Polycystic Ovary Syndrome (PCOS)

The most common hormone condition in women

Polycystic Ovary Syndrome (PCOS)

The most common hormone
condition in women

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Polycystic Ovary Syndrome
(PCOS)

PCOS affects around 10% of women and people born with ovaries, but it is a hormone condition that is still widely underdiagnosed by healthcare providers.

As with many conditions that impact women, a lot of research still needs to be undertaken in order to understand PCOS, how common it is and what causes it.

What we do know about PCOS is:

  • It is a common hormonal condition that affects how your ovaries work and as a result can stop ovulation.
  • Causes small sacs of fluid to develop which produce more of the androgenic hormones (reproductive and growth hormones that are produced in male and female bodies that have masculinizing effects).
  • Overproduction of androgens can lead to symptoms such as acne and facial hair growth (androgens are important hormones that impact lots of functions in the body. In women, they are produced mainly by the ovaries and by the adrenal glands. Testosterone is the most well-known androgen.)
  • PCOS can affect fertility and the way our bodies use insulin, which can affect your weight.
  • Around 50-75% of people who have PCOS remain unaware they have the condition.
  • Diagnosing PCOS is difficult. The process can take a long time because:
    • the condition varies from person to person
    • there’s a lack of knowledge among clinicians about PCOS
    • there’s different criteria when it comes to diagnosing it.

Treatment options for PCOS may include:

    • following a Mediterranean style diet
    • maintaining a healthy weight
    • using birth control to regulate your menstrual cycle
    • fertility support (if desired)
    • medication for insulin resistance.

If you have PCOS, you may find it has an impact on your life, your appearance, your physical health and any plans you have for having children in the future.

It’s important to remember that there are effective treatment options available to help manage PCOS. Being aware of the condition, knowing your symptoms, the implications for your future health, and what treatment options are best for you, can support you to feel more empowered to manage your PCOS.

Healthcare providers have a responsibility to investigate and treat any woman of reproductive age who thinks they may have PCOS. Physicians should be up-to-date and knowledgeable about diagnosing PCOS and be able to help you manage it.

So, keep scrolling for more information about PCOS and how you can manage this common condition.

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Further reading

How hormones affect body shape

Eating for Healthy Hormones

Testosterone

Help spread the knowledge

PCOS

70% of women

affected by PCOS remain undiagnosed.

Source: World Health Organization

What is PCOS?

PCOS is a hormone condition that affects how your ovaries work. It can stop ovulation from occurring. When no ovulation occurs, the ovaries become bigger and develop small fluid-filled sacs (cysts) containing follicles that haven’t matured enough to produce an egg.

When these follicles don’t produce an egg, they start producing androgens (hormones that cause masculinizing effects) in larger quantities. Women usually produce androgens in small amounts, but with PCOS, greater quantities of androgens are produced and this has an effect on your whole body.

You can be diagnosed with PCOS without having cysts in your ovaries, or, you can have cysts in your ovaries and not have PCOS.

 

PCOS can affect fertility as your menstrual cycle is less regular meaning ovulation becomes infrequent or stops altogether. People with PCOS may also develop a condition called insulin resistance. Insulin resistance is where your body can’t make use of insulin in the way it needs too. As a result, insulin levels build up and cause you to produce higher levels of androgens.

Your weight can also impact your insulin levels and worsen PCOS symptoms. There is somewhat of a vicious cycle when it comes to insulin resistance, high androgen levels, weight and the development of PCOS.

PCOS can also run in families so it’s common for sisters, or mothers and daughters to all be affected. Without good management, PCOS can also increase your risk of developing type 2 diabetes, high blood pressure, high cholesterol levels, cardiovascular disease, and uterine cancer.

What are the symptoms of PCOS?

Lots of women don’t get any symptoms with PCOS and it may only be when they’re finding it difficult to get pregnant that an investigation shows the ovaries are not functioning in a typical way.

Symptoms are most likely to start in your teenage years or in your 20s.
The three most well known features of PCOS are:

  • Irregular periods (because ovulation isn’t happening regularly, your periods are unlikely to follow a consistent pattern).
  • Increase in androgenic hormones (which can lead to hair growth on face and body and equally some baldness on the head).
  • Polycystic ovaries (despite this name, the fluid-filled sacs are not actually cysts).

