What is polycystic ovary syndrome?

Polycystic ovary syndrome or PCOS for short is a condition that affects the function of the ovaries. Polycystic literally means 'many cysts' and if you have PCOS, multiple fluid-filled cysts develop in the ovaries and eggs may not be released regularly.

PCOS is the most common cause of fertility problems in women and affects approximately 20-30% of women.

What are the ovaries?

The ovaries make up part of the female reproductive system, each ovary is about the shape and size of an almond. The ovaries main function is to release eggs and make hormones such as oestrogen, the main female hormone and small amounts of hormones known as androgens, the main androgen (the one most people have heard of) is testosterone, which is found at much higher levels in men. For more information on ovulation click here.

What causes polycystic ovary syndrome ?

The exact cause of PCOS is unknown though there are several factors thought to play a part. The symptoms of PCOS are caused by a hormone imbalance which can interfere with ovulation, making it rare or irregular. 4 in 10 women with PCOS have raised levels of Luteinising hormone (LH). LH is the hormone that stimulates the ovaries to ovulate and is the hormone that ovulation tests look for. Women with PCOS also have excess androgens.

Insulin is also believed to be involved. The main role of insulin is to regulate blood sugar levels and many women with PCOS have insulin resistance, especially women who are overweight. Insulin resistance means the level of insulin in the blood needs to be higher than normal to control the blood sugar level. High levels of insulin signals the ovaries to release extra testosterone. However, doctors do not fully understand why this hormone imbalance takes place. It is thought that PCOS is inherited but more research is still being carried out.

What are the symptoms of polycystic ovary syndrome?

The symptoms of PCOS vary in each woman and some women may not even notice that they have it. Some women may experience mild symptoms and have normal periods. Symptoms of PCOS could include any of the following :

• Acne, usually in the face.
• Sudden and unexplained weight gain
• Period problems such as irregular or absent periods. 7 out of 10 women with PCOS experience period problems.
• Excess body hair, known as hirsutism. This hair is usually found on the chin, upper lip, nipple area and on the abdomen. This excess hair is caused by the increased levels of testosterone.
• Thinning of scalp hair

Symptoms of PCOS typically begin in women in their late teens or early 20's.

What are the long term effects of polycystic ovary syndrome?

A woman with PCOS is more at risk of developing diabetes, as a result of diabetes there is then an increased risk of heart disease or a stroke. Women who have very infrequent periods, less than 4 a year may also have an increased risk of cancer of the womb. Fortunately however, this cancer is still quite rare.

How is polycystic ovary syndrome diagnosed?

If a doctor suspects PCOS then they may take blood samples to measure levels of the sex hormones LH and testosterone. You may also have an ultrasound scan to look for the presence of ovarian cysts. The cysts are 2-8mm in diameter and often form a chain, described as a 'chain of pearls' sign.

The diagnosis is then made from the results of the ultasound and hormonal tests.

As women with PCOS have an increased risk of developing diabetes some doctors may recommend regular checks of blood sugar.

What treatment is available for polycystic ovary syndrome?

There is no actual cure for PCOS but the symptoms can be treated. The treatment you receive will depend on the severity of your symptoms and also if you are trying to conceive. Treatment for PCOS is aimed at rebalancing the hormones involved.

Infertility problems caused by PCOS can be treated with drugs that stimulate the body to ovulate. However, if you are not currently trying for a baby then the contraceptive pill is a popular choice as it regulates your periods and can also reduce acne.

Symptoms like hair growth can be treated with bleaching the facial hair to make it less noticeable or by removal methods such as hair removal creams, plucking, waxing, electrolysis or shaving. Though shaving the face is not usually a good idea as the hair will usually grow back more coarse and so will be more obvious.

Acne can be treated with antibiotics and can usually be kept under control.

Lifestyle changes may be beneficial and it is particularly helpful to lose any excess weight. Weight loss can lessen many of the PCOS symptoms. Stick to a healthy balanced diet, give up smoking and try to get plenty of exercise.