Polycystic Ovary Syndrome (PCOS)

Formerly referred to as Polycystic Ovarian Disease or PCOD

Around 20% of women have small cysts on their ovaries. For the majority of women these will cause few problems, but in some cases will be accompanied by further troublesome symptoms. This condition is then known as polycystic ovary syndrome.

What is it?

Polycystic ovary syndrome is a hormonal disorder. With PCOS, a woman has a particular appearance of the ovaries on an ultrasound examination, as well as additional symptoms. Symptoms vary between women and can include menstrual irregularities, fertility problems, weight gain and excessive facial hair.

Polycystic ovaries have many small cysts. The cysts are not large swellings that burst or cause pain, but are actually developing eggs that grow to about one centimetre in size and then stop growing.

Up to 1 in 5 women have some characteristics of PCOS, but only a small number of these have the actual syndrome.

Causes

The symptoms of PCOS are due to an imbalance of hormones produced by the ovaries.

The exact cause of PCOS is unknown, but it is thought that it is an inherited condition. Women with PCOS may have family members with irregular periods, diabetes or heart disease.

For some women the condition only occurs when they are overweight, though research suggests that PCOS can be the actual cause of weight gain. It is thought that PCOS is related to the body’s resistance to the insulin hormone. When insulin resistance occurs, the body produces more of the hormone to compensate, which in turn stimulates fat cells to make and store more fat.

Symptoms

Symptoms of PCOS vary between women. A woman may experience a few or all of the following symptoms, in addition to having polycystic ovaries.

Menstrual irregularities
Women with PCOS always have a degree of irregularity with their periods. Periods may be lighter or heavier, or may stop altogether.

Fertility problems
Irregular ovulation can mean that it is more difficult to become pregnant. If a woman is not ovulating at all, it is not possible for her to conceive without treatment. Women with PCOS may also have an increased risk of miscarriage.

Others
Unwanted or excessive body or facial hair
Acne on the face and back
Weight problems, including difficulty in losing weight.

Women with PCOS also have an increased risk of developing:

• Diabetes – research suggests that PCOS is related to the development of maturity onset (type 2) diabetes, and an increased chance of diabetes in pregnancy.
• High cholesterol and heart disease – excess weight is connected to high blood pressure and excessive cholesterol levels, both of which are risk factors for heart disease.
• Cancer of the uterus – menstrual irregularities have been linked with cancer. This can happen when the womb lining (endometrium) becomes too thick due to incomplete ovulation.

You should discuss any concerns you have about your health with your doctor.

How do I know if I have it?

PCOS is usually diagnosed based on a woman’s medical history and an examination by a doctor. An ultrasound of the ovaries and blood tests may be used to confirm the condition.

PCOS can affect women between late adolescence and menopause. Knowledge of the condition is important to allow symptoms to be managed and to help prevent long term health conditions from developing. The time of diagnosis can depend on the severity and number of symptoms a woman experiences.

Management of PCOS

The management of PCOS depends on the problems a woman has.

Weight
The first step in management of PCOS is achieving weight loss for those who are overweight. In some women, weight loss can restore normal ovarian function. It is important to eat a healthy, balanced diet and exercise regularly. Your doctor may advise you to have a test for diabetes and can suggest a program to help you lose weight if necessary.

Menstrual irregularities
Hormones such as the combined oral contraceptive pill may be prescribed to regulate a woman’s menstrual cycle. In the future, other hormone treatments may be available via different methods, such as a vaginal ring or skin patches.

If you have not had a period for over 6 months and are not on any hormonal treatment, it is advisable to see your doctor to have this investigated.

Fertility problems
Most women with some features of PCOS will be able to become pregnant, and it is important not to stop using contraception unless a pregnancy is desired.

If after losing weight a woman with PCOS is still unable to conceive, she may be prescribed fertility drugs to induce ovulation.

Sometimes surgery is an option for women wanting to increase their chances of getting pregnant. This is done to remove tissue in the ovaries that is producing an abnormal balance of hormones.

Excessive hair growth or acne
Particular types of contraceptive pills can help reduce hair growth and acne. Some women may find waxing or electrolysis useful in removing unwanted hair.

For more information about PCOS contact the Sexual Health Helpline on
9227 6178 or 1800 198 205 (country callers) or email.

Practising safe sex reduces the risk of contracting HIV and other sexually transmissible infections (STIs).

Page last updated Fri, 13 Aug 2010 14:41