Polycystic ovarian syndrome (PCOS) is associated with problems such as irregular (usually less frequent) menstrual cycles, excessive hair growth, acne, obesity, reduced fertility and an increased risk of diabetes. Management of PCOS can include weight reduction or the use of medications or hormones.
Polycystic ovarian syndrome (or polycystic ovary syndrome – PCOS) is a complex condition in which a woman’s ovaries are generally bigger than average. Polycystic means the ovaries have many small, immature follicles that rarely, if ever, grow to maturity and produce eggs capable of being fertilised.
PCOS is relatively common among infertile women. It affects 12 to 18 per cent of women of reproductive age (between late adolescence and menopause). Almost 70 per cent of these cases remain undiagnosed.
Symptoms of polycystic ovarian syndrome
Women who have PCOS may experience:
- Irregular menstrual cycles – menstruation may be less or more frequent due to less frequent ovulation
- Amenorrhoea – some women with PCOS do not menstruate, in some cases for many years
- Excessive hair growth and acne – possibly due to increased free testosterone
- Reduced fertility – (difficulty in becoming pregnant) related to less frequent or absent ovulation
- Mood changes – including anxiety and depression
Causes of polycystic ovarian syndrome
PCOS is a hormonal condition involving high levels of insulin or male hormones or both. The cause of this is unclear.
In some cases, PCOS runs in the family, whereas for other women, the condition only occurs when they are overweight.
Long-term health risks of polycystic ovarian syndrome
PCOS is associated with long-term health risks. Research shows that polycystic ovary syndrome is related to insulin resistance and the development of diabetes, especially if women are overweight.
Diagnosis of polycystic ovarian syndrome
Diagnosis of PCOS is likely to involve:
- Your medical history
- An examination, which may include an ultrasound
- Tests to measure hormone levels in the blood.
Treatment of polycystic ovarian syndrome
Depending on the associated problems, management of PCOS can include lifestyle modifications, weight reduction and treatment with hormones or medications.
It is important that a multidisciplinary approach be used to manage and treat PCOS. You will need the help of your local doctor. You may also be referred to specialists including an endocrinologist (hormone specialist) and a gynaecologist, as well as a dietitian and possibly a psychologist.
If only one or two symptoms of PCOS are treated on a short-term basis, a woman may be left with long-term clinical problems. PCOS is a long-term condition and long-term management is needed.
For all women with PCOS, it is important to relieve symptoms and reduce the risk of diabetes by preventing weight gain through a healthy lifestyle, or by losing weight if you are already overweight.
PCOS treatments include:
- The oral contraceptive pill – if you are suffering from irregular, heavy periods, the oral contraceptive pill is often prescribed for contraception, to regulate the cycle, reduce hirsutism (excess hair) and acne, and prevent the lining of the womb from thickening excessively
- Infertility medications – if infertility is a problem, clomiphene nitrate (sold as Clomid®) or metformin may be taken orally to induce ovulation
- Psychological counselling.
Where to get help
- Your doctor
- A gynaecologist especially for fertility issues
- An endocrinologist for hormonal issues
- Your local women’s health clinic or community health centre
Things to remember
- Polycystic ovary syndrome (PCOS) is associated with problems such as irregular menstrual cycles, excessive hair growth, acne, obesity, reduced fertility and increased risk of diabetes.
- PCOS can be diagnosed by history, examination, blood tests and an ultrasound.
- Treatment for PCOS includes a healthy lifestyle and targeted therapy such as hormones and medications.
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Last reviewed: February 2013
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