Managing PCOS

Written in association with: Top Doctors^®

Published: 12/12/2024

Edited by: Jessica Wise

Polycystic ovary syndrome (PCOS) is something that plagues many people around the world. The exact causes of it are still yet unknown, but there are a myriad of ways to manage it. In this article, a consultant gynaecologist shares how PCOS can be treated medically or alleviated with lifestyle choices.

What is PCOS?

PCOS is a gynaecological condition where the ovaries – which are the female gonads and the producers of the sexual reproductive hormones oestrogen, progesterone, and androgens – begin to overproduce androgens. This puts the sexual hormones out of balance and disrupts the menstrual cycle, and causes small cysts to grow on the ovaries and the fallopian tubes. Those with PCOS are born with it, but do not have symptoms until puberty or even later around the early twenties.

What are the effects of PCOS?

These cysts can stop eggs from being released by the ovaries as they normally are during menstruation, and can affect fertility. The menstruation period may be abnormally heavy and irregular. Aside from its complications for the menstrual cycle, PCOS also can cause excessive body hair growth, acne or oily skin, unexplained weight gain, and thinning or pattern-balding hair.

It is also possible for these symptoms to compound and impact mental health, leading to depression, anxiety, body dysmorphia, and low confidence.

Specialists and researchers don’t know why androgen production would increase, but PCOS is believed to be connected with other conditions and factors like family genetics, type-2 diabetes, hypertension, high cholesterol, and heart disease.

How can PCOS be managed?

PCOS cannot be cured, so treatment focuses on improving the symptoms to increase fertility, address acne and hair loss, and regulate menstruation.

Medications can be prescribed like clomiphene, which helps stimulate egg production, and metformin, which is typically used for diabetes management but can lower insulin levels to regulate the period.

Medication and treatments for hair growth and eliminating acne will depend on person-to-person, based on their hair and skin type – a dermatologist will be able to provide the best advice regarding this. Combined contraceptive pill prescriptions can be particularly effective for reducing acne and hair loss due to the augmentation of oestrogen, as well as reducing heavy blood flow.

A surgical procedure called laparoscopic ovarian drilling, which involves a laser or heat source excising sections of the ovarian tissue that is producing the androgens and stimulating the ovaries to release more eggs, can be beneficial for those trying to conceive, but the results only last up to a year.

Those who have PCOS and also have high cholesterol, hypertension, or obesity can minimise PCOS symptoms by addressing these conditions with lifestyle adjustments.

This can be done through increasing weekly aerobic activity: