Summary

  • Polycystic ovary syndrome (PCOS) is a complex hormonal condition. 
  • PCOS can be associated with problems such as irregular menstrual cycles, excessive facial and body hair growth, acne, obesity, reduced fertility and increased risk of diabetes.
  • PCOS can be diagnosed by taking a medical history, examination, blood tests and an ultrasound.
  • Treatment for PCOS includes a healthy lifestyle, weight loss and targeted therapy such as hormones and medication.

What is polycystic ovary syndrome?

Polycystic ovary syndrome (or polycystic ovarian syndrome – PCOS) is a complex hormonal condition. ‘Polycystic’ literally translates as ‘many cysts’. This really refers to there being many partially formed follicles on the ovaries, which each contain an egg. These rarely grow to maturity or produce eggs that can be fertilised.

Women with PCOS commonly have high levels of insulin, or male hormones known as 'androgens', or both. The cause of this is unclear, but insulin resistance is thought to be the key problem driving this syndrome. 

In some women, PCOS runs in the family, whereas for others, the condition only occurs when they are overweight. 

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.

Up to a third of women may have polycystic ovaries seen on an ultrasound, but they do not all have PCOS. To be diagnosed with PCOS, women need to have polycystic ovaries and the typical symptoms described below.

Symptoms of polycystic ovary 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 facial or body hair growth (or both) 
  • acne
  • scalp hair loss
  • reduced fertility (difficulty in becoming pregnant) – related to less frequent or absent ovulation
  • mood changes – including anxiety and depression
  • obesity
  • sleep apnoea.
  • you don’t have to have all of these symptoms to have PCOS.

Treatment of PCOS

It is important that all the symptoms of PCOS are addressed and managed long term, to avoid associated health problems. PCOS is a long-term condition and long-term management is needed.

Depending on the symptoms you experience, management of PCOS can include:

  • lifestyle modifications – increasing your physical activity levels and eating a healthy diet can both help to manage PCOS
  • weight reduction – research has shown that even five to 10 per cent weight loss can provide significant health benefits
  • medical treatment – with hormones or medications. 

 

Lifestyle modifications

Lifestyle changes – such as eating a healthy, balanced diet and introducing regular physical activity into your weekly routine – can have a positive effect on your health in so many ways. For women who have PCOS, a healthy lifestyle can lead to an improvement in symptoms, particularly if your new lifestyle helps you to lose weight. 

 

Weight reduction

You don’t even have to lose much weight to feel the benefit. Studies suggest that just 5 to 10 per cent weight loss can:

  • restore normal hormone production – which can help regulate periods and improve fertility
  • improve mood
  • reduce symptoms such as:
    • facial and body hair growth
    • scalp hair loss
    • acne. 

It can also reduce your risk of developing type 2 diabetes and cardiovascular disease.

Medical treatments for PCOS 

Medical treatments for 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 excess hair growth 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. 

Your PCOS management team

A multidisciplinary approach is the best way to manage and treat PCOS. A health care team to help manage PCOS may include:

  • Your GP
  • an endocrinologist (hormone specialist) 
  • a gynaecologist (for fertility issues)
  • a dietitian 
  • an exercise physiologist or physiotherapist
  • a psychologist.

Long-term health risks of PCOS

PCOS is associated with the following long-term health risks:

  • insulin resistance 
  • increased risk of the development of diabetes, especially if women are overweight
  • cholesterol and blood fat abnormalities
  • cardiovascular disease (heart disease, heart attack and stroke)
  • endometrial cancer.

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.

Where to get help

  • Your doctor 
  • Gynaecologist 
  • Endocrinologist 
  • Local women's health clinic
  • Community health centre
  • Jean Hailes for Women’s Health 1800 JEAN HAILES (532 642)
  • Dietitian
  • Exercise physiologist
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

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Last updated: October 2016

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