PCOS Specialist | Naas Endocrinology Clinic
PCOS & Hormonal Health · Naas, Co. Kildare

PCOS & Hormonal Health

Specialist endocrine assessment of polycystic ovary syndrome (PCOS), hormonal imbalance, insulin resistance, and metabolic complications. Compassionate, evidence-based care from Dr Kazmi, Consultant Endocrinologist.

What is PCOS?

Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders affecting women of reproductive age, estimated to affect 8–13% of women. It is characterised by a combination of hormonal imbalance (elevated androgens), ovulatory dysfunction, and polycystic ovarian morphology on ultrasound.

PCOS is a heterogeneous condition — not every patient has all features, and the clinical presentation varies widely. It has significant metabolic implications, with high rates of insulin resistance, Type 2 diabetes risk, and cardiovascular risk factors. The psychological burden — including anxiety, depression, and effects on body image — is also important and often underaddressed.

It is worth noting that polycystic ovarian morphology (PCOM or PMOS) — the appearance of multiple small follicles on ultrasound — can occur in women without the full syndrome and does not alone establish a PCOS diagnosis.

This page is for educational purposes only. It does not constitute medical advice. Always consult a qualified healthcare professional for assessment and management of PCOS.

Recognising PCOS

  • Irregular or absent periods
  • Difficulty conceiving
  • Excess facial/body hair (hirsutism)
  • Acne
  • Hair thinning or scalp hair loss
  • Weight gain or difficulty losing weight
  • Mood disturbance
  • Fatigue
  • Skin tags
  • Acanthosis nigricans

Symptoms vary significantly between individuals. Some women with PCOS are lean with normal periods but have elevated androgens; others have significant metabolic features. Specialist assessment allows precise characterisation of the phenotype.

How We Can Help

Dr Kazmi provides a thorough endocrinological assessment of PCOS, addressing hormonal, metabolic, and clinical aspects of the condition and providing a structured management plan.

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Diagnostic Evaluation

Comprehensive hormonal assessment including LH, FSH, total and free testosterone, DHEAS, SHBG, AMH, and exclusion of other androgen excess disorders such as congenital adrenal hyperplasia and androgen-secreting tumours.

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Insulin Resistance Assessment

Fasting glucose, insulin, HbA1c, and lipid profile. Identification and management of metabolic syndrome features — a key component of long-term health in PCOS.

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Menstrual Irregularity

Assessment and management of oligo/amenorrhoea, including medical treatment to regulate cycles and monitoring for endometrial health implications of prolonged anovulation.

Hirsutism & Androgen Excess

Evaluation and treatment of excess hair growth and androgen-related features, with medical management options discussed alongside cosmetic approaches.

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Fertility Concerns

Assessment of ovulatory dysfunction affecting fertility. Coordination with reproductive medicine where ovulation induction or further fertility assessment is indicated.

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Long-term Metabolic Health

Proactive monitoring and management of long-term PCOS-associated risks including Type 2 diabetes, cardiovascular disease, and non-alcoholic fatty liver disease.

The Rotterdam Criteria & PCOS Diagnosis

PCOS is diagnosed using the Rotterdam criteria (2003), which require two out of three features: oligo- or anovulation, clinical or biochemical signs of hyperandrogenism, and polycystic ovarian morphology on ultrasound — after exclusion of other conditions such as thyroid disease, hyperprolactinaemia, and congenital adrenal hyperplasia.

Management is tailored to the individual's presenting features and priorities. Lifestyle interventions (dietary modification, physical activity, and weight management where appropriate) remain fundamental. Medical management may address insulin resistance, menstrual regularity, androgen excess, and fertility depending on clinical needs.

All consultations are led by Dr Syed Kashif Hussain Kazmi, Consultant Endocrinologist (IMC: 213626), who provides a structured, evidence-based assessment in a sensitive and supportive environment.

Frequently Asked Questions

PCOS (polycystic ovary syndrome) is a clinical and biochemical diagnosis requiring at least two of the three Rotterdam criteria: irregular periods, signs of androgen excess (clinical or biochemical), and polycystic ovarian morphology on ultrasound. PMOS (polycystic morphology of the ovary — also called PCOM, polycystic ovarian morphology) refers specifically to the ultrasound finding of multiple small follicles in the ovary (typically 20 or more follicles per ovary, or increased ovarian volume). PMOS can occur in women who do not have irregular periods or androgen excess — meaning they do not meet criteria for PCOS. Conversely, not all women with PCOS have PMOS on ultrasound. The distinction matters because PMOS alone does not carry the same metabolic implications as full PCOS and should not automatically lead to the same diagnostic label or management pathway.
PCOS is diagnosed by applying the Rotterdam criteria after ruling out other conditions. Your doctor will typically take a clinical history (asking about menstrual cycle regularity, symptoms of androgen excess, weight, and fertility concerns), perform a clinical examination, arrange blood tests (hormones including LH, FSH, testosterone, prolactin, thyroid function, and metabolic markers), and may arrange a pelvic ultrasound. No single test diagnoses PCOS — it is a clinical diagnosis based on the combination of features. An endocrinologist can provide a thorough and nuanced assessment, particularly in cases where the diagnosis is uncertain or other conditions need to be excluded.
Yes, lifestyle interventions are the first-line treatment for many women with PCOS, particularly those with insulin resistance and metabolic features. Even modest weight loss (5–10% of body weight) in those with overweight can improve hormonal profiles, restore ovulation, reduce androgen levels, and improve insulin sensitivity. Regular physical activity has benefits beyond weight management, including direct effects on insulin resistance. Dietary approaches focusing on low glycaemic index foods and adequate protein may be beneficial. However, for many women medication is an important part of management — the decision depends on the individual's symptoms, priorities, and PCOS phenotype.
The primary mechanism by which PCOS affects fertility is ovulatory dysfunction — irregular or absent ovulation means eggs are not released predictably, making natural conception more difficult. However, many women with PCOS do conceive naturally, and PCOS is very much a treatable cause of subfertility. First-line approaches include lifestyle optimisation, and ovulation induction with medications such as letrozole or clomiphene citrate (prescribed by a specialist) when needed. For women who do not respond, further reproductive medicine assessment may be warranted. It is important to note that PCOS does not cause infertility in all patients — some women with PCOS have perfectly regular cycles and normal fertility.
Yes. Insulin resistance is present in approximately 65–80% of women with PCOS and is thought to play a central role in its pathogenesis. Elevated insulin levels stimulate the ovaries to produce excess androgens and interfere with normal follicle development. Insulin resistance in PCOS occurs independently of BMI — lean women with PCOS can also have significant insulin resistance. It increases the long-term risk of Type 2 diabetes, metabolic syndrome, and cardiovascular disease. Identifying and addressing insulin resistance is therefore an important component of comprehensive PCOS management, even in women who are not currently seeking fertility treatment.

Specialist Care for PCOS

Book a private consultation with Dr Kazmi, Consultant Endocrinologist, for a comprehensive assessment of PCOS and hormonal health.

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