Polycystic Ovary Syndrome (PCOS)

PCOS is a common condition that is thought to affect about 1 in 5 women in the UK. More than half of these women do not have symptoms. The 3 main features are irregular periods, excess “male” hormones causing excess body hair and polycystic ovaries. There are no universally accepted diagnostic criteria, therefore it is quite difficult to recognise this condition.

Signs and symptoms of PCOS usually become apparent in late teens or early 20s.

The cause of PCOS is unknown but it often runs in families. It is related to abnormal levels of insulin and testosterone which means there is an increased risk of developing diabetes and problems associated with high cholesterol in later life.

The most common symptoms of PCOS are

• Irregular periods or not having periods at all
• Difficulty getting pregnant
• Excessive hair on the face, chest, back or buttocks
• Weight gain
• Hair loss
• Oily skin or acne

There is no cure but symptoms can be treated. Not being overweight and eating a healthy diet can help some of the symptoms. Medications can help with irregular periods, fertility problems and excessive hair. In some cases, surgery can be used to remove the tissue in the ovaries that is causing the symptoms.

Specialist doctors can tell from complaints and an examination if a woman has PCOS, however the final diagnosis and the stage of syndrome can only be confirmed by laboratory and clinical tests.

The following tests are used to diagnose PCOS:

• Female sex hormones (oestrogen and progesterone), pelvic ultrasound
• LDL and HDL cholesterol levels, high blood glucose levels and elevated triglyceride levels (PCOS patients tend to have low LDL and HDL cholesterol levels, high blood glucose levels and elevated triglyceride levels)
• Thyroid hormone levels, blood prolactin levels (in order to exclude thyroid disorders and prolactinoma)
• Male sex hormones (testosterone) (important to exclude ovarian tumours)
• Also, people with high risk have relatives with diabetes, alopecia (early baldness), obesity and PCOS.

PCOS treatment depends on the age of patient and symptoms (and their intensity) observed.

Women who do not wish to get pregnant receive oral contraceptives. They regulate the menstrual cycle and can reduce the risk of cervical cancer. Alternative options include intermittent hormonal therapy, which regulates the menstrual cycle and reduces the risk of cervical cancer but does not prevent pregnancy. If a woman with PCOS is overweight it is very important to lose weight as it helps to reduce the risk of many complications, such as type II diabetes and cardiac diseases. Moreover, women with PCOS should avoid foods that are rich in fat or sugar. Surgical treatment for PCOS patients who wish to get pregnant is given only in case they do not respond to other types of treatment.