What is Polycystic Ovary Syndrome (PCOS)?
Polycystic ovary syndrome is a complex but fairly common hormonal disorder that affects 12-20% of Australian women of childbearing age. It can’t be cured but it can be treated.
The ‘Polycystic’ Bit
‘Polycystic’ draws on some old Greek words. It basically means ‘many cysts’. So, you’d think that, if you have PCOS, you have many cysts on your ovaries.
It’s not that simple though because:
- Some women have PCOS without having multiple cysts
- Some women do have multiple cysts but don’t have PCOS
- The cysts in question aren’t actually cysts but partially formed hair follicles containing one egg each.
Signs and Symptoms of PCOS
Signs and symptoms of PCOS vary enormously from one woman to another. You may have some of the following symptoms:
- No periods
- Irregular periods
- Long or heavy periods
- Difficulty getting pregnant
- Excessive body hair (hirsutism)
- Thinning hair or hair loss from your scalp
- Acne (spots)
- Oily skin
- High blood pressure
- Overweight or obesity
- Mood and sleep
Criteria for Diagnosing PCOS
There are three key criteria for diagnosing PCOS, which are:
- Your periods are non-existent, irregular, or you don’t release an egg (ovulate)
- You have high levels of male hormones (androgens) in your blood, affecting your hair growth and your skin
- Your ovaries are large or polycystic with 12+ follicles found on one ovary during ultrasound.
You only need to meet two of these three criteria for your doctor to diagnose PCOS (after ruling out other conditions).
Causes of PCOS
PCOS is a complex condition and we’re still learning about its exact cause. So far, we can say it’s linked to your family history, hormones, and lifestyle.
You’re more likely to get PCOS if another woman in your close family has it, so there’s clearly a genetic component to the condition.
Hormonal imbalances are a big factor. Women with PCOS often have insulin resistance. You’re making insulin (the hormone that controls your blood sugar) but your body won’t respond to it. Your overworked pancreas therefore makes more and more insulin until your body finally responds and lets the sugar (glucose) out of your bloodstream and into your cells where it’s converted to energy. Insulin resistance makes you more likely to develop type 2 diabetes.
Insulin resistance has a knock-on effect on your ovaries, making them produce greater amounts of male hormones, including androgens like testosterone. These higher levels of male hormones then disrupt your menstrual cycle causing absent, irregular or prolonged periods. High levels of male hormones also make you more prone to acne and to excessive hair growth.
Lifestyle factors include being overweight and inactive. These can both increase your insulin resistance, which affects your ovaries as mentioned above. That’s why losing weight and exercising more are some of the techniques for managing PCOS.
Treatment for PCOS
Because PCOS is a complex condition that crosses several areas of medicine, it often takes a team of specialists to manage it. Your treatment team might include your:
- GP (who coordinates your care)
- Endocrinologist (who deals with your hormones)
- Gynaecologist (who deals with your periods and fertility)
- Psychologist (who helps you maintain good mental health)
- Dietician (to help you eat well and manage your weight)
- Exercise physiologist (to help your body become more sensitive to insulin and to help you lose weight).
Some treatments focus on lifestyle changes like increased exercise, improved diet, and weight loss. These can all help you maintain a healthy weight and a better mood. They can also help you to become more sensitive to insulin.
Other symptoms are treated with medication. Hormonal contraceptives such as the pill can help to regulate your periods and reduce the amount of male hormones in your system. A diabetes medicine called metformin can also be used to improve your insulin sensitivity and settle your system down. It stops your body trying to make so much insulin, which stops your ovaries reacting by making more male hormones. You can also use certain creams or hair removal techniques to cope with excess hair growth.
Self-care is also important. PCOS is a long-term condition and that can be hard to deal with. It’s important to look after yourself, do the things you enjoy and have supportive people around you.
Your GP should be one of those supportive people. It’s important to find someone you feel comfortable with and can trust. At Elm Rd., we like building ongoing relationships with our patients. We’ll get to know you so that we know how to help you better. Your Elm Rd. GP is an understanding and capable doctor who can help you handle PCOS. Make an appointment today.