Polycystic Ovary Syndrome (PCOS) is thought to affect 1 in 5 women in the UK, but awareness of the condition is still relatively low. As with many conditions that affect fertility, a lot of women will not be diagnosed with PCOS until they are trying to conceive and find that they are having difficulties, especially if their symptoms are mild, so education about the syndrome is important for early diagnosis.

What are polycystic ovaries?

If your ovaries are polycystic, they become enlarged and develop fluid-filled bubbles just below the surface. These bubbles or follicles contain eggs that have not fully developed. Most women with polycystic ovaries will not have any problems other than irregular periods. As well as having polycystic ovaries, to be diagnosed with PCOS you will also be experiencing one or more symptom from the list below.

What is PCOS?

Polycystic ovarian syndrome is a name given to a group of problems. In order to have PCOS you should have two of the following three – polycystic ovaries, an irregular menstrual cycle or an excess of male hormone.

The symptoms of PCOS can vary greatly between women and include:

  • Irregular periods
  • Unwanted facial/body hair (hirsutism)
  • Oily skin/acne
  • Thinning hair/hair loss
  • Weight gain
  • Reduced fertility

What causes PCOS?

Polycystic ovary syndrome is associated with hormonal imbalances in the body, although the exact cause is unknown. Its likely that there is a genetic link as it often (but not always) runs in families. One of the main issues is that PCOS women will have higher than normal levels of the hormone Insulin. Insulin helps to control the level of sugar in the blood by moving glucose from the bloodstream into the body’s cells to be used for energy. PCOS women will be more likely to be resistant to Insulin, so the body produces high amounts of it to overcome this resistance.

The high Insulin levels then lead to other hormone problems including high LH and Testosterone. High levels of LH through the cycle is why ovulation sticks are often falsely positive in women with PCOS.

Although typically thought of as a male hormone, all women produce a small amount of Testosterone in their ovaries and the majority of it is usually converted to Oestrogen. For women with PCOS, the amount of Testosterone produced tends to be higher and even a small rise in Testosterone in a woman’s body can affect menstruation and ovulation.

Who suffers from PCOS?

About 1 in every 4 young women will have polycystic ovaries on ultrasound, but only some of these women will go onto have other problems associated with PCOS. Symptoms usually begin in adolescence but can also appear later in life, usually in a woman’s early or mid-twenties. PCOS often runs in families, so if there is a history of the condition in your family tree you should be aware of the symptoms in case you start to display them.

How do I know if I have PCOS?

If you are experiencing any of the symptoms of PCOS, the first step is to make an appointment with your doctor to discuss it and to rule out any alternative causes. Your doctor will look at your symptoms, arrange for tests to check your levels of certain hormones and possibly arrange for an ultrasound to confirm diagnosis.

What treatment is available for PCOS?

If you have had a diagnosis of PCO or PCOS then the most important thing is not to worry. Although PCOS cannot be “cured’ most of the symptoms can be helped.

The first of the suggested treatment plans is usually lifestyle changes, especially if you are carrying excess weight. Excess fat in the body causes an increase in Insulin production, which can worsen the symptoms of PCOS, so losing weight can lead to a significant improvement in quality of life.

I can’t stress enough how important it is to try and get to a healthy weight. Remember that there are many women who are on the too “light side”.  Being a healthy weight may not completely treat your symptoms, but certainly will be beneficial if you need medical treatment as you will respond much better.

Crash and fad diets should be avoided and healthy eating is far to be preferred. I often hear how PCOS patients have been advised to avoid certain types of food at all cost. Forget about this and concentrate on having a healthy. balanced diet whilst being very careful about how much energy (Calories) you consume. I love exercise and it is very important, but its probably more important to the average person to be strict and consistent with what they eat than anything else when it comes to weight control.

There are many medical interventions depending on your specific symptoms and your views on how you would like to be treated. No two PCOS women are alike.

Many of my patients who have irregular cycles with their PCOS have worked with acupuncture practitioners to regulate their cycles. It’s not a treatment for everyone – and I don’t really understand how it would work – but certainly anecdotal evidence is that it seems to work for some.

How does PCOS affect fertility?

I see many women with PCOS who are struggling to conceive. The biggest issue with PCOS and sub-fertility is irregular or even totally absent ovulation. There’s often a lot of confusion, because as I mentioned before, urinary ovulation sticks can be falsely positive.  The good news is that with treatment, most women with PCOS will go on to have healthy pregnancies and there are many treatment options depending on your specific requirements.

To discuss PCOS and fertility options, contact Yvonne on liebermanpa@gmail.com