Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is the most common hormonal condition affecting women.

The main problems experienced may include:

Irregular or absent periods
Difficulty getting pregnant (infertility)
Difficulty controlling weight (often weight gain)
Skin problems such as acne
Unwanted hair growth on the face and body

Not all women with PCOS experience all of these symptoms. Symptoms can be more noticeable and may worsen in women who continue to gain weight.

Weight loss often leads to an improvement in symptoms and can help regulate periods and restore fertility.

How is polycystic ovary syndrome diagnosed?

If you have more than one of the symptoms listed above, your gynaecologist may suspect PCOS.

Tests used to help confirm the diagnosis may include:

Blood tests to measure reproductive hormone levels
An ultrasound scan to look at the appearance of the ovaries

Does PCOS mean I have abnormal cysts on my ovaries?

Despite its name, polycystic ovary syndrome does not mean that you have abnormal ovarian cysts.

The ovary is naturally a cyst-like structure. The small cysts seen in PCOS are called follicles, which contain immature eggs.

In women without PCOS, one follicle grows each month and releases an egg during ovulation. In women with PCOS, many small follicles are present but do not mature properly due to hormone imbalance. As a result:

Ovulation may not occur regularly or at all
Periods may be irregular or infrequent
Fertility may be affected

These small follicles do not cause pain and do not need to be removed.

Is PCOS dangerous to my health?

The small follicles seen in PCOS are usually less than 5mm in size and do not cause ovarian cancer.

However, women who have very infrequent or absent periods are at risk of excessive thickening of the womb lining (endometrium). If this lining is not shed occasionally, abnormal cells can develop over time.

To reduce this risk, women with PCOS who do not have periods may be advised to take a tablet called medroxyprogesterone two or three times a year to help shed the womb lining. Your GP or gynaecologist will discuss this with you if needed.

If you are overweight or obese, it is important to try to lose weight through a healthy diet and regular exercise. This can:

Improve PCOS symptoms
Reduce the risk of diabetes
Reduce the risk of heart disease and high blood pressure

Is PCOS hereditary?

PCOS often runs in families and there is evidence of a genetic link.

Symptoms usually appear after puberty or with weight gain, although not all women with PCOS are overweight. Slim women can also have PCOS and experience symptoms such as irregular periods and infertility.

Is there any treatment for PCOS?

PCOS itself cannot be cured, but treatments are available to help manage symptoms.

Some medications can improve:

Excessive body or facial hair
Acne

These treatments are not suitable if you are trying to conceive, as they may affect a developing pregnancy.

If you are having difficulty getting pregnant, treatment options may be available. This usually starts with simple but effective medication such as clomifene tablets. Your gynaecologist or fertility specialist will advise on the most appropriate treatment for you.