PCOS

Polycystic Ovary syndrome (PCOS) is a common condition in which a hormone imbalance causes irregular periods, increased hair and acne and may affect fertility. 

PCOS is associated with obesity and increased insulin resistance and therefore increases the risk of developing diabetes, heart disease and other conditions later in life. 

Women with PCOS can reduce the risk of long-term health problems by having a healthy lifestyle and maintaining normal body weight.

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 of how many women it affects vary widely from 2 to 26 in every 100 women. This information is about the effects on your long-term health and does not cover specific treatment options for PCOS. 

(6–7%) of women with polycystic ovaries have PCOS. Having polycystic ovaries on an ultrasound can does not necessarily mean that you have PCOS. Women with PCOS have symptoms as well as polycystic ovaries. 

What are the symptoms of PCOS? 

The symptoms of PCOS include: 

• irregular periods or no periods at all 
• an increase in facial or body hair (hirsutism) 
• loss of hair on your head 
• being overweight, experiencing a rapid increase in weight or having difficulty losing weight 
• oily skin, acne 
• difficulty becoming pregnant (reduced fertility). 
• depression and psychological problems can also result from having PCOS.  

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. 

PCOS can cause of fertility problems in women.  You may still become pregnant even if you do not have periods. If you do not want to become pregnant, you should seek advice from your gynaecologist about contraception.  

What causes PCOS? 

The cause of PCOS is not yet known but it sometimes runs in families. If any of your relatives (mother, aunts, sisters) are affected with PCOS, your risk of developing PCOS may be increased. The symptoms are related to abnormal hormone levels: 

Testosterone is a hormone that is produced in small amounts by the ovaries in all women. Women with PCOS have slightly higher than normal 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 (a type of sugar) in the blood.

If you have PCOS, your body may not respond to insulin (this is known as insulin resistance), so the level of glucose is higher. To try to prevent the glucose levels becoming higher, your body produces even more insulin. High levels of insulin can lead to weight gain, irregular periods, fertility problems and higher levels of testosterone. 

How is PCOS diagnosed?

Having polycystic ovaries on an ultrasound scan does not mean you have PCOS. Women with PCOS often have symptoms that come and go, particularly if their weight goes up and down. This can make it a difficult condition to diagnose, which means it may take a while to get a diagnosis. 

A diagnosis is made when you have any two of the following: 

• 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. 

Have regular health checks 

Once you have a diagnosis of PCOS, you should be monitored to check for any early signs of health problems: 

• Diabetes: Depending on your risk factors, you may be offered testing for diabetes every1-3 years.
• Cancer of the uterus: It is important to have a period every 3-4 months to reduce the risk of excessive thickening of the lining of the uterus. If you have not had a period for over 4 months, you may need hormone tablets to make you have a period. You may also be offered further tests such as an ultrasound scan of your uterus.
• High blood pressure: Discuss with your doctor how often you should have your blood pressure checked and whether you should have blood tests to check your cholesterol levels.
• Depression and psychological problems: You can be referred to a counsellor or trained specialist if necessary.

Is there a cure?

There is no cure for PCOS. Medical treatments aim to manage and reduce the symptoms or consequences of having PCOS. Medication alone has not been shown to be any better than healthy lifestyle changes (weight loss and exercise). Many women with PCOS successfully manage their symptoms and long-term health risks without medical intervention. They do this by eating a healthy diet, exercising regularly and maintaining a healthy lifestyle.