What is PCOS?
Polycystic ovaries is a finding on ultrasound scan, where the ovaries are found to contain lots of small follicles or ‘cysts’. This can sound very worrying but these are actually just small follicles that haven’t matured and ovulated properly; they don’t grow or burst or need surgery. Around 20% of women have PCO on ultrasound scan but this doesn’t mean you have PCOS.
Polycystic ovarian syndrome (PCOS) is the most common female hormone condition and affects around 1 in 10 women in the UK.
Symptoms of PCOS
PCOS is usually diagnosed based on having 2 out of the following 3 features (known as the Rotterdam Criteria), with other causes ruled out:
- Ovulation problems – irregular or no periods
- High androgen and testosterone levels – these can cause acne, increased hair growth
- Polycystic ovaries on ultrasound scan
PCOS can cause a wide range of symptoms including:
- Irregular or absent periods
- Difficulty conceiving
- Acne and oily skin
- Excess hair growth on the face or body (hirsutism)
- Hair loss from the head or thinning hair
- Weight problems – being overweight or finding it difficult to lose weight
- Mood disturbance – anxiety, depression, mood swings and low self esteem
What causes PCOS?
It is not known. PCOS symptoms occur due to hormonal imbalance but it is not fully understood what causes this. There is a genetic element in that it can run in families but as yet there are no specific genetic tests that can be done to diagnose it.
Many women with PCOS have higher than normal levels of insulin because they have a resistance to insulin and so to compensate the body produces excess insulin. In turn, this causes the ovaries to produce higher levels of androgens including testosterone. Androgens are hormones typically thought of as male hormones, but actually women also normally produce androgens from the adrenal glands and ovaries. In PCOS however, the androgen levels are abnormally high and this combined with the elevated insulin causes the common symptoms.
Long term health effects
Getting accurate advice on how to manage PCOS is really important, not just because of the immediate symptoms or for fertility, but also because PCOS is associated with long term health implications.
Diagnosing PCOS
First your doctor will ask about your symptoms and background medical history. You may then be examined . You will then commonly be advised to have the following investigations:
- Blood tests – to check hormone levels and rule out any other conditions
- Ultrasound scan – to look for the presence of polycystic ovaries and assess the womb
PCOS can cause a range of symptoms, some women may only have very mild symptoms and some may be more severely affected.
As well as diagnosing and managing PCOS we can offer risk factor assessment and counselling on how to look after your long term health if you have PCOS.
Treatment options
There is no cure for PCOS and so treatment is focussed on managing the symptoms and preventing the risk of long term health effects. At your consultation we will discuss a wide range of lifestyle and medication options. Depending on your individual symptoms these can include: