What is Polycystic Ovarian Syndrome (PCOS)?
Polycystic ovarian syndrome is the most common endocrine disorder experienced by women of reproductive age. It results in imbalances of sex hormones; oestrogen and progesterone, problems with menstruation and fertility, and also causes unwanted changes in one’s appearance.
Polycystic ovaries contain a large number of harmless follicles (fluid filled sacs), that are unable to release an egg, therefore ovulation doesn’t take place.
There are three main features associated with PCOS;
- Irregular periods – the ovaries don’t regularly release eggs
- Excess androgens – high levels of ‘male hormones’ in your body, which result in physical changes such as excess facial or body hair.
- Polycystic ovaries – the ovaries become enlarged and contain many follicles, which surround the eggs.
Women with PCOS are at an increased risk of developing Type 2 diabetes, depression, high blood pressure, high cholesterol and sleep apnoea.
PCOS has no cure and cannot be reversed, but a variety of treatment options are available to alleviate the symptoms of the disease, including infertility.
Symptoms associated with PCOS usually become apparent in your late teens or early twenties, but may sometimes develop later during reproductive years. Symptoms can vary from person to person and vary in severity.
Common symptoms of PCOS include;
- Irregular or no periods at all
- Difficulty in conceiving
- Excessive hair growth, on the face, chest, back or buttocks
- Weight gain
- Thinning hair
- Oily skin and acne
PCOS may also cause other serious conditions, such as;
- Type 2 diabetes
- High blood pressure
- Metabolic syndrom
- Sleep apnoea
- Depression and anxiety
- Abnormal uterine bleeding
There is no exact cause leading to PCOS, however a number of factors contribute to its development.
Hormonal imbalance
- Raised levels of testosterone
- Raised levels of lutenising hormone, which usually stimulates ovulation, can have adverse effects when too high.
- Low levels of sex hormone-binding globulin, usually binds to testosterone reducing its effect.
- Raised levels of prolactin, which stimulates breast glands to produce milk during pregnancy.
Genetics
- If your mother or sister has PCOS, you are at an increased risk of developing it too.
Resistance to insulin
- Insulin, produced by the pancreas to move glucose from the blood to the cells, is produced extra when body tissues are resistant to its effects. High levels cause the ovaries to produce too much testosterone, interfering with the development of follicles and normal ovulation.
It is important to recognise the symptoms and diagnose the condition early on, to reduce long-term complications.
Your GP will ask about your family and medical history and all your symptoms to rule out other possible conditions.
Further tests might be carried out to confirm the diagnosis.
Physical exam
The doctor will examine your height, weight and blood pressure
Pelvic exam
The doctor might inspect your reproductive organs for signs of masses, growth or other abnormalities
Blood tests
A blood sample may be drawn to measure the levels of hormones, cholesterol, glucose and triglyceride levels
Ultrasound
An ultrasound scan can show the appearance of your ovaries and if there are a high number of follicles present in them.
Treatment for PCOS usually focuses on managing the symptoms such as infertility, acne, obesity of excessive hair growth.
We can prescribe Metformin, to control hair growth and lower insulin, blood sugar and cholesterol levels in women with PCOS. It can also stimulate ovulation and encourage regular periods.
