What is polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome (PCOS) is a complex hormonal condition affecting how a woman’s ovaries function due to an imbalance of reproductive hormones.  

PCOS causes the ovaries to produce abnormal androgens (male sex hormones). Hormones regulate the ovaries, which release eggs to be fertilised. These eggs develop in follicles (sacs). If the hormones which trigger the release of the egg from the follicles are not present in the right proportions, the eggs will remain in the follicle which can develop into cysts.

PCOS gets its name from the cysts that can form on the ovaries. Despite its name, women can have PCOS without developing cysts, which can be misleading.  

Who is at risk of developing PCOS?

PCOS can affect women of all races and ethnicities, who are of a childbearing age.

Symptoms can appear when a woman starts menstruating during puberty or become apparent following substantial weight gain.  

How common is PCOS?

The exact number of people who suffer from PCOS is unknown. Many women who have PCOS actually are unaware of their condition because they have no symptoms.  It’s thought to affect approximately 10% of women in the UK. 

What causes PCOS?

The exact cause of this condition is unknown. It is suspected that several factors play a role, including: 

• genetics  
• obesity 
• insulin resistance
• inflammation 

What are the symptoms of PCOS?

Symptoms of PCOS may include: 

• periods that are irregular, very light, or non-existent  
• enlarged ovaries  
• ovarian cysts
• excessive body hair
• weight gain, particularly around the abdomen 
• acne and/or oily skin  
• male pattern baldness or thinning hair  
• skin tags  
• dark skin patches in skin creases  
• pelvic pain  

Can PCOS affect fertility?

PCOS is one of the leading causes of female infertility, but it is treatable. People often don’t realise they have PCOS until they experience difficulties conceiving.

Approximately 70-80 per cent of people with PCOS will struggle to get pregnant because the cysts interfere with ovulation, preventing the release of an egg for fertilisation.  

Can PCOS affect pregnancy?

Having PCOS does not always cause infertility. You can still conceive, but it may be more challenging.

There is an increased risk of pregnancy complications for someone with PCOS, such as miscarriage, giving birth prematurely, getting gestational diabetes, or experiencing high blood pressure brought on by pregnancy.

Women with PCOS are more likely to need a C-section when delivering their baby.  

What other complications can PCOS lead to?

People with PCOS can develop serious health problems, such as: 

• type 2 diabetes 
• high blood pressure  
• cardiovascular issues  
• high cholesterol 
• endometrial cancer  
• sleep apnoea 
• mood disorders  
• anxiety or depression 
• steatohepatitis (severe liver inflammation)  

When should you seek medical advice on PCOS?

If you are experiencing any of the aforementioned symptoms (inconsistent periods, excessive hair, acne or weight gain) and they are affecting your quality of life, you should seek medical advice.

Additionally, if you are struggling to conceive after 12 months of trying, you should visit your doctor.  

How is PCOS diagnosed?

Although there is no singular test that can diagnose PCOS, an early diagnosis can reduce the risks of long-term complications.

A doctor will take a detailed medical history and focus on symptoms. A range of physical exams will be done, such as a pelvic exam, to check for abnormal growths on the ovaries or uterus. Blood tests, to determine hormone, cholesterol and insulin levels, may also be performed. An ultrasound might also be used to look for cysts on the ovaries.  

If you have at least two of the three main features - irregular periods, excess androgen and/or polycystic ovaries - you may be diagnosed with PCOS. You may be referred to an endocrinologist for specialist treatment.  

How is PCOS treated medically?

Treating PCOS depends on varies factors such as your age, severity of symptoms, general wellbeing and whether you’re trying to get pregnant or not.

PCOS is mostly treated with lifestyle changes, but the following medication can also help:  

• ovulation medication, if trying to get pregnant 
• birth control 
• diabetes medication  
• medication to treat symptoms like acne or hair growth   

Can PCOS be treated with surgery?

If medication and lifestyle changes do not help, surgery may be considered. Laparoscopic ovarian drilling (LOD) is a procedure that uses heat or laser to eradicate the ovarian tissue responsible for producing the androgens. 

Can PCOS be cured?

There is no cure for PCOS, but with treatment the symptoms can be managed and risks can be reduced.

PCOS can go away in some women when they go through the menopause, but in some cases, hormonal imbalance continues as women age.  

How is PCOS managed?

Regular doctor visits are recommended to test for potential conditions that can develop from PCOS.

Leading a healthy lifestyle can reduce the symptoms someone with PCOS experiences. A healthy diet and doing physical activity three times a week for 30 minutes can improve symptoms.

Additionally, if someone is suffering from poor self-image, perhaps because of weight gain, excess body hair, or acne, they can avail cosmetic treatments like laser hair removal which can improve their self-confidence.

Studies suggest that acupuncture can improve symptoms, but results are inconclusive.