The Pill — What Every Woman Deserves to Know
Clear, honest answers about oral contraceptive pills — written for you, not for a textbook.
Polycystic Ovarian Syndrome, also known as PCOS, is a common hormonal condition seen in many women, especially in Sri Lanka. It happens when the body makes certain hormones in an unbalanced way. This can affect your monthly cycle, cause unwanted hair growth or acne, make it harder to lose weight, and sometimes make it difficult to get pregnant. Even though the name sounds worrying, PCOS is a condition that can be managed very well with the right lifestyle changes and medical support. Many women with PCOS live healthy, active lives and go on to have normal pregnancies.
The Basics
When should I see my doctor?
Seek medical advice if you have one or more of the following symptoms, which may suggest underlying PCOS;
- Have very irregular or absent periods
- Struggling to get pregnant
- Notice worsening acne or unwanted hair growth
- Finds it harder to lose weight
or any of the following symptoms,
How is PCOS diagnosed?
PCOS is diagnosed based on a combination of symptoms, blood tests, and an ultrasound scan. Not every woman will have the same pattern – so listen to your doctor, before your neighbor!
PCOS is diagnosed if you have two of the following three features (after excluding other causes):
- Irregular or absent ovulation (irregular periods)
- Signs of higher male-type hormones: acne, excess hair, or raised hormone levels on blood tests
- Polycystic appearance of the ovaries on ultrasound (not all women need an ultrasound scan)
How It Works
How is PCOS managed?
One of the most important parts of managing PCOS is healthy lifestyle habits. Regular exercise and balanced meals help the body use sugar better and improve hormone balance. Losing even a small amount of weight—about 5% of your body weight—can help bring back regular periods and improve chances of pregnancy. Exercise does not need to be intense; brisk walking, swimming, or simple home routines are enough if done consistently.
Eating regular meals without skipping, reducing sugary drinks, choosing whole grains, and following a simple ‘plate method’ can make a big difference.
Some women may also need medication. Doctors may prescribe oral contraceptive pills to regulate your cycles or help with symptoms like acne or unwanted hair growth.
Are there long-term health risks?
PCOS is not only about periods and fertility; if not managed well, it can also increase the risk of long-term problems such as:
- Diabetes
- Changes in cholesterol levels
- High blood pressure
- Gestational diabetes in pregnancy
- Thickening of the womb lining (endometrial hyperplasia) if periods are very infrequent.
This is why regular follow-up with your doctor is important, even when your symptoms seem mild. Early care helps prevent these problems and supports your overall health.
Types of Pill
PCOS and Planning a Pregnancy
If you have PCOS and are thinking about becoming pregnant, it is helpful to meet with your doctor early.
Your doctor may advise weight optimization first and choose different medicines that are safe for fertility. For women who have difficulty getting pregnant, treatments such as ovulation-inducing tablets, such as letrozole, may be recommended.
Metformin is sometimes used to improve sugar handling in the body, especially when there are signs of insulin resistance, but your doctor will decide whether it is right for you. Early medical advice improves success and safety.
With early antenatal care and good planning, most women with PCOS enjoy safe and succesful pregnancies.
PCOS can feel overwhelming, but you are not alone. With the right support, healthy habits, and regular medical care, you can keep your symptoms under control and protect your long-term wellbeing.
💡 Stop exercising and get help straight away if you notice:
Stop at once and go to the nearest maternity unit or call your doctor if, while exercising, you notice any of the following:
- Bleeding from the vagina
- Water leaking from the vagina
- Strong belly pain or regular tightening like labour pains
- Chest pain or feeling that you cannot catch your breath
- Feeling faint, dizzy, or very weak
- Sudden, severe headache or problems with vision
- Pain, swelling, or redness in your calf (back of lower leg)
- Your baby is moving much less than usual
Do not restart exercise until you have been checked and cleared by a doctor.
Sources & References
This leaflet is based on guidance from the National Institute for Health and Care Excellence (NICE), the Royal College of Obstetricians and Gynaecologists (RCOG), and the NHS.
It is intended as general information and does not replace personalised medical advice.
Last reviewed April 2026 · Always speak to a qualified healthcare professional before starting, changing, or stopping contraception · NHS.uk · NICE.org.uk · RCOG.org.uk