Polycystic ovary syndrome: what every woman should know

It is estimated that polycystic ovary syndrome (PCOS) affects 1 in 10 women worldwide, which impacts not only physical but mental health, relationships and family matters of the affected woman. Accomplished consultant obstetrician and gynaecologist Dr Elizabeth Egbase explains everything you must know about the condition.

What is PCOS, and what are its common symptoms?

Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects women of reproductive age. It is characterised by an imbalance of hormones, particularly an excess of androgens, which are often called "male hormones," though women also produce them in smaller amounts. This imbalance can interfere with normal ovulation (the release of eggs from the ovaries), leading to irregular or absent periods, difficulty conceiving, and small cysts in the ovaries.

Common symptoms of PCOS include irregular menstrual cycles, excessive hair growth (known as hirsutism), acne, and weight gain, particularly around the abdomen. Some women also experience hair thinning or hair loss from the scalp. It’s important to note that the symptoms can vary widely—some women may have only mild symptoms, while others experience more severe effects.

Polycystic ovaries

Polycystic ovaries contain numerous small, harmless follicles, each up to about 8mm (or 0.3 inches) in size.

These follicles are underdeveloped sacs where eggs form. In cases of PCOS, these sacs often cannot release an egg, preventing ovulation.

While the exact prevalence of PCOS is uncertain, it is believed to be quite common, and as previously mentioned, affecting roughly 1 in 10 women in the UK. More than half of these women experience no symptoms.

How is PCOS diagnosed, and what tests are typically performed?

PCOS is usually diagnosed using a combination of medical history, physical examination, and specialised tests. A specialist will assess your symptoms, such as irregular periods, weight changes, or skin and hair issues.

A pelvic examination may be performed to check for signs of enlarged ovaries or other abnormalities. Blood tests are often used to measure hormone levels, including androgens and other reproductive hormones like luteinising hormone (LH) and follicle-stimulating hormone (FSH), which can help assess ovulation. Additionally, an ultrasound scan of the ovaries is often recommended. The ultrasound can detect the presence of multiple small cysts, which are not harmful but are a feature of PCOS.

There is no single test for PCOS, so diagnosis is usually based on a combination of factors, including irregular periods, elevated androgen levels, and polycystic ovaries on ultrasound.

What are the signs ans symptoms of PCOS?

Symptoms of PCOS do not affect every woman, and the severity of symptoms range from mild to severe. While some women only experience problems related to menstruation, some are unable to conceive. In some cases, both become a problem.

Common symptoms of PCOS include:

• Irregular or absent periods.
• Difficulty becoming pregnant (due to irregular or absent ovulation).
• Excessive hair growth (hirsutism), typically on the face, chest, back, or buttocks
• weight gain.
• Thinning hair or hair loss on the scalp.
• Oily skin or acne.

If you experience any of these symptoms and suspect you may have PCOS, it’s a good idea to discuss them with your GP. It’s important to note that the symptoms can vary widely—some women may have only mild symptoms, while others experience more severe effects.

What lifestyle changes can help manage PCOS symptoms?

Lifestyle modifications are one of the most effective ways to manage PCOS. Weight management through diet and exercise plays a crucial role, as even a modest weight loss of 5-10% can significantly improve symptoms such as irregular periods and insulin resistance, which occurs commonly with women who have PCOS.

A healthy, balanced diet that is low in processed foods and rich in whole grains, fruits, vegetables, and lean proteins can help regulate blood sugar levels and promote weight loss. Regular physical activity, particularly exercises like walking, swimming, or strength training, can also help with weight management and improve insulin sensitivity.

Stress management techniques, such as mindfulness or yoga, may also help to improve overall well-being and balance hormone levels.

Are there medications or treatments available to address PCOS-related issues like irregular periods or fertility problems?

Yes, there are several treatments available depending on your symptoms and goals. For women experiencing irregular periods, hormonal contraceptives (such as the birth control pill) are often prescribed to regulate the menstrual cycle and reduce androgen levels. If fertility is a concern, medications like clomiphene or letrozole may be used to stimulate ovulation.

To manage insulin resistance, medications like metformin are often prescribed. This drug helps lower blood sugar levels and can improve menstrual regularity in some women with PCOS. For women struggling with hirsutism or acne, anti-androgen medications, such as spironolactone, may be beneficial.

Can PCOS increase the risk of other health conditions, and if so, what can be done to minimise these risks?

Yes, PCOS is associated with an increased risk of several other health conditions, including type 2 diabetes, high blood pressure, and cardiovascular disease. This is primarily due to insulin resistance and obesity, which are common in women with PCOS. Women with PCOS are also at a higher risk of developing endometrial cancer due to irregular periods and a lack of ovulation over time.

To minimise these risks, it is essential to maintain a healthy weight, eat a balanced diet, and engage in regular physical activity. Regular check-ups with a specialist are important for monitoring blood pressure, cholesterol levels, and blood sugar levels. Early detection and management of these risks can greatly reduce the likelihood of developing more serious complications.

With proper care and lifestyle management, many women with PCOS lead healthy, fulfilling lives and successfully manage their symptoms.

If you are suffering from PCOS and would like to book a consultation with Dr Egbase, simply visit her Top Doctors profile today.