Polycystic ovary syndrome (PCOS / PMOS) at OpenMed Warsaw
At OpenMed Warsaw we diagnose and treat polycystic ovary syndrome, or PCOS - one of the most common hormonal and metabolic disorders in women of reproductive age. We help patients with irregular periods, absent ovulation, acne, excessive hair growth, difficulty losing weight, insulin resistance or problems conceiving.
PCOS calls for an individual approach, because it can look different in every patient. In one person menstrual disturbances dominate, in another the symptoms of androgen excess, insulin resistance or problems with ovulation. During the appointment the doctor reviews the symptoms, the medical history, the results of hormonal and metabolic tests and the appearance of the ovaries, then sets out the plan for further diagnostics and treatment.
Who we help
We help patients who:
- have irregular or infrequent periods,
- have not menstruated for a longer time,
- suspect they have polycystic ovary syndrome,
- have polycystic ovaries described on ultrasound,
- struggle with acne, seborrhoea or excessive hair growth,
- have elevated androgens in hormonal tests,
- have insulin resistance, difficulty losing weight or frequent hunger pangs,
- are trying to conceive and suspect ovulation disorders,
- need hormonal and gynaecological diagnostics,
- are looking for PCOS treatment in Warsaw,
- want treatment matched to their symptoms and plans regarding pregnancy.
Doctors treating PCOS in Warsaw
Meet the OpenMed Warsaw doctors who diagnose and treat polycystic ovary syndrome. During the appointment the doctor discusses the symptoms, reviews the menstrual cycle, assesses the results of hormonal and metabolic tests and, where needed, performs a gynaecological ultrasound.
What is PCOS?
PCOS, or polycystic ovary syndrome, is a hormonal and metabolic disorder that can affect the menstrual cycle, ovulation, the skin, body weight, insulin metabolism and fertility. Some patients experience infrequent periods, absent ovulation, difficulty conceiving, acne, excessive hair growth or elevated androgens.
PCOS is not merely a problem of the ovaries. It is a disorder that often requires a broader assessment: gynaecological, hormonal and metabolic. Both the symptoms and laboratory tests, ultrasound and an assessment of the risk of insulin resistance, type 2 diabetes and lipid disorders therefore matter in the diagnosis.
What is PMOS and why is the name PCOS changing?
For years the name polycystic ovary syndrome suggested that the main problem was ovarian cysts. In reality many patients with PCOS have no typical cysts, and what dominates are hormonal and metabolic disturbances along with problems related to ovulation and insulin metabolism. International medical circles have therefore begun to use the term PMOS, that is polyendocrine metabolic ovarian syndrome.
From a medical point of view the condition is linked to excessive androgen production and disturbed insulin action. It can lead to fertility problems, menstrual disorders, skin changes and an increased risk of metabolic disease. Experts also emphasise that PMOS affects not only physical health but also mental wellbeing and quality of life.
How is polycystic ovary syndrome diagnosed?
Diagnosing PCOS involves a conversation with the doctor, an analysis of the symptoms, a gynaecological examination, ultrasound and laboratory tests. The doctor asks about the length of the cycle, the frequency of periods, acne, excessive hair growth, hair loss, body weight, attempts to conceive and conditions that run in the family.
The following matter in diagnosing PCOS:
- menstrual and ovulation disorders,
- clinical signs of hyperandrogenism,
- elevated androgens in tests,
- the appearance of the ovaries on ultrasound,
- exclusion of other causes of similar symptoms,
- assessment of insulin resistance and metabolic risk.
A diagnosis of PCOS should be made after a complete analysis, not on the basis of a single result.
Irregular periods, acne and excessive hair growth - when to suspect PCOS
PCOS is worth suspecting when irregular periods are accompanied by signs of androgen excess such as acne, seborrhoea, excessive hair growth or hair loss. Long cycles, periods appearing every few months or the absence of periods without an obvious cause are also warning signals.
It is worth seeing a doctor particularly if:
- cycles are longer than usual or very irregular,
- periods appear infrequently,
- acne is resistant to standard skincare,
- excessive hair growth appears in areas typical for androgens,
- hair thins at the crown of the head,
- there is difficulty conceiving,
- polycystic ovaries have been described on ultrasound,
- tests have shown elevated androgens.
