Endocrinology and gynaecology MDT · UK
A private PCOS clinic, built around a full MDT.
Rotterdam workup in one visit, a consultant endocrinologist leading the plan, and gynaecology, dietetics, dermatology, psychology and fertility available when the plan calls for them. GLP 1 pathways handled by the same team.
Indicative pricing
What a private PCOS clinic costs in the UK.
Indicative ranges across UK private providers.
In short
A full MDT PCOS workup in London: £750 to £1,600, results in 3 to 7 days.
| Service | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Initial consultant endocrinology consultation | £280 to £450 | 45 to 60 min | Same visit |
| Comprehensive PCOS workup (consult, bloods, US) | £750 to £1,600 | 2 to 3 hours | 3 to 7 days |
| 75 g oral glucose tolerance test (OGTT) | £180 to £320 | 2 hours | 3 days |
| Follow up consultation | £150 to £350 | 20 to 30 min | Same visit |
| MDT programme (12 months, endo + gynae + dietetics) | £2,400 to £6,500 | Rolling | Ongoing |
| Second opinion review of prior results | £220 to £400 | 30 min | 48 hours |
Prices vary by clinic, by the named consultant, and by whether a scan and OGTT are included. GLP 1 medications, if prescribed, are billed separately on self pay.
The journey
From first appointment to a written plan, in one to two weeks.
One team from first message to long term follow up, including dietetics, dermatology, psychology and fertility if you want them.
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On the day
Comprehensive consultation
45 to 60 minutes with the consultant. Full history, examination, hirsutism scoring, blood pressure, BMI and waist circumference.
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On the day
Tests done the same visit
Androgen panel, LH, FSH, SHBG, prolactin, TSH, HbA1c, fasting insulin, lipids, LFTs, vitamin D and transvaginal ultrasound.
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After
Diagnosis and written plan
Results in 3 to 7 days with a written treatment plan covering lifestyle, cycle regulation, androgen control, metabolic risk and fertility if relevant.
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After
Ongoing MDT review
Follow up at 3 and 6 months, with dietetics, dermatology, psychology and fertility looped in when the plan calls for it.
When it helps
The reasons women reach a PCOS clinic.
PCOS affects 5 to 15 percent of women of reproductive age. These are the most common presentations, and the red flag that means urgent workup.
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Irregular or absent periods
Cycles longer than 35 days, fewer than 8 per year, or amenorrhoea. The commonest reason women reach a PCOS clinic.
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Hirsutism, acne or hair thinning
Terminal hair on the face, chest or back, adult persistent acne, or androgenic thinning at the crown.
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Trouble losing weight
Weight gain around the waist that resists normal calorie restriction, often with cravings and post meal sleepiness.
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Trying to conceive
Anovulatory subfertility. Letrozole is now first line ovulation induction per the PPCOS II trial, ahead of clomiphene.
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Family history of type 2 diabetes
PCOS carries a four fold lifetime risk of type 2 diabetes. Metabolic screening and prevention start here.
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Low mood, anxiety or disordered eating
PCOS carries higher rates of depression, anxiety and eating disorders. Psychology is part of the plan, not an afterthought.
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Endometrial protection
Fewer than four bleeds a year with unopposed oestrogen raises endometrial hyperplasia risk. A regular withdrawal bleed protects the lining.
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Red flag: virilisation or rapid onset
Deep voice, clitoromegaly, or rapidly progressive androgenic features need urgent workup to exclude an androgen secreting tumour or non classical CAH.
Treatment options
PCOS is a spectrum, and so is the treatment plan.
What each pillar of the plan actually involves, and how they layer together per NICE, Rotterdam and the international 2018 guideline update.
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Lifestyle, first and always
Mediterranean or low glycaemic index diet, resistance plus aerobic exercise, sleep and stress. A 5 to 10 percent weight loss can restore ovulation and insulin sensitivity.
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Cycle regulation with a COC
A combined oral contraceptive, often one with anti androgen properties, gives cycle control, androgen suppression and endometrial protection in one tablet.
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Anti androgen therapy
Spironolactone 100 to 200 mg daily for hirsutism and acne, topical eflornithine for facial hair, laser hair removal, and isotretinoin for stubborn acne.
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Metformin for insulin resistance
Titrated from 500 mg up to 2,000 mg daily. Improves menstrual regularity, insulin sensitivity and, in some women, restores ovulation.
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Ovulation induction
Letrozole is first line for anovulatory subfertility, then gonadotropins and IVF. Coordinated with a fertility unit when appropriate.
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GLP 1 agonists for weight
Semaglutide or tirzepatide (Wegovy, Mounjaro) for concomitant obesity. Substantial weight loss improves cycles, insulin sensitivity and fertility markers.