As well as these symptoms, PCOS can also cause:

  • changes to your weight
  • acne and/or increased oil production on the skin. The type of acne is often on the jaw line and termed ‘cystic acne’ meaning the acne presents as painful hard lumps under the skin with no visible ‘head’.
  • skin tags
  • dark or thick patches of skin on the back of the neck, armpits or under the breasts
  • difficulties becoming pregnant.

How is PCOS diagnosed?

If you think you may have PCOS, you should talk to your doctor. They will:

  1. take some of your medical history
  2. ask you more about your symptoms
  3. do a physical exam which could involve a pelvic exam
  4. organize an ultrasound and some blood tests if other conditions need to be ruled out.

Most specialists would want to see that you have at least two of the three main features of PCOS in order to diagnose you with the condition.

What are the treatments for PCOS?

Treatments for PCOS generally depend on whether you are planning to get pregnant at the time you are undergoing investigation for the condition.

Usually, your diet, weight and level of physical activity will be discussed with your healthcare provider. Your doctor may suggest that you think about adopting a Mediterranean style diet, as this has been shown to be helpful for PCOS symptoms.

This way of eating includes ensuring you are eating plenty of vegetables, legumes like nuts and beans, whole grains, extra virgin olive oil, nuts and seeds, fermented dairy foods like kefir yogurt, fish and seafood, fresh fruit and trying to eat only a little meat. A Mediterranean diet can easily be adapted if you’re vegetarian or vegan too.

Symptoms of PCOS can affect those who are of a higher weight more, so seeking support with your weight could be something to think about if you want to reduce your PCOS symptoms. Good nutrition and regular exercise can also help your body use insulin more effectively, it lowers your blood glucose levels, and this may help you to ovulate.

If you don’t want to become pregnant, contraception could be prescribed to help you control your menstrual cycle and reduce the level of androgen hormones you are producing.

If you have insulin resistance, diabetes medication may be needed, and this might help some of your other symptoms too. There may be medications you can take to address other symptoms (such as skin concerns or hair growth).

Fertility support

Most people with PCOS are able to get pregnant with the right support. So, If you’d like to get pregnant (now or maybe one day) remember that PCOS won’t necessarily stop this from happening.

Along with nutritional and exercise advice, your doctor may suggest medications you can take to support ovulation. With these treatments, you may release more than one egg at a time, which means multiple births (like twins) are a possibility.

If you were already seeking fertility support for other reasons, make sure to tell your fertility specialist that you have PCOS, because it could affect the treatment plan your doctor suggests.

If fertility medicines don’t work for you, there’s another option in which you undergo a simple surgical procedure called laparoscopic ovarian drilling, (it sounds scarier than it is!). This procedure involves using heat or a laser to get rid of the tissue that is producing the androgen hormones. This improves the way your ovaries work and increases the chances of ovulation.

A note about perimenopause and menopause

When you enter perimenopause and menopause, you may think your PCOS is flaring up as some of the symptoms are similar, but it may just be the start of your menopausal transition.

You might get symptoms of testosterone deficiency as your body may have become used to higher levels of androgenic hormones over the course of your life. You can still take hormone therapy for your perimenopause and menopause if you have PCOS, and this can help with any symptoms you are experiencing.

To learn more about perimenopause and menopause check out our resources here.

Birth control…

could be suggested by your doctor even if you are in a same-sex relationship. This is because birth control can help to alleviate symptoms by regulating your hormone levels.

Living with PCOS

If you have PCOS you will have it for the rest of your life. Some people find this fact upsetting, but remember, with the right lifestyle adjustments and use of medications, PCOS can be treated effectively and pregnancy is still possible with help.

If certain symptoms like excessive hair growth, irregular periods, or skin concerns are bothering you, there are treatments you can try for these. For unwanted hair you can think about exploring laser hair removal, threading or waxing and for concerns with your skin, your healthcare provider will be able to prescribe a range of topical treatments along with skin specific medications.

The important thing to remember is that you are not alone and talking about how your symptoms affect you is the first step towards feeling more confident living with your condition.

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