Polycystic ovarian syndrome (PCOS)

Polycystic ovarian syndrome, commonly known as PCOS, is a common, yet complex hormonal condition that affects around 8-13% of women in their reproductive years. PCOS is associated with increased insulin levels and androgens which can cause a range of symptoms. It also contributes to infertility.

PCOS symptoms

Women with PCOS can experience several symptoms which can change throughout different stages of their life. Symptoms can be different for everyone and can range from mild to severe. They include:

  • irregular or no periods

  • excess hair on your face and body (hirsutism)

  • hair loss (alopecia)

  • skin conditions such as acne, skin tags or rough, dark patches of skin

  • stress, anxiety and depression

  • difficulty managing your weight

  • trouble getting pregnant.

What causes PCOS?

The name ‘polycystic ovary’ suggests the problem is related to multiple cysts on your ovaries. With an ultrasound, it’s common to see multiple follicles on the ovaries of women with PCOS. However, these are not cysts. They are eggs that haven’t fully developed.

While the exact cause of PCOS is still unknown, genetics and family history do play a role. Around a third of women with PCOS have a relative (e.g. mother, aunt, sister, daughter) who also has the condition.

Hormones also contribute to the condition; increased levels of insulin produce high levels of male-type hormones called androgens. These hormones affect how the ovaries work which in turn, affects the menstrual cycle and contributes to other symptoms.

About 85% of women with PCOS have insulin resistance.3This means that the body doesn’t respond to insulin and can’t use glucose from the blood for energy. This causes the body to make more insulin.

Diagnosing PCOS

PCOS is a complex condition so you may need to see an endocrinologist (hormone specialist) or gynaecologist to be diagnosed. Early diagnosis can help reduce the risk of long-term health problems associated with the condition. Diagnosing PCOS may involve:

  • discussion of your symptoms and medical history

  • blood tests

  • ultrasound of your ovaries.

You don’t need an ultrasound to be diagnosed with PCOS. Diagnosis can be made if you have two or more of the following:

  • absent or irregular periods

  • symptoms of high androgen levels such as acne, excess hair growth or high androgen levels in your blood

  • polycystic ovaries that can be seen on an ultrasound.

Complications of PCOS

If you have PCOS you are at a higher risk of developing other health conditions. These include:

  • high cholesterol

  • heart disease

  • type 2 diabetes or gestational diabetes

  • endometrial cancer

  • sleep apnoea.

Does PCOS cause infertility?

PCOS can contribute to infertility as high androgen levels prevent follicles in the ovary from developing and releasing eggs. This can cause irregular ovulation or ovulation may not happen at all.

While many women with PCOS can have children naturally, some may need help. This may involve medication to stimulate ovulation or surgery to improve the function of the ovaries.

PCOS can also increase pregnancy complications, such as:

  • miscarriage

  • gestational diabetes

  • high blood pressure and preeclampsia

  • premature birth

  • caesarean delivery.

Treating and managing PCOS

There is no cure for PCOS but there are many ways to manage and treat it.

A healthy lifestyle is one of the most effective ways to manage the condition. This means:

  • eating a balanced diet

  • avoiding smoking and excessive drinking

  • being as active as possible

  • maintaining a healthy weight.

Even a small amount of weight loss can help your ovaries function better and may result in normal hormone production, which will improve symptoms. For example losing 5-10% of your body weight can:

  • reduce insulin resistance by about 50%

  • restore ovulation

  • regulate menstrual cycles

  • improve fertility

  • reduce pregnancy complications

  • improve the health of mother and child during pregnancy

  • improve emotional health (self-esteem, anxiety, depression)

  • reduce the risk of developing diabetes and heart disease.

Other treatment and management options may include:

  • medications, such as hormonal contraception to- re-establish regular periods- reduce the production of testosterone- prevent hair loss- assist with weight loss- help manage depression and anxiety

  • dermatology treatments for skin problems

  • hair removal

  • counselling and other therapies to manage emotional symptoms.

What else can you do?

If you suspect you have PCOS it’s important to see your doctor to be diagnosed. Treatment and management may involve a range of healthcare professionals so the sooner you are diagnosed, the sooner you can begin treatment.

Your local MediADVICE pharmacist is available to help you manage your health. Our Pharmacists can provide in-store health checks such as blood pressure, cholesterol, blood glucose and weight checks to help you monitor your condition.

We can provide expert advice and recommend products that may help you manage your PCOS symptoms, including hair removal products. We can also provide advice on medications that may be helpful and can refer you to a doctor if necessary.

Visit your nearest pharmacy today

Disclaimer
General advice only – this information should not replace the information provided to you by your health care professional. If symptoms are severe or persist, please speak to your healthcare professional. Information is current as of date of publishing.

Resources:
1Medical Journal of Australia, Australian-led PCOS guidelines an international first,Media Release,https://www.mja.com.au/journal/2018/australian-led-pcos-guideline-international-first
2Jean Hailes for Women’s Health, PCOS Symptoms and causes,https://www.jeanhailes.org.au/health-a-z/pcos/symptoms-causes
3Monash University. International evidence-based guideline for the assessment and management of polycystic ovary syndrome. 2018. Melbourne, Australia.
4Better Health Channel, Polycystic ovarian syndrome (PCOS),https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/polycystic-ovarian-syndrome-pcos
5Healthdirect, Polycystic ovarian syndrome (PCOS),https://www.healthdirect.gov.au/polycystic-ovarian-syndrome-pcos
6Jean Hailes for Women’s Health, PCOS Fertility and pregnancy,https://www.jeanhailes.org.au/health-a-z/pcos/fertility-and-pregnancy#pregnancy
7McCartney CR, Marshall JC. Clinical Practice: Polycystic Ovary Syndrome. N Engl J Med. 2016;375(1):54–64.
8Jean Hailes for Women’s Health, PCOS Treatment and management,https://www.jeanhailes.org.au/health-a-z/pcos/management-treatment