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Inositol supplements
Myo inositol 2 g twice daily with D chiro inositol 50 mg. Modest evidence for menstrual regularity and insulin sensitivity, useful as an adjunct.
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Psychology and bariatric pathways
CBT for mood, anxiety, body image and disordered eating. A bariatric surgery referral for a BMI over 35 when medical routes have plateaued.
Safety and long term care
What good PCOS care actually looks like.
A firm diagnosis, the mimics excluded, and the long term risks screened annually. Not one prescription and a review in a year.
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A firm diagnosis, before treatment
Rotterdam criteria require two of three: oligo or anovulation, clinical or biochemical hyperandrogenism, or polycystic ovarian morphology on ultrasound.
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Exclude the mimics
17 hydroxyprogesterone to exclude non classical congenital adrenal hyperplasia, prolactin for hyperprolactinaemia, TSH for thyroid disease, cortisol if Cushing features.
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Metabolic screening at baseline
HbA1c or a 75 g OGTT if BMI is over 30 or with a family history of diabetes, plus lipids, LFTs, blood pressure and a sleep questionnaire.
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Endometrial protection is not optional
If you have fewer than four bleeds a year without contraception, we plan a regular progestogen induced bleed to protect the endometrium.
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COC contraindications, checked
Blood pressure, BMI, migraine with aura, VTE history and family history are all reviewed. If a COC is not suitable, a progestogen only route is used.
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Metformin, GI side effects
Nausea and loose stools are common in the first weeks. Titrate slowly, take with food, and use modified release if standard release is not tolerated.
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GLP 1 monitoring
Weekly injections with dose titration, nausea and constipation counselling, pancreatitis and gallbladder awareness, and thyroid family history checked.
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Mental health, taken seriously
PHQ 9 and GAD 7 at baseline, with a low threshold for psychology referral. Body image and disordered eating are actively asked about, not left for you to raise.
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Long term cardiovascular risk
Annual review of weight, waist, blood pressure, HbA1c, lipids, LFTs and mood. PCOS is a lifelong condition, not a fertility problem alone.
Frequently asked
Straight answers on private PCOS care.
The questions we hear most from women booking a PCOS assessment, answered by the consultants who see them.
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What is PCOS and how is it diagnosed?
PCOS is diagnosed by the Rotterdam criteria: two of three features must be present. These are irregular or absent ovulation, clinical or biochemical signs of high androgens (hirsutism, acne, or raised testosterone), and polycystic ovarian morphology on ultrasound (12 or more follicles per ovary, or ovarian volume above 10 mL). Other causes of the same picture, such as thyroid disease, hyperprolactinaemia and non classical congenital adrenal hyperplasia, must be excluded first.
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How much does a private PCOS clinic cost in the UK?
An initial consultant endocrinology consultation is £280 to £450. A full comprehensive workup including consult, bloods and transvaginal ultrasound is £750 to £1,600. Ongoing follow up is £150 to £350 per visit. A structured 12 month MDT programme covering endocrinology, gynaecology and dietetics is £2,400 to £6,500. GLP 1 medications, if prescribed, are billed separately on a self pay basis.
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Is metformin or a GLP 1 agonist better for PCOS?
They do different jobs. Metformin improves insulin sensitivity, can regularise cycles and modestly aids weight loss. GLP 1 agonists such as semaglutide or tirzepatide produce far greater weight loss, which itself improves PCOS features, insulin sensitivity and fertility markers. In practice the two are often used sequentially or together, with the choice driven by BMI, cardiovascular risk, fertility plans and tolerability.
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Can I get pregnant with PCOS?
Yes. Most women with PCOS can conceive, though anovulation makes it slower. A 5 to 10 percent weight loss restores ovulation in a meaningful proportion. Letrozole is the first line ovulation induction agent, superior to clomiphene per the PPCOS II trial. If letrozole does not work, options step up to gonadotropins and then IVF, coordinated with a fertility unit.
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Do I need a scan to be diagnosed?
Not always. If you clearly meet two of the three Rotterdam criteria without imaging, for example irregular cycles plus raised testosterone or hirsutism, a scan is not mandatory. A transvaginal ultrasound is still useful for a full baseline, to look at ovarian volume and follicle count, and to check the endometrial thickness if you have infrequent bleeds.
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What are the long term health risks of PCOS?
PCOS carries a four fold lifetime risk of type 2 diabetes, higher rates of dyslipidaemia, hypertension, non alcoholic fatty liver disease and obstructive sleep apnoea, and a higher risk of endometrial hyperplasia and cancer if periods are absent and unopposed. Depression, anxiety and eating disorders are also more common. A good clinic screens for and manages all of these, not just the cycle.