Polycystic ovarian syndrome (PCOS)

What is PCOS?

Polycystic ovarian syndrome (PCOS) is a common hormonal condition that affects up to 1 in 10 females in their reproductive years. It may cause disruptions to the menstrual cycle, skin and hair changes, as well as cysts on the ovaries.

It is one of the leading causes of infertility, yet many people don’t know they have it — many females with PCOS are not diagnosed.

PCOS can’t be cured, but if you have it, you and your doctor can manage many of the symptoms.

What are the symptoms of PCOS?

PCOS can cause a wide range of symptoms, and looks different for everyone.

PCOS symptoms include:

• excess hair growing on your face, chest, stomach or back (hirsutism)
• thinning hair or baldness (alopecia)
• irregular periods or no periods at all
• difficulty falling pregnant or not falling pregnant at all
• acne on your face and/or body

Your doctor may also look for:

• high blood pressure
• symptoms and signs of diabetes

What causes PCOS?

Females with PCOS produce high levels of male hormones from their ovaries. These male hormones affect the menstrual cycle and cause other symptoms.

Females with PCOS often have enlarged ovaries. Their ovaries may have many cysts on them, which is where the name comes from.

The cause of PCOS is unknown, but it is thought this happens because increased levels of insulin affect how the ovaries work.

You are more likely to develop PCOS if you have a close family member with the condition, there were increased hormones while you were in the womb, or due to your lifestyle or environment.

Immediate female relatives (daughters or sisters) of people with PCOS have as much as a 1 in 2 chance of having PCOS. Type 2 diabetes is also common in families of those with PCOS.

When should I see my doctor?

If you think you might have PCOS, it is important you see a doctor. An early diagnosis can help you manage the symptoms of PCOS and reduce the risk of long-term effects on your health.

It’s important to have regular health checks because of your increased risk of developing health problems later in life.

Talk to your doctor if you need help to manage your weight. Your doctor can refer you to the right health professional for your situation, such as a dietitian or exercise specialist.

How is PCOS diagnosed?

The diagnosis of PCOS is often difficult because there is a wide range of symptoms, and you don’t have to have all of them to be diagnosed with the condition.

There isn’t a simple test that rules PCOS in or out.

You should see your doctor if you are feeling unwell and have any of the symptoms that could be caused by PCOS.

Your doctor will talk to you to try to understand your symptoms. They will examine you. You may be asked to have:

• blood tests to check your hormones (such as testosterone), cholesterol and glucose levels in the blood
• an ultrasound scan to look at your ovaries and check for the presence of multiple cysts (fluid-filled sacs)

How is PCOS treated?

Treatment depends on the main problems you have. It can involve medicines, cosmetic treatments and maintaining a healthy lifestyle.

A healthy lifestyle is the main way to manage PCOS. Eating a healthy diet and getting regular exercise can help many of the physical and emotional problems caused by PCOS. Exercise can improve your mental health too.

Losing even a small amount of weight, if you live with overweight or obesity, can help:

• regulate your periods
• improve your chance of becoming pregnant
• reduce your risk of diabetes and heart disease

There are a number of different medical therapies to help manage PCOS symptoms, such as period problems, infertility, excess hair growth, acne and weight gain.

These therapies include:

• the oral contraceptive pill
• insulin-sensitising medicines
• hormone therapies
• weight loss medicines and interventions
• antidepressants and anti-anxiety medicines

What are the complications of PCOS?

If you have PCOS, you have a higher risk than other females of developing health problems such as:

• type 2 diabetes and gestational diabetes
• high cholesterol
• heart disease
• endometrial cancer
• sleep apnoea
• sexual health problems

Managing your PCOS symptoms and attending regular follow up appointments with your doctor can reduce your chance of developing these conditions, or help you recognise them early.