Such symptoms do not always mean PCOS, but they do require hormonal and gynaecological diagnostics.
What does the first appointment for suspected PCOS look like?
The first appointment for suspected PCOS begins with a detailed history. The doctor asks about periods, the length of the cycle, skin symptoms, hair growth, body weight, chronic conditions, medication taken, attempts to conceive and previous test results. Information about PCOS, diabetes, thyroid disease or hormonal disorders in the family is also important.
During the appointment the doctor may:
- review previous results,
- perform a gynaecological examination,
- perform or plan an ultrasound,
- order hormonal tests,
- order metabolic tests,
- assess whether an endocrinology consultation is needed,
- discuss the first lifestyle recommendations,
- plan treatment once the results are available.
It is worth bringing previous hormonal tests, ultrasound reports, glucose, insulin, lipid profile, TSH and prolactin results, and a list of medication and supplements taken.
PCOS treatment matched to the symptoms and plans of the patient
PCOS treatment is chosen individually. The approach differs for a patient who wants to regulate her cycle and reduce the symptoms of androgen excess, for a woman with insulin resistance, and again for a patient planning a pregnancy.
Treatment may include:
- regulating the menstrual cycle,
- treating acne and the symptoms of androgen excess,
- supporting ovulation in patients planning a pregnancy,
- treating insulin resistance,
- monitoring body weight and metabolic parameters,
- modifying diet and physical activity,
- cooperation with an endocrinologist or dietitian,
- monitoring long-term effects such as the risk of diabetes and lipid disorders.
PCOS usually requires long-term care, because the aim of treatment is not only to improve current symptoms but also to limit metabolic risk and protect health in the future.
PCOS treatment in women planning a pregnancy
In patients planning a pregnancy, PCOS treatment focuses on assessing ovulation, improving metabolic conditions and choosing an approach that supports fertility. If cycles are irregular, the doctor can assess whether ovulation occurs and whether it needs to be stimulated.
The approach may include:
- assessing the regularity of the cycle,
- confirming ovulation,
- hormonal tests,
- assessing insulin resistance,
- monitoring body weight and metabolic parameters,
- treatment supporting ovulation,
- monitoring the cycle,
- referral for further infertility diagnostics if attempts have lasted longer or there are additional indications.
It is important that the treatment plan takes into account not only PCOS but also the age of the patient, how long she has been trying to conceive, her partner results and other possible causes of infertility.
Polycystic ovary syndrome in Warsaw - PCOS diagnosis and treatment
Diagnosing PCOS is not simply a matter of performing an ultrasound. Polycystic ovary syndrome is recognised on the basis of a complete assessment: the menstrual cycle, clinical symptoms, hormonal test results, metabolic parameters and the appearance of the ovaries. Excluding other conditions that can produce similar symptoms is also important.
At OpenMed Warsaw a patient can discuss symptoms suggesting PCOS, undergo gynaecological diagnostics, review her test results and receive a treatment plan tailored to her needs. Care differs for a patient who wants to regulate her cycle and reduce the symptoms of androgen excess and for a woman who is planning a pregnancy and needs support with ovulation.
PCOS versus polycystic ovaries on ultrasound - why they are not always the same
Polycystic ovaries on ultrasound do not always mean PCOS. In some women the ovaries may contain numerous follicles while the patient has regular periods, normal ovulation and no signs of androgen excess. In such a situation the ultrasound image alone is not enough to diagnose polycystic ovary syndrome.
PCOS is diagnosed only once the appearance of the ovaries is considered alongside the symptoms and test results. The doctor takes into account the regularity of the cycle, ovulation, acne, excessive hair growth, androgen results, metabolic parameters and other possible causes of hormonal disturbance. This helps avoid both missing PCOS and diagnosing it on the basis of ultrasound alone.
Symptoms of polycystic ovary syndrome
The symptoms of PCOS can vary and do not all have to occur at once. In some patients the problem starts with irregular periods, in others with acne, excessive hair growth, weight gain or difficulty conceiving.
