If you have PCOS then acne is almost always a problem. Some times are worse than others, particularly when you have your period, times of stress and illness, weight gain and pregnancy. 

The word 'polycystic' means lots of eggs in the ovary waiting to hatch that are in hibernation. The release of these eggs is triggered by pituitary hormones and in PCOS there is faulty triggering. 

A third of people with polycystic ovaries are born with faulty release of luteinising hormone from the pituitary gland in the brain. The other two-thirds are not releasing their eggs because they are too young (puberty), too old (menopause), too thin (anorexia) or too stressed (lifestyle). 

The eggs (ova, hence ovulation) ripen over three months, but the follicular cyst (bag of fluid containing the ova) doesn't burst. This cyst then shrinks but the cells around the now smaller cyst release excessive amounts of male hormone - hence the hair, pimples, menstrual problem, bulking up and mood problems. Sugar and insulin issues are a result of this (insulin resistance and diabetes). As a result, there is a cumulative effect, worsening with each month, particularly if more weight is gained. 

Ideally doctors like to stop the accumulating cycle as early as possible in the teenage years. Because the likely cause is a genetic defect, control is achieved by blocking the excessive male hormone with medication. Most women do well with an anti-diabetic drug called metformin. 

Most oral contraceptive pills contain a hormone that breaks down to testosterone and so expert advice as to which pill is suitable is essential. 

Natural therapists, despite their claims, have yet to produce any research evidence that natural therapies do help in PCOS. 

Your own doctor is the first place to get help. He or she may then refer you to a gynaecologist or if required, an endocrinologist. 

PCOS is manageable. A simple history taking, ultrasound and hormone blood tests provide the answer to best treatment.