Polycystic ovary syndrome (PCOS)

If you’re suffering from irregular periods, skin problems and excess hair growth, you may have polycystic ovary syndrome (PCOS). 


What is polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome (PCOS) occurs when lots of tiny fluid-filled sacs form in your ovaries. The follicles that surround the eggs have failed to develop properly, which can cause health problems. The condition is believed to be linked to hormonal imbalance. PCOS is the commonest hormonal condition in women, affecting around 1 in 10 women of reproductive age. Around 75% of women who don’t have periods (amenorrhea) have PCOS. 


What are they symptoms of polycystic ovary syndrome (PCOS)?

Classically, symptoms include irregular or absent periods, acne or excess hair growth in unwanted areas, such as your chin, and sometimes thinning hair on your scalp. Typically, the skin can be oily with acne affecting the chin, neck, shoulders and back which can be very distressing. Other features which may indicate PCOS are being overweight, with a thickened waist, and difficulty shifting the weight. Many women experiencing depression and irritability. There is a relationship with difficulty conceiving. There is a hereditary component, with 40% of women having a sister with PCOS, and 35% having a mother with PCOS. 

How is polycystic ovary syndrome (PCOS) diagnosed?

PCOS is diagnosed when 2 out of 3 criteria are present.

  • Symptoms such as missed periods, acne, excessive hair growth
  • Cysts appearing ovaries on ultrasound 
  • High levels of testosterone and other ‘male’ hormones on blood tests.

When investigating PCOS, blood levels of hormones are measured, as well as lipids, insulin and markers for diabetes. Many women cannot process cortisol adequately, leading to elevated cortisol levels in the body. Thyroid hormones levels and prolactin should also be checked to exclude other causes of irregular periods. 

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Why is it important to treat polycystic ovary syndrome (PCOS)?

There is an imbalance of the hormones, so ovulation is inhibited, which perpetuates the high levels of ‘male’ hormones, which will cause problems to any woman wishing to conceive. Half of women with PCOS have insulin resistance and have a sevenfold increase in the risk of diabetes. Left untreated, there is a higher risk of heart disease and elevated cholesterol. Studies have noted women with PCOS have decreased antioxidant levels, which is associated with poor health.


How can polycystic ovary syndrome (PCOS) be treated?

The good news is, PCOS can be managed with a combination of diet and lifestyle changes, medication and HRT. Woman with PCOS should aim for a balanced diet containing protein such as lean meat, fish, eggs, and tofu and of course plenty of fresh vegetables and fruits. Regular exercise can manage weight, regulate periods and improve ovulation. This can also reduce stress. Medications can also help. There are different approaches to managing PCOS with medications. The standard hormone rebalancing with the combined oral contraceptive pill, but there are more natural alternatives with hormone rebalancing using progesterone and specific supplements and vitamins. Other treatments such as metformin and spironolactone may also be used. 

Talking to a gynaecologist with experienced in endocrinology and PCOS will enable you to find the best individualised approach for your condition.