Summary

  • 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.
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 have PCOS.

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
  • obesity.

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.
References
  • March WA, Moore VM, Willson KJ et al. 2010, ‘The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria’, Human Reproduction, vol. 25, no. 2, pp. 544–51. More information here.
  • Polycystic ovary syndrome (PCOS), netdoctor, UK. More information here.
  • Teede HJ, Misso ML, Deeks AA et al. 2011, ‘Assessment and management of polycystic ovary syndrome: summary of an evidence-based guideline’, Medical Journal of Australia, vol. 195, no. 6, pp. s65–s112. More information here.
  • Sirmans SM, Pate KA, 2013, ‘Epidemiology, diagnosis, and management of polycystic ovary syndrome’, Clin Epidemiol. vol. 18, no. 6, pp. 1-13. More information here.
  • Setji TL, Brown AJ, 2014, ‘Polycystic ovary syndrome: update on diagnosis and treatment’, Am J Med, vol. 127, no. 10, pp. 912-919. More information here.

More information

Reproductive system - female

The following content is displayed as Tabs. Once you have activated a link navigate to the end of the list to view its associated content. The activated link is defined as Active Tab

Fertility, pregnancy and childbirth

Content Partner

This page has been produced in consultation with and approved by: Jean Hailes for Women's Health

Last updated: February 2015

Page content currently being reviewed.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.