Extra hair on the face or body, acne, oily skin and thinning hair on the scalp are possible signs of PCOS (polycystic ovary syndrome). Anxiety and low mood are also linked with PCOS. These changes can affect how you feel about your body and your daily life.
This is health information for learning and planning. It is not medical advice. A screening questionnaire can start a conversation with your clinician. It cannot confirm PCOS or any mood problem.
Seek care now: If you have thoughts of ending your life or of harming yourself, get help now. Visit the help page for support routes. You can also contact local emergency services or go to the nearest emergency department.
Extra hair on the face or body
The World Health Organization (WHO) lists excess hair on the face or body among the signs of PCOS. The medical name is hirsutism. The NHS describes it as thick, dark hair on places such as the face, neck, chest or tummy. Lighter, finer hair is usually not hirsutism.
The NHS says hirsutism is usually linked to higher levels of "male-type" hormones (androgens), or to the body being more sensitive to them. PCOS is the most common cause. Sometimes no cause is found. Less often, it comes from certain medicines or other hormone conditions.
The 2023 international PCOS guideline says a clinician may score hair growth across several body areas. The cut-off used can vary by ethnic background. The guideline also says extra hair on its own is a stronger clue to PCOS in adults than acne or hair thinning on their own.
Hair removal options include shaving, waxing, creams, electrolysis and laser, the NHS says. Your clinician can talk through these, and medicines for extra hair too. See treatment options to discuss.
Acne and oily skin
WHO lists acne and oily skin as possible PCOS signs. The guideline says acne on its own, without extra hair, is a weak clue for PCOS.
Acne has many causes. The NHS lists hormone changes during puberty, periods and pregnancy. It also lists PCOS, some medicines, and skin or hair products that make skin greasy.
The NHS says creams, gels and tablets can help acne. A pharmacist can advise on creams you can buy. Ask your clinician which option suits your skin and health.
Thinning hair on the scalp
WHO also lists female-pattern hair thinning on the scalp as a possible sign. The guideline says hair thinning on its own is a weak clue for PCOS.
Hair loss has other causes too. The NHS lists illness, stress, weight loss, iron deficiency and cancer treatment. Female-pattern hair loss can also run in families. So a clinician may check for other causes.
Note when the thinning started and whether it is getting worse. This helps your visit.
Anxiety, low mood and body image
WHO says people with PCOS may have anxiety, depression, eating disorders and a negative body image. WHO adds that symptoms such as unwanted hair face social stigma in many places.
The guideline says clinicians should screen all adults and teens with PCOS for depression. It says they should screen adults for anxiety too. They should use questionnaires checked for use in your region. A screen is a starting point, not a diagnosis. Share your answers with your clinician.
The guideline says the best gap between repeat screens is not known. One practical approach is a screen at diagnosis, then again based on your clinician's judgement and your life events.
The guideline also says eating disorders should be considered in PCOS, whatever a person's weight. It notes that PCOS features can affect body image.
Support that can help
If depression, anxiety or an eating disorder is found, the guideline says psychological therapy should be offered. It names cognitive behaviour therapy as one option for body image worries and eating problems. The NHS describes it as a talking therapy where a therapist helps you change how you think and act.
The NHS also says talking therapy can help when PCOS symptoms lead to depression or anxiety. You can ask about it at any visit.
You do not have to raise everything at once. Start with the change that worries you most. Your feelings about these changes are valid.
When to see a doctor
Ask for an urgent GP or clinic appointment if new thick, dark hair suddenly starts growing on your face and body. Do the same if your voice is getting deeper or your muscles are getting bigger. The NHS gives this advice. The guideline says changes that start suddenly or get worse quickly need further checks.
Book a visit if acne, hair changes or mood affect your daily life, work or relationships. The NHS uses this same test for when to see a GP about PCOS symptoms. The NHS also advises a GP visit if acne is painful or deep, is leaving scars, or is affecting your mental health.
Book a visit if low mood or worry lasts, or keeps coming back. Book a visit if you have worries about eating or body image.
Questions to ask your clinician
- Which hair score or check do you use for me?
- Could my acne or hair change have another cause we should check?
- Would a mood check fit this visit?
- What support is available near me, such as talking therapy?
- Which hair or skin option fits my goals?
What femio does and does not do. femio lets you note hair, skin and mood changes, so your visit is clearer. femio does not confirm PCOS. A screen it offers is a starting point, not a diagnosis. femio is not a crisis service. For urgent help, use the help page.