Polycystic ovary syndrome – often abbreviated as PCOS – is a common yet complex hormonal condition that affects women in their childbearing years. As the name suggests, PCOS refers to there being multiple (“poly”) partially formed follicles (“cysts” ) in the ovaries, each which contain an egg.
It should be noted that these follicles are not technically cysts – this can lead to confusion about the condition.
Not all women who have PCOS present the same symptoms, and you do not have to have all symptoms to be diagnosed with PCOS. The symptoms also vary greatly, ranging from hair loss, to acne, to irregular periods and difficulties with fertility. Also, not all women who have multiple “cysts” have PCOS. For these reasons, it is quite a complex condition.
Causes of Polycystic Ovary Syndrome
The exact cause of PCOS is unknown, however, it is believed that several different factors play a role.
• High levels of androgens is one. Androgens are what are referred to as “male hormones”, although women also produce a small amount. These control the development of male-specific traits, such as baldness. Higher androgen levels in women can prevent ovulation during the menstrual cycle. It can also cause hair growth and acne – two common symptoms of PCOS.
• High levels of insulin is another. A resistance to insulin can cause blood insulin levels become higher than normal – many women who have PCOS are insulin resistant.
Symptoms of Polycystic Ovary Syndrome
Symptoms of PCOS vary greatly and can present in different ways. Some are mild and can go by undetected, while others can be quite severe. Often women do not find out they have PCOS until their 20s or 30s when they’re trying to have kids but are finding it difficult and seek help from their gynaecologist to discover why.
Irregular Periods – High levels of androgens and insulin can disrupt ovulation and menstruation, causing irregular periods. Sometimes periods can stop all together. PCOS can also cause heavy bleeding (menorrhagia).
Excess hair (hirsutism) – High androgen levels can cause more hair to grow on the face and body than is usual for women due to over-stimulated hair follicles. The hair will usually be found in places where men grow more hair than women, i.e. sideburns, upper lip, chest, around the nipples and on the thighs. The hair will usually be darker and thicker than usual.
Acne – Higher level of androgens can increase oil production in glands on the skin, causing acne. Obviously acne is common during adolescence, however, young women with PCOS tend to have more severe acne than usual.
Reduced Fertility – Both high levels of androgens and insulin can affect the menstrual cycle and ovulation, which can become irregular or cease completely. This can cause issues with fertility and also increase the risk of miscarriage. However, not all women with PCOS are infertile, and many can still become pregnant without medical assistance.
Weight Gain – High levels of insulin can cause weight management to become quite difficult resulting in weight gain or trouble with losing weight. Being overweight can also contribute to fertility problems.
Hair loss – High androgen levels can cause hair loss.
Psychological problems – Hormone imbalances, as well as the physical issues mentioned above, can cause psychological problems such as anxiety, depression and sleep apnoea. Problems with fertility can also impact on mood, causing mood swings.
Remember, women don’t have to have all of these symptoms to have PCOS. Women will usually present different symptoms in different ways. If you suffer from any of the above, it is recommended you see your doctor or gynaecologist as soon as possible.
Further Health Problems Associated With PCOS
Women with PCOS often have an increased risk of developing the health problems later in their lives, such as:
• Insulin resistance
• High cholesterol
• Cardiovascular disease
• Endometrial cancer
As PCOS can present such a wide range of symptoms, diagnosis may include a variety of tests and questions about your medical history from your doctor. This may include physical examination, pelvic exam and pelvic ultrasound, and blood tests to check androgen and insulin levels.
Treatment of PCOS
As the cause of PCOS is unknown, direct treatment is not possible. However, it is important that any symptoms are addressed and managed in the long term to avoid associated health problems.
Depending on your symptoms, treatment and management can vary greatly, from weight management and lifestyle modification, to medical treatments such as infertility medication. Your doctor or gynaecologist will discuss long-term treatment with you and tailor it to what best suits you.