Common symptoms of PCOS include:
- irregular periods,
- infrequent or absent periods,
- ovulation disorders,
- difficulty conceiving,
- acne,
- oily skin and hair,
- excessive hair growth on the face, abdomen, chest or back,
- androgenic hair loss,
- insulin resistance,
- difficulty losing weight,
- increased appetite or hunger pangs,
- low mood, fatigue or mood swings.
The intensity of symptoms can change over time. With suspected PCOS, diagnostics matter rather than treating a single symptom.
PCOS, insulin resistance and body weight
PCOS is often linked to insulin resistance, that is a weakened response of the tissues to insulin. This can contribute to fluctuations in glucose, hunger pangs, difficulty losing weight and a higher risk of metabolic disorders. Insulin resistance can also occur in patients with a normal body weight, so risk should not be assessed by appearance alone.
In the diagnostics the doctor may recommend assessing:
- fasting glucose,
- fasting insulin,
- the glucose and insulin curve,
- glycated haemoglobin,
- the lipid profile,
- body weight and waist circumference,
- blood pressure,
- other metabolic parameters if indicated.
PCOS treatment often involves not only regulating the cycle but also improving insulin sensitivity, working on lifestyle and controlling metabolic risk factors.
PCOS, ovulation, fertility and planning a pregnancy
Polycystic ovary syndrome can make conception more difficult, because it is often linked to irregular or absent ovulation. This does not mean that every patient with PCOS will be infertile. Many women with PCOS do become pregnant, but some need diagnostics of the cycle, confirmation of ovulation or treatment supporting fertility.
If a patient is planning a pregnancy, the doctor may assess:
- the regularity of the cycle,
- whether ovulation occurs,
- hormonal test results,
- the appearance of the ovaries,
- body weight and metabolic parameters,
- insulin resistance,
- how long she has been trying to conceive,
- other factors that may affect fertility.
PCOS treatment in women planning a pregnancy differs from treatment in patients who are not currently planning one. The aim may be to restore or support ovulation, improve metabolic parameters and plan what happens next.
Ultrasound and hormonal tests for suspected PCOS
Gynaecological ultrasound helps assess the structure of the ovaries, the number of follicles, ovarian volume and the endometrium. It is an important part of the diagnostics but does not replace hormonal tests and an assessment of the symptoms. Polycystic ovaries can also be found in women without PCOS.
With suspected PCOS the doctor may recommend tests such as:
- total or free testosterone,
- androstenedione,
- DHEA-S,
- SHBG,
- LH and FSH,
- oestradiol,
- progesterone in the assessment of ovulation,
- prolactin,
- TSH,
- 17-OH-progesterone,
- glucose and insulin,
- the lipid profile,
- glycated haemoglobin,
- other tests depending on the symptoms.
The doctor determines the range of tests. Not every patient needs the same panel, and some results must be obtained on a specific day of the cycle or under particular conditions.
Which conditions must be excluded before diagnosing PCOS?
PCOS can produce symptoms similar to other hormonal disorders, so before making a diagnosis the doctor should exclude other possible causes of irregular periods, acne, excessive hair growth or absent ovulation.
The differential diagnosis takes into account:
- thyroid disease,
- hyperprolactinaemia,
- non-classic adrenal hyperplasia,
- adrenal dysfunction,
- ovarian dysfunction,
- premature ovarian insufficiency,
- androgen-secreting tumours,
- side effects of medication,
- eating disorders,
- intense physical activity and significant weight loss.
Excluding other causes matters, because treatment depends on the actual source of the problem.
Diet, physical activity and lifestyle with PCOS
Lifestyle plays a large part in the treatment of PCOS, particularly where there is insulin resistance, excess weight, difficulty losing weight or lipid disorders. This is not about a short-term diet but about consistent measures that support hormonal and metabolic balance.
With PCOS the following can help:
- regular meals matched to the needs of the patient,
- limiting large fluctuations in glucose and insulin,
- an adequate amount of protein, fibre and healthy fats,
- physical activity combining endurance and strength training,
- good quality sleep,
- stress reduction,
- weight management where needed,
- treatment of insulin resistance as recommended by the doctor.
