Polycystic Ovary Syndrome (PCOS)
What is Polycystic Ovary Syndrome?
PCOS is a condition that can affect your periods, fertility, hormones and aspects of your appearance. It can also affect your long-term health. Estimates suggest the incidence between 2 and 26 in every 100 women.
What are polycystic ovaries?
Polycystic ovaries are slightly larger than normal ovaries and have a higher number of follicles, which release the eggs when a woman ovulates. Polycystic ovaries can be present without causing any symptoms.
What are the symptoms of PCOS?
The symptoms of PCOS include:
- Irregular periods, or no periods at all
- Hirsutism (an increase in facial or body hair)
- Loss of hair on your head
- Experiencing a rapid increase in weight or having difficulty losing weight
- Oily skin and acne
- Difficulty becoming pregnant
In some cases, PCOS can also cause depression and psychological problems.
The symptoms vary from woman to woman. Some women have very few mild symptoms, while others are affected more severely by a wider range of symptoms.
What causes PCOS?
The cause of PCOS is not yet known. However, it can run in families, so if any relatives are affected with PCOS, the risk of developing PCOS may be increased. The symptoms are related to abnormal levels of the hormones testosterone and insulin.
- Testosterone is a hormone that is produced in small amounts by the ovaries in all women. Women with PCOS have higher levels of testosterone and this is associated with many of the symptoms of the condition.
- Insulin is a hormone that controls the level of glucose in the blood. When suffering from PCOS, the body may not respond to insulin as efficiently and this can result in the level of glucose increasing. This may also be referred to as Insulin Resistance. The body’s reaction to this increase in glucose is to produce even more insulin. These high levels of insulin can lead to the symptoms of weight gain, irregular periods, fertility problems and higher levels of testosterone that are associated with PCOS.
How is PCOS diagnosed?
It can be a difficult condition to diagnose, as there may be a number of other reasons for the symptoms. A diagnosis of PCOS can be made when any two of the following are experienced:
- Irregular, infrequent periods or no periods at all
- An increase in facial or body hair and/or blood tests that show higher testosterone levels than normal
- An ultrasound scan that shows polycystic ovaries
When the diagnosis is made, the next step is usually a referral to a gynaecologist or an endocrinologist.
What are the long-term health implications of PCOS?
PCOS means untreated women may be at a greater risk of:
- Insulin resistance and diabetes (up to 20% of women with PCOS may go on to develop diabetes)
- High blood pressure
- Womb cancer (please note, PCOS does not increase the risk of breast or ovarian cancer)
- Depression and mood swings
In each case, careful monitoring of the symptoms should be conducted.
What can be done to reduce long-term health risks?
The main ways to reduce your overall risk of long-term health problems are to:
- Follow a healthy balanced (Low Glycaemic Index) diet, including in particular fruit and vegetables, wholemeal bread, whole-grain cereals, brown rice, lean meat, fish and chicken
- Reduce intake of sugar, salt, caffeine and alcohol
- Have regular meals, especially breakfast
- Food supplements which reduce insulin resistance can help e.g. InoFolic
- Regularly exercise
How is PCOS treated?
Whilst there is not a specific cure for PCOS, medical treatments in combination with lifestyle options can be used to manage and reduce the symptoms or consequences of having PCOS.
- Hormonal options include certain contraceptive pills, specialised hormone therapy and low dose fertility drugs to trigger egg release in women wanting to achieve a pregnancy
- Non hormonal options include dietary supplements and the diabetes drug metformin
Due to the complexity of the condition, it is advisable to seek the guidance of a specialist gynaecologist