Polycystic ovarian syndrome

Treatment & diagnosis for PCOS

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Polycystic ovary syndrome, or PCOS, is a common female endocrine condition affecting the ovaries, which affects millions of women in the UK – around 1 in 5. ‘Poly’ means many, & ‘–cystic’ refers not to cysts but to the fluid-filled sacs that surround the eggs in the ovaries. In PCOS, ovulation can be delayed or prevented, which is why it causes infertility.

During your consultation with the GP, she will examine you & discuss your symptoms. She may recommend that you take some blood tests to check your glucose & hormone levels, & monitor the activity of your thyroid. An ultrasound scan may be recommended in order to see whether you have ovarian cysts or enlarged ovaries. If the GP suspects that you have PCOS, they may refer you to a specialist for further investigation & treatment, at no extra cost.

Symptoms

The two main components of PCOS are:
1) irregular or absent periods (amenorrhea), caused by the ovaries not releasing eggs regularly (irregular ovulation).
2) a higher than normal level of androgens (male hormones, such as testosterone) in the body, which causes the symptom of excess body hair (hirsutism), predominantly on the face, around the nipples, or on the low abdomen.

In addition to irregular periods & hirsutism, other symptoms of polycystic ovarian symptom include:
infertility
weight gain
loss or thinning of the hair on the head
insulin resistance
overweight
acne and/or oily skin

In a healthy menstrual cycle, ovulation occurs monthly in the middle of the cycle, around day 14. During ovulation, an egg is released from a follicle, a small swelling in the ovary, into the fallopian tubes. If the egg does not fully mature inside of the follicle, it will not be released, & ovulation will not take place. The result of this is a missed or late period. In the absence of ovulation, a chain reaction ensues, altering normal hormone levels, leading to an increase of androgens & decreased levels of oestrogen & progesterone.

PCOS can increase your risk of developing other health problems, such as high cholesterol, high blood pressure, heart disease, & type 2 diabetes.

The causes of PCOS are unknown, & a number of factors may be at play. There is often a genetic link, however, & it therefore may affect more than one family member. There is a relationship between the condition & high levels of insulin, the hormone that controls sugar levels. In women with PCOS, there is a resistance to the action of insulin, which leads to overproduction. This in turn also triggers the overproduction of testosterone. Weight gain or overweight can also affect the production of insulin, leading to exacerbation of symptoms. Possible treatments include lifestyle changes, hormone-based medicines, & surgery, but these will all depend on your individual situation & needs.