A change in lifestyle does not replace diagnostics, but it can significantly support the treatment of PCOS symptoms and improve metabolic parameters.
Support from a gynaecologist, endocrinologist and dietitian
PCOS often calls for cooperation between several specialists. The gynaecologist assesses the cycle, ovulation, the ovaries, the endometrium and the treatment plan according to the needs of the patient. An endocrinologist may be needed with hormonal disorders, insulin resistance, thyroid disease or results that are difficult to interpret. A dietitian helps choose a way of eating that supports insulin metabolism and reduces metabolic symptoms.
This approach is particularly important when the patient has:
- insulin resistance,
- overweight or obesity,
- difficulty losing weight,
- lipid disorders,
- thyroid disease,
- severe acne or hirsutism,
- problems with ovulation,
- difficulty conceiving.
PCOS treatment should be matched to the priorities of the patient: regulating the cycle, improving the skin, reducing hair growth, treating insulin resistance, planning a pregnancy or long-term health prevention.
The consequences of untreated PCOS
Untreated or uncontrolled polycystic ovary syndrome can lead to persistent menstrual disturbances, problems with ovulation, worsening signs of androgen excess and difficulty conceiving. In some patients PCOS is also linked to a higher risk of insulin resistance, type 2 diabetes, lipid disorders and metabolic problems.
The possible consequences of untreated PCOS are:
- chronically irregular periods,
- absent ovulation,
- difficulty conceiving,
- severe acne,
- hirsutism,
- androgenic hair loss,
- insulin resistance,
- type 2 diabetes,
- lipid disorders,
- endometrial hyperplasia with long gaps between periods,
- reduced quality of life and poorer wellbeing.
Early diagnosis and well-chosen treatment help control the symptoms and reduce the risk of long-term complications.
The cost of PCOS diagnosis and treatment in Warsaw
The cost of PCOS diagnosis and treatment depends on the scope of the consultation, the number of laboratory tests, the need for an ultrasound, metabolic diagnostics and any additional consultations. A first appointment discussing the symptoms will cost differently from fuller hormonal and metabolic diagnostics.
The cost may be affected by:
- the gynaecological consultation,
- gynaecological ultrasound,
- hormonal tests,
- metabolic tests,
- follow-up on results,
- an endocrinology consultation,
- dietary support,
- cycle monitoring when planning a pregnancy,
- pharmacological treatment recommended by the doctor.
Current prices for consultations, ultrasound and tests can be checked in the OpenMed price list or obtained at reception.
Frequently asked questions about polycystic ovary syndrome
Yes. PMOS is the new name proposed for PCOS, which better describes the hormonal and metabolic nature of the disorder.
No. Polycystic ovaries on ultrasound do not always mean PCOS. A diagnosis requires an assessment of the symptoms, the menstrual cycle, androgens and ovulation, and the exclusion of other causes of hormonal disturbance.
The most common symptoms of PCOS are irregular periods, infrequent periods, absent ovulation, acne, excessive hair growth, androgenic hair loss, insulin resistance, difficulty losing weight and problems conceiving.
The doctor determines the range of tests. Most often sex hormones, androgens, TSH, prolactin, metabolic parameters, glucose, insulin and the lipid profile are assessed, and a gynaecological ultrasound is performed. Additional tests are sometimes needed to exclude other conditions.
PCOS is usually a chronic disorder that can be effectively controlled. Treatment is matched to the symptoms, the age of the patient, the test results and plans regarding pregnancy. The aim is to improve the cycle, ovulation, the signs of androgen excess and metabolic parameters.
In patients planning a pregnancy the doctor assesses ovulation, the cycle, hormonal results, insulin resistance and other factors affecting fertility. Treatment may involve a change in lifestyle, improving metabolic parameters, monitoring the cycle or treatment supporting ovulation.
Not always, but an endocrinology consultation may be needed if hormonal results are abnormal, if there is thyroid disease, hyperprolactinaemia, insulin resistance that is difficult to control, or symptoms requiring broader diagnostics.