Polycystic ovary syndrome (PCOS) affects up to 1 in 10 women of reproductive age in the UK. It is one of the most common hormonal conditions affecting women, yet it frequently goes undiagnosed for years. If you suspect you may have PCOS — or have been told you might but never received a formal diagnosis — a specialist assessment can provide clarity, answers, and a personalised management plan.

Understanding PCOS: What is Polycystic Ovary Syndrome?

Polycystic ovary syndrome is a hormonal condition in which the ovaries produce an excess of androgens (male hormones) and may contain a large number of small, immature follicles — often referred to as “cysts”, although they are not true cysts. PCOS disrupts the normal hormonal cycle that regulates ovulation, leading to irregular or absent menstrual periods and a range of associated symptoms.

PCOS is not a single condition but a syndrome — a cluster of features that may present differently in different women. Some women experience significant symptoms affecting their quality of life and fertility; others have few symptoms and are diagnosed incidentally. Understanding which features are present in your case is essential to tailoring an effective management plan.

Symptoms of PCOS

PCOS symptoms vary in type and severity. The most common include:

• Irregular or absent periods — cycles longer than 35 days, or fewer than 8 periods per year
• Excess hair growth (hirsutism) — particularly on the face, chest, or back
• Acne — often persistent and affecting the face, chest, or back
• Weight gain — particularly around the abdomen, or difficulty losing weight
• Thinning scalp hair — diffuse hair loss or female-pattern hair thinning
• Difficulty conceiving — due to irregular ovulation or anovulation
• Mood changes — including anxiety, low mood, or fatigue

Not all women with PCOS will experience all of these symptoms. Some women present primarily with fertility concerns and have few outward signs of the condition. Others may have significant skin or hair symptoms with minimal menstrual irregularity.

How PCOS is Diagnosed

PCOS is diagnosed using the Rotterdam criteria, which requires the presence of at least two of the following three features:

1. Irregular or absent ovulation — typically presenting as irregular or absent menstrual periods
2. Clinical or biochemical signs of excess androgens — either visible features (excess hair, acne, scalp hair loss) or elevated androgen levels on blood tests
3. Polycystic ovarian morphology on ultrasound — either an increased number of antral follicles (typically 20 or more per ovary) or an increased ovarian volume on ultrasound scan

Pelvic ultrasound is therefore a key diagnostic tool in PCOS assessment. It provides a direct view of ovarian morphology, antral follicle count, and ovarian volume — information that cannot be obtained from blood tests alone. This is why same-day ultrasound is central to the PCOS assessment at AristoGP.

In addition to the Rotterdam criteria, a full PCOS assessment should exclude other conditions that can cause similar symptoms — including thyroid dysfunction, hyperprolactinaemia, and congenital adrenal hyperplasia. Blood tests are often recommended as part of a thorough assessment.

PCOS Assessment at AristoGP

Dr Anastasia Mermigka (GMC 7640566) provides consultant-led PCOS assessment at AristoGP’s Central London EC1 clinic. A full assessment includes:

• Detailed consultation reviewing your symptoms, menstrual history, medical and family history, and any previous test results
• Same-day pelvic ultrasound performed by Dr Mermigka, assessing ovarian morphology including antral follicle count and ovarian volume — the key ultrasound markers for PCOS diagnosis
• Blood test recommendations if indicated — including hormones (LH, FSH, testosterone, SHBG, prolactin), glucose and insulin levels, thyroid function, and other markers as relevant to your presentation
• Personalised management plan covering lifestyle recommendations, medical treatment options, and fertility guidance where relevant
• Written report summarising findings and recommendations

PCOS Assessment Packages

• Gynaecology consultation + pelvic ultrasound: £250 (Easter Offer, normally £270)
• Fertility assessment: £220

No GP referral is needed. You can book directly using our online booking system.

PCOS and Fertility

PCOS is one of the most common causes of subfertility in women. Because PCOS disrupts ovulation, conception can take longer or may require assistance. However, many women with PCOS do conceive naturally, particularly with appropriate management of the underlying hormonal imbalance.

At AristoGP, Dr Mermigka can provide a fertility assessment as part of or alongside the PCOS assessment. This reviews ovarian reserve, antral follicle count, and other relevant markers, and forms the basis for an individualised fertility plan. Where onward referral to a fertility specialist is needed, Dr Mermigka will advise on appropriate next steps.

When to See a PCOS Specialist

You should consider seeking a specialist PCOS assessment if:

• Your periods have been irregular or absent for three or more months
• You have been trying to conceive for 12 months or more without success
• You have been told by a GP that you may have PCOS but have not had a formal ultrasound assessment
• You have significant acne, excess hair growth, or scalp hair loss affecting your quality of life
• You have a family history of PCOS and are concerned about your own risk
• You have been diagnosed with PCOS previously but wish to review your management or fertility outlook

A specialist assessment at AristoGP provides a definitive diagnosis or exclusion of PCOS, a full picture of any related hormonal issues, and a clear management plan — all in a single appointment. See our full list of services, or visit our private gynaecologist London page for more about our approach to care. You can also read about the female gynaecologist service and pelvic ultrasound options at AristoGP.

Frequently Asked Questions