to be dismissed or attributed to something else.
For a long time, irregular periods in adolescence have been explained away as normal — something you will grow out of. In some cases that is true. In others, it is PCOS presenting at the earliest opportunity, and the lost years matter when fertility becomes a concern.
What a proper diagnosis involves
PCOS is diagnosed using the Rotterdam criteria: at least two of the following three — irregular or absent ovulation, clinical or biochemical signs of excess androgens, and polycystic ovaries on ultrasound. Blood tests (LH, FSH, testosterone, AMH, thyroid, prolactin) and a pelvic ultrasound are the core investigations.
What to do if you suspect PCOS
See a gynaecologist. Do not wait to be referred; do not assume your symptoms are not serious enough. PCOS is manageable — with the right investigation and the right plan, most women with PCOS can manage their symptoms and achieve the reproductive outcomes they are hoping for.