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Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome

Understanding Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder common among women of reproductive age and is usually associated with some degree of insulin resistance.

PCOS is characterized by irregular menstrual periods, excess androgen (testosterone) levels, and polycystic ovaries on ultrasound, which contain higher than normal follicles. Follicles, contain immature eggs and in PCOS, rather than one follicle developing to be ovulated, multiple follicles develop and produce excess androgens and oestrogen but no progesterone.

If not managed appropriately, this can cause various symptoms and complications including infertility and increased risk of endometrial cancer.

Common Symptoms of PCOS

The symptoms of PCOS can vary widely but often include:

  • Irregular periods: Infrequent, prolonged, or absent menstrual cycles.
  • Excess hair growth: Particularly on the face, chest, and back (hirsutism).
  • Acne and oily skin: Hormonal changes can lead to persistent acne.
  • Weight gain: Difficulty losing weight or unexplained weight gain.
  • Thinning hair: Hair loss or thinning on the scalp.
  • Darkening of the skin: Patches of dark, velvety skin, often in body creases.
  • Poor Mental Health: Women with PCOS have increased risk of depression, anxiety and eating disorders.

Diagnosing PCOS with Irregular Periods

If you have irregular periods, it could be a sign of PCOS. A diagnosis is typically made when you have at least two of the following: irregular periods, excess androgen levels, and polycystic ovaries. Other symptoms such as acne, hirsutism, and weight gain can also indicate PCOS. It’s important to consult with a healthcare provider for a proper diagnosis.

Can You Have PCOS Without Being Overweight?

Yes, you can still have PCOS even if you are not overweight. While weight gain is a common symptom, many women with PCOS maintain a normal weight. This condition, known as “lean PCOS,” still involves hormonal imbalances and can cause symptoms such as irregular periods, acne, and excess hair growth.

Treatment Options for PCOS

There are several treatment options available for managing PCOS, including:

  • Lifestyle Changes: Weight loss through a healthy diet and regular exercise can help manage symptoms. Even a modest reduction in weight can improve the condition.
  • Medications:
    • Metformin: This medication improves insulin resistance and can help with weight loss and menstrual regularity and fertility.
    • Birth Control Pills (The Pill): Whilst the pill does not treat the underlying PCOS, it does help manage symptoms and complications. The pill is especially useful for acne and excess hair growth and preventing endometrial hyperplasia which is a risk factor for endometrial cancer.
    • Anti-Androgens: Medications such as Spironolactone can reduce hair growth and acne by blocking the effects of androgens.
    • Fertility Treatments: For those trying to conceive, medications like Clomiphene or Letrozole can stimulate ovulation.

Importance of Treating PCOS

Treating PCOS is crucial to prevent long-term complications such as type 2 diabetes, heart disease, and endometrial cancer. Managing symptoms can also improve quality of life, reduce the risk of infertility, and alleviate physical discomforts like acne and excess hair growth.

Can PCOS Resolve on Its Own?

Women with PCOS will always have a predisposition to having the condition, however, its symptoms can be managed effectively with treatment and lifestyle changes. While it doesn’t go away on its own, many women find that their symptoms improve significantly with proper management leading to improved fertility, metabolic health and quality of life.

Dr Smith's Blog Posts on PCOS

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