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PCOS

Updated 04.04.2022
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Polycystic ovary syndrome (PCOS) is a hormonal disorder which affects about 1 in 10 women in the UK. Women can have irregular periods, longer menstrual bleeding and excessive androgen levels. The ovaries develop numerous follicles and fail to regularly release eggs, which can impact on fertility. For diagnosis of the syndrome, symptoms other that period-related problems are usually present, such as acne and hair in unwanted places. PCOS is related to Type 2 diabetes and high cholesterol levels in later life, in a collection of conditions making up metabolic syndrome. The cause of PCOS is unknown but early diagnosis and treatment is needed to help manage the symptoms.

How is PCOS diagnosed?

There are three main features of PCOS, and at least two must be present for a diagnosis. The first is irregular periods. The second is excessive male-type hormones in your body called androgens, which can be measured on a blood test. They lead to symptoms such as coarse facial hair around the cheeks, upper lip and chin, chest hair, moderate to severe acne and weight gain. Androgens can be measured in a blood test. A pelvic ultrasound scan may show multiple emerging follicles (or cysts) on the ovaries. This is only significant if other features are present - many women can have multiple cysts on the ovaries without having PCOS.

What causes PCOS?

People don’t clearly know why PCOS occurs, but it is known to run in families. PCOS sufferers are typically insulin-resistant, which leads to high levels of insulin in the body. Insulin normally controls the sugar levels in the blood. A high level of insulin is also triggered by being overweight and can lead to increased levels of other hormones like testosterone. Complications of PCOS include infertility, type 2 diabetes, depression and anxiety, abnormal bleeding and endometrial cancer.

What will the doctor do?

Your doctor will want to know all about your symptoms, your concerns and any conditions that run in the family. They will offer a physical exam to check for excessive hair growth and acne and they will take a measurement of your weight and height. Your doctor can organise for blood tests and also a pelvic ultrasound scan for confirmation. They will likely take your blood pressure and order blood tests for diabetes and high cholesterol, to flag up any cardiovascular risks.

How is PCOS treated?

There is no cure for PCOS so it is important to manage the symptoms. If you are overweight, it is very important to lose weight as this contributes to high levels of insulin in the body, affecting the production of other hormones. Treating acne, excessive hair growth and fertility can be done with lifestyle or medications. If you are not trying to get pregnant, the contraceptive pill is an effective method to regulate your periods. If you are trying to get pregnant, a specialist may suggest you trial a medication called clomifene to stimulate egg release. Metformin is another medication initiated by specialists to lower the insulin levels in the body.

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