Polycystic Ovarian Syndrome

What is PCOS?

Polycystic ovarian syndrome (PCOS) is a common hormonal condition that affects close to 1 in 7 women and girls. 

What are the symptoms of PCOS?

  • Irregular periods or large gaps in your periods         

  • Severe acne or excess facial hair

  • Weight gain and/or trouble losing weight

  • Infertility

  • Insulin resistance

  • Emotional challenges such as anxiety and depression

More information about Polycystic Ovarian Syndrome

How is PCOS diagnosed?

To be diagnosed with PCOS you need to have at least two out of the three:

  1. Polycystic ovaries on ultrasound

  2. Clinical evidence of excess hair, acne or elevated testosterone on blood test

  3. Infrequent periods

80% of the time PCOS is due to high insulin which causes the follicles in the ovaries to make too much testosterone which interferes with the signals from the brain to the ovary to bring about ovulation.  As women with PCOS don’t usually ovulate every month, it can be hard to fall pregnant.  The excess testosterone made in the ovary can cause the facial and body hair growth, acne and sometimes, male pattern hair loss. 

How is PCOS treated?

Management very much depends on the presenting problem ie weight, excess acne or hair growth, infertility etc.

Diet and exercise is the cornerstone of treatment.  Reducing insulin, and body weight can correct many of the issues for most women.  Stress plays a big factor too, as stress increases the hormones that can raise insulin, as well as increasing inflammation in the body.

Women with an elevated BMI are encouraged to lose at least 5-10% of the body weight.  Regular exercise is also encouraged, with adults requiring up to 150 minutes of moderate intensity exercise.

For excessive facial hair cosmetic procedures such as laser or waxing, alternative options is the oral contraceptive pill.  Medications such as the COCP or the mirena can be used for menstrual irregularities. 

If you are trying to fall pregnant and lifestyle changes such as diet, exercise and stress reduction have not normalised your cycles, medications to help you ovulate such as letrozole may be appropriate. It is important to remember, that 30% of patients with PCOS have no problems getting pregnant.

Due to the risk of developing metabolic syndrome, regular screening is also advised with your GP.  This includes having your cholesterol checked every 2 years, blood pressure checked annually and having a glucose tolerance test every 2 years.   

There is a wealth of resources and information on PCOS at the monash website which I encourage my patients to read.