Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) is a hormonal condition that affects up to 1 in 5 Australian women of reproductive age. Although women with PCOS can present with a wide range of symptoms, it’s typically characterised by irregular menstrual cycles, skin and hair changes, and reduced fertility.
That being said, polycystic ovarian syndrome can be tricky to diagnose, partly because its symptoms can indicate several other gynaecological issues. In fact, up to 70% of women with PCOS don’t know they have it.
Let’s look deeper at what PCOS is, how to know if you’ve got it, and what you can do to treat it.
What is polycystic ovarian syndrome?
PCOS is a complex condition caused by an imbalance of reproductive hormones. Women with PCOS produce higher-than-normal amounts of male hormones called androgens.
These extra androgens can disrupt the menstrual cycle. Eggs may not develop properly, or they might not be released at all during ovulation. Because of this, PCOS is a common cause of infertility. However, having PCOS doesn’t necessarily mean you can’t have children.
It’s important to note that although the word ‘polycystic’ translates as ‘many cysts’, the name of this disorder is a bit misleading. Only about 15% of women with polycystic ovaries will develop ovarian cysts.
What causes PCOS?
The exact cause of polycystic ovarian syndrome is unknown. That being said, several factors are believed to play a role. These include:
Genetics
PCOS generally runs in families, although the exact combination of genetics contributing to this condition is unclear.
Inflammation
Women with PCOS often also have increased levels of inflammation in their bodies. As inflammation has been linked to higher androgen levels, it’s likely there’s a link.
Insulin resistance
The pancreas produces insulin to help the body convert sugar from food into energy. Excess insulin can trigger the ovaries to produce more androgens.
Symptoms of PCOS
Polycystic ovarian syndrome presents with a variety of symptoms, which makes it a complex condition to diagnose. Every woman is different, so your experience might be different to someone else.
If you have PCOS, you may notice one - or several - of the following:
- Abnormal vaginal bleeding
- Irregular periods
- No periods at all (amenorrhoea)
- Excess hair on your face or body
- Acne
- Dark patches of skin
- Hair thinning or bald patches (alopecia)
- Difficulty getting pregnant
- Mood changes including depression and / or anxiety
- Weight gain and / or a swollen belly
Women with PCOS also run a higher risk of developing further problems including:
- Type 2 diabetes
- Obesity
- Sleep apnoea
- Heart disease
- High cholesterol
- Endometrial cancer
Although this can sound scary, a PCOS diagnosis is not necessarily a reason to expect the worst. Your gynaecologist will discuss your individual prognosis with you, including how to reduce your risk of the condition causing more issues down the track.
How is PCOS diagnosed?
A PCOS diagnosis is typically based on having two out of these three indicators: no ovulation, high androgen levels, and ovarian cysts.
If your gynaecologist or GP suspect you might have the condition, diagnosis is likely to involve a few different assessments. These usually include:
Medical history
Getting a clear picture of your medical history is the first step. Your gynaecologist needs to have an understanding of your symptoms, as well as knowledge of any other conditions that may be related.
If there are other women in your family with polycystic ovaries, especially first degree relatives (such as your mum or sister), this information is important to share too.
Physical exam
Your gynaecologist will measure your blood pressure and body mass index (BMI). They will also look for signs of possible PCOS such as skin discoloration, acne, and excess hair on your face.
They might also look for hair loss or signs of other health conditions that might be playing a part in your symptoms.
Pelvic ultrasound
This can involve examining your ovaries for cysts and checking the lining of the uterus.
Blood tests
These indicate your androgen hormone levels. Your gynaecologist will also check other hormone levels related to other common conditions that can be mistaken for polycystic ovarian syndrome. Blood tests also check cholesterol and glucose levels in the blood.
Can I still get pregnant with PCOS?
Because this condition affects your eggs, it can make it harder for you to get pregnant. Around 70-80% of women with PCOS also have reduced fertility. But it’s not impossible - many women with PCOS do have children. If you are having trouble getting pregnant, fertility treatments are available to help improve your chances of ovulation.
It’s important to be aware that PCOS can cause complications during pregnancy such as high blood pressure and gestational diabetes. It is also linked to higher levels of premature delivery and miscarriage. If you get pregnant with polycystic ovaries, your gynaecologist and obstetrician will discuss risk management with you, and monitor you carefully.
Losing weight and lowering your blood sugar levels can also help improve your odds of a healthy pregnancy.
Treatment for Polycystic ovarian syndrome
There is no ‘cure’ for PCOS. Dealing with the condition involves managing your symptoms on a long-term basis.
Here are some recommendations from the team here at Northside Gynaecology in Brisbane:
Get up and moving
The first step of managing PCOS is embracing an active lifestyle. Introducing regular physical activity into your weekly routine can have a positive effect on your health in so many ways.
You don’t need to make a big commitment to get started - just try a few 30 minute walks a week first. You’ll soon notice an improvement in your weight, your energy levels, and also your emotional wellbeing.
These all have a knock-on positive effect on your symptoms of PCOS. It’s win-win!
Watch your weight
Excess weight can lead to both insulin resistance and inflammation, which are contributing factors for polycystic ovarian syndrome.
Just a 5-10% weight loss can have multiple benefits for your health, including reducing insulin resistance and inflammation, and reducing your risk of diabetes - all of which are believed to be directly related to PCOS.
Diet and PCOS
The saying ‘you are what you eat’ is not far from the truth - the types of foods we eat act as fuel for a variety of bodily functions and processes, so eating a PCOS-friendly diet can be effective in helping you manage the symptoms of PCOS.
This is one of the reasons that all our doctors highly recommend adopting a healthy diet and exercise routine to help manage PCOS symptoms.
In particular, diet can help you manage insulin levels, which plays a significant role in the condition.
For a dietary plan tailored towards managing your own personal condition, we recommend consulting with a dietician. We are able to refer to one on request.
Maintaining a healthy diet is not only helpful for managing PCOS, it’s important for reducing the likelihood of other health conditions such as cardiovascular disease and many types of cancer.
Medical therapies for managing PCOS
Along with lifestyle improvements, there are a number of medical treatments available to help manage symptoms of PCOS.
Oral contraceptives
If you’re suffering from irregular periods, the oral contraceptive pill can help regulate your cycle, it can also help reduce excess hair growth and acne. If you have heavy periods, an oral contraceptive can also help to prevent the lining of the womb from thickening excessively. Thinner lining equals lighter periods.
Hormone-blockers
Some medications such as spirouolactone may be used to block hormones that may be contributing to excess hair growth or scalp hair loss.
Infertility medication
If you’re having trouble becoming pregnant, your gynaecologist may discuss infertility medications that are designed to encourage ovulation.
Living a full life with PCOS
If you experience symptoms of PCOS, are having trouble getting pregnant, or simply feel something is ‘not right’, it’s important to speak up.
Although there is currently no cure for PCOS, it is possible to reduce your symptoms and improve your quality of life with the guidance of a healthcare professional.
Northside Gynaecology is a female-only practice located at convenient North Brisbane locations including Kedron and North Lakes. To book an appointment with one of our PCOS specialists, call us on 07 3054 4687.
