Understanding polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is the name given to a group of symptoms
caused by a hormonal imbalance in the ovaries. This is a very common
condition affecting more than 10% of women in their reproductive age. The
hormonal variance can cause period problems, fertility issues, weight gain and
excess hair growth.

What causes PCOS?
The exact cause of PCOS is not yet know although it is related to family history,
obesity and hormonal imbalance including insulin resistance.
Insulin is a hormone that controls sugar levels in the body. If the cells in the
body become resistant to the effect of normal levels of insulin, more insulin is
then produced to keep the blood sugar normal. This increase in insulin
contributes to an increase in production of other hormones like testosterone.
In addition, obesity also increases the amount of insulin produced by the body.

What are the symptoms of PCOS?
The symptoms of PCOS usually become apparent in the late teens or early 20s.
They can change over time and can vary from woman to woman. The
symptoms are caused by an excess level of insulin and testosterone including:

  • Irregular periods or no periods at all
  • Difficulties getting pregnant due to reduced fertility
  • Excess hair growth on face, stomach and back (hirsutism)
  • Loss or thinning of scalp hair (alopecia)
  • Acne prone skin which may persist beyond the normal teenager years
  • Weight gain and increased risk of type 2 diabetes
  • Emotional problems (anxiety, depression, poor body image)

How to diagnose PCOS?
The diagnosis of PCOS is made when two out of the following 3 criteria are present:

  • Irregular or infrequent periods – this indicates that ovulation is not happening monthly
  • Symptoms and/or blood tests that show excess testosterone levels. e.g. acne, increase in facial or body hair or blood test with high androgen levels.
  • Ultrasound scan demonstrating polycystic ovaries

Blood tests are useful to rule out other hormonal conditions in case of doubt 
about diagnosis. An ultrasound scan can be used as one of the two criteria to make the diagnosis if multiple cysts is observed in the ovaries. However, it is possible to have PCOS without multiple cysts in the ovaries.

What are the treatments for PCOS?
Lifestyle changes is the best way to improve PCOC symptoms and to manage
long-term health. There is no cure for PCOS but there are a number of
medicines available to treat the symptoms caused by the disease.
For instance:

  • Irregular periods can be managed with contraceptive pill
  • Fertility can be managed with clomiphene citrate, metformin, letrozole or IVF under a fertility clinic team
  • Acne can be managed with contraceptive pills or Isotretinoin
  • Depression can be managed with counselling support and medication if required.
  • Medication alone has not been shown to be any better than eating well, staying physically active and preventing weight gain.


Long term health issue related to PCOS?
PCOS causes an increased risk in developing long-term health problems usually related to insulin resistance and to being overweight rather than to the PCOS itself. Possible long-term problems of polycystic ovary syndrome include:

  • Obesity
  • High blood pressure and cardiovascular disease
  • High cholesterol levels
  • Developing type 2 diabetes
  • Endometrial cancer

owever, these risks can be reduced with a healthy balanced diet, exercising regularly and weight reduction.

To conclude
Polycystic ovary syndrome (PCOS) is a name given to a condition which affects
the way a woman’s ovaries work. There is an excess of testosterone levels
which can contribute to acne prone skin, increase hair growth on face, weight
gain and irregular periods.There is no cure for PCOS available at the moment
but symptoms can be managed with lifestyle changes.
Hormone medication usually helps to correct PCOS symptoms if becoming pregnant is not the focus.