Polycystic ovarian syndrome (PCOS)
What is PCOS?
Polycystic ovarian syndrome (PCOS) is a common hormonal condition that affects up to 1 in 10 girls and women in their reproductive years. It may cause disruptions to the menstrual cycle, skin and hair changes, as well as cysts on the ovaries.
It is one of the leading causes of infertility, yet many women don't know they have it — many women with PCOS remain undiagnosed.
PCOS can’t be cured, but if you have it you and your doctor can manage many of the symptoms.
What causes PCOS?
Women with PCOS produce high levels of male hormones from their ovaries. These male hormones affect the menstrual cycle and cause other symptoms.
Women with PCOS often have enlarged ovaries. Their ovaries may have many cysts on them, which is where the name comes from.
The cause of PCOS is unknown, but it is thought this happens because increased levels of insulin affect how the ovaries work. You are more likely to develop PCOS if you have a close family member with the condition, there were increased hormones while you were in the womb, or due to your lifestyle or environment.
Immediate female relatives (daughters or sisters) of women with PCOS have as much as a 1 in 2 chance of having PCOS. Type 2 diabetes is also common in families of those with PCOS.
What are the symptoms of PCOS?
Women with PCOS can have a wide range of symptoms. Not every woman with PCOS will have every symptom, and each woman will have their own individual experience.
If you think you might have PCOS, it is important you see a doctor. An early diagnosis can help manage the symptoms of PCOS and reduce the potential long-term health risks.
PCOS symptoms include:
- excess hair growing on your face, chest, stomach or back (hirsutism)
- thinning hair or baldness (alopecia)
- irregular periods or no periods at all
- abnormal vaginal bleeding
- difficulty falling pregnant or not falling pregnant at all
- dark patches on the skin
- easy weight gain
- swollen belly
- mental health problems such as depression, anxiety, mood changes and low self-esteem
Your doctor may also look for:
- high blood pressure
- symptoms and signs of diabetes
Women with PCOS have a higher risk than other women of developing health problems such as:
- type 2 diabetes
- high cholesterol
- heart disease
- endometrial cancer
- sleep apnoea
- sexual health problems
How is PCOS diagnosed?
The diagnosis of PCOS is usually difficult because there is a wide range of symptoms and you don't have to have all of them to be diagnosed with the condition.
There isn't a simple test that rules it in or out.
You should see your doctor if you are feeling unwell and have any of the symptoms that could be caused by PCOS.
Your doctor will talk to you to try to understand your symptoms. They will examine you. You may be asked to have:
- blood tests to check hormone (such as testosterone), cholesterol and glucose levels in the blood
- an ultrasound scan to look at the ovaries and check for the presence of multiple cysts (fluid-filled sacs)
How is PCOS treated?
Treatment depends on the main problems you have. It can involve medicines, cosmetic treatments and having a healthy lifestyle.
A healthy lifestyle is the main way to manage PCOS. Eating a healthy diet and getting regular exercise can help many of the physical and emotional problems caused by PCOS. Exercise can improve your mental health too.
Exercise can improve your mental health. Losing even a small amount of weight can help regulate your periods, improve your chance of becoming pregnant and reduce your risk of diabetes and heart disease.
There are a number of different medical therapies to help manage PCOS symptoms, such as period problems, fertility, excess hair, acne and weight gain. These therapies include the oral contraceptive pill, insulin-sensitising drugs, hormone therapies, weight loss drugs, antidepressants and anti-anxiety drugs.
It's important to have regular health checks because of your increased risk of developing health problems later in life.
Talk to your doctor if you need help to control your weight. Your doctor can refer you to the right health professional for your situation, such as a dietitian or exercise specialist.
For more information on PCOS visit the Jean Hailes for Women's Health website.
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Last reviewed: October 2020