Polycystic ovarian syndrome (or polycystic ovary syndrome – PCOS) is a complex condition in which a woman’s ovaries are generally bigger than average. Polycystic means the ovaries have many cysts or follicles that rarely grow to maturity or produce eggs capable of being fertilised.
Up to a third of women may have polycystic ovaries seen on an ultrasound, but they do not all
PCOS is relatively common, especially in infertile women. It affects 12 to 18 per cent of women of reproductive age (between late adolescence and menopause). Almost 70 per cent of these cases remain undiagnosed.
Symptoms of polycystic ovarian syndrome
Women who have PCOS may experience:
- irregular menstrual cycles – menstruation may be less or more frequent due to less frequent ovulation (production of an egg)
- amenorrhoea (no periods) – some women with PCOS do not menstruate, in some cases for many years
- excessive hair growth and acne – possibly due to increased free testosterone
- scalp hair loss
- reduced fertility – (difficulty in becoming pregnant) related to less frequent or absent ovulation
- mood changes – including anxiety and depression
Causes of PCOS
PCOS is a hormonal condition commonly involving high levels of insulin or male hormones known as ‘androgens’, or both. The cause of this is unclear.
In some women, PCOS runs in the family, whereas for others, the condition only occurs when they are overweight.
Long-term health risks of PCOS
PCOS is associated with long-term health risks. Research shows that PCOS is related to insulin resistance and the development of diabetes, especially if women are overweight.
Diagnosis of PCOS
Diagnosis of PCOS is likely to involve:
- your medical history
- an examination, which may include an ultrasound
- tests to measure hormone levels in the blood.
Early diagnosis is important as it can allow symptoms to be managed and may prevent the development of long-term health problems such as diabetes.
Treatment of PCOS
Depending on the problems, management of PCOS can include lifestyle modifications, weight reduction, and treatment with hormones or medications. Research has shown that even a five to 10 per cent loss of weight in those who are overweight can restore normal hormone production and help regulate periods and improve fertility.
It is important that a multidisciplinary approach be used to manage and treat PCOS. You will need the help of your local doctor. You may also be referred to specialists, including an endocrinologist (hormone specialist) and a gynaecologist, as well as a dietitian and possibly a psychologist.
If only one or two symptoms of PCOS are treated on a short-term basis, a woman may be left with long-term clinical problems. PCOS is a long-term condition and long-term management is needed.
For all women with PCOS, it is important to relieve symptoms and reduce the risk of diabetes by preventing weight gain through a healthy lifestyle, or by losing weight if you are already overweight.
PCOS treatments include:
- the oral contraceptive pill – if you are suffering from irregular, heavy periods, the oral contraceptive pill is often prescribed for contraception, to regulate the cycle, reduce hirsutism (excess hair) and acne, and prevent the lining of the womb from thickening excessively
- medication to block hormones such as testosterone (for example, spironolactone) – these may be used to reduce excess hair growth or scalp hair loss
- infertility medications – if infertility is a problem, clomiphene citrate (sold as Clomid) or metformin may be taken orally to bring about ovulation (egg production)
- psychological counselling.
Your doctor and specialists can advise you about what treatment best suits you.
Where to get help
- Your doctor
- Gynaecologist especially for fertility issues
- Endocrinologist for hormonal issues
- Local women’s health clinic
- Community health centre
Things to remember
- Polycystic ovary syndrome (PCOS) can be associated with problems such as irregular menstrual cycles, excessive hair growth, acne, obesity, reduced fertility and increased risk of diabetes.
- PCOS can be diagnosed by history, examination, blood tests and an ultrasound.
- Treatment for PCOS includes a healthy lifestyle and targeted therapy such as hormones and medication.
This page has been produced in consultation with and approved by:
Jean Hailes for Women's Health
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