Author: Obstetrician Dr Peter England
Polycystic Ovarian Syndrome is commonly known as PCOS.
It ‘s important to diagnose PCOS correctly, for both your long and short-term health implications. With appropriate treatment and diagnosis, PCOS symptoms and implications can all be addressed satisfactorily.
The underlying cause of PCOS is not yet fully known.
The cause of Polycystic Ovary Syndrome likely has a genetic basis. PCOS can be more common in families with Type 2 Diabetes and may also be associated with a family history of irregular menstruation in female relatives.
Excessive weight gain over time or pre-existing obesity can be a factor in the cause of PCOS.
What is PCOS?
Think of your ovaries as being fully functional, but a little bit lazy.
The physical anatomy is all there.
The eggs are there.
But you are not ovulating.
Due to changes in the hormonal environment, you can find that your periods are irregular, or infrequent. This happens because you are not ovulating very often, or at all. When ovulation does not occur regularly, the ovaries produce higher levels of male hormones.
With PCOS, you can also have a change of female (estrogen) hormones into male hormones. When these hormones change, they can cause:
- acne,
- unwanted male hair patterns,
- thinning of scalp hair,
- associated body image disturbance and
- depression or low mood.
When you are first diagnosed with PCOS, many women confirm there has been a noticeable change in weight over the preceding years. This weight gain needs further investigation.
In addition to the points listed above, due to a lack of ovulation, PCOS can result in problems if you are planning to have a baby.
Polycystic Ovarian Syndrome Diagnosis
When you first visit a gynaecologist to discuss possible PCOS, we will review some of your vital signs and ask you about your medical history, including:
- Blood Pressure
- Pulse
- Your weight – and compare it to previous years (has there been a change?)
- Male pattern hair distribution
- Review your scalp hair
- Discuss irregular periods – are they being missed, or very spaced out?
- Look at your skin for acne signs and body hair distribution.
- Internal ultrasound – a vaginal ultrasound is conducted to look at your ovaries.
On ultrasound, we might notice if the ovaries have multiple small cysts (POLYCYSTIC) appearance.
When you ovulate, you release an egg. You usually release an egg follicle that grows to 2-2.5cm across and pops mid-cycle, releasing the egg.
In PCOS, this frequently does not occur, and then ovulation does not occur. Instead, a small cyst of 5-8mm in size is grown, and no egg is released. After a few years, increased cysts appear. You can spot these cysts on ultrasound, and usually, once 15 or more are evident, a diagnosis of PCOS will be made.
PCOS is a disorder of hormonal production.
Your doctor will arrange blood tests to assess your hormonal profile, which will be helpful in the diagnosis.
We will look at hormones produced by the pituitary gland that normally drive the menstrual cycle.
We will check your male hormone levels to determine whether they are within a normal range or elevated.
A glucose tolerance test may also check for diabetes, especially if you have gained weight or have a family history of Type 2 Diabetes.
Long-term health implications of PCOS
It is important to seek medical advice if you think you may have PCOS. Over time PCOS can lead to:
- Type 2 Diabetes
- Sleep Apnoea
- High Blood Pressure
All have serious implications for your cardiac health and life expectancy.
A visit to a dietitian can be useful to help you reduce simple carbohydrates and focus on increasing complex carbohydrate intake.
Obvious foods to look at reducing: white bread, white rice, pasta, and potatoes. These foods are broken down into pure glucose in the bloodstream, and this energy is stored as increased fat. The increased fat causes the derangement in hormone levels. Fat cells can alter female hormones into male hormone precursors and lead to unwanted signs and symptoms as mentioned above.
PCOS treatment is aiming to reduce the impact of male hormones on the skin, acne, hirsutism and to trigger ovulation.
Regular exercise is important for women with PCOS
You are encouraged to exercise at least three times a week. To start, you could consider:
- Gym work,
- walking,
- swimming,
- bike riding
Choose an exercise that you enjoy to help ensure you will continue. Walking multiple times a week is a great place to begin.
Exercise will assist to improve any low mood or mental health concerns that can be present when you have PCOS.
Read about Medications to help with PCOS.
For information about medications that can assist with management of PCOS please read the article on Medications to Treat PCOS
For assistance with any gynaecological issue, speak with your GP or ask your healthcare provider for a gynaecological referral to a specialist.
This blog post is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition