What is it?
PCOS is an endocrine function disorder characterised by irregular or absent periods, elevated production of male hormones (androgens) and polycystic ovaries.
Polycystic ovaries are enlarged ovaries that contain a large number of fluid filled sacs in them (cysts). These cysts form around the eggs in the ovary, preventing them from being released so ovulation does not occur.
It may be a genetic condition but currently the causes are unknown. PCOS sufferers often also suffer from insulin resistance which may contribute to the metabolic disturbances associated with PCOS and often exacerbates symptoms.
While it is clear there is a connection between the two, it is unclear if insulin resistance may be one cause of PCOS.
What are the symptoms?
· Irregular periods(oligomenorrhea) or absence of periods (amenorrhea)
· Hirsutism -excess facial or body hair (usually on the chest and back)
· Alopecia - hair loss or thinning hair from the head
· Increased insulin resistance causing high blood sugar
· Weight gain
· Difficulties getting pregnant
How can you screen for it?
The three main factors assessed to diagnose PCOS are:
1. Irregular periods
2. High levels of androgen hormones
3. Polycystic ovaries
If you have at least two of these factors a clinical diagnosis of PCOS can be made.
To assess these factors normally an ultra sound scan and blood tests are used.
The ultrasound scans the ovaries and pelvis to check for ovary enlargement and the presence of multiple small cysts.
The blood tests should check the levels of androgens (e.g testosterone)and also the levels of hormones involved in egg development such as follicle stimulating hormone (FSH).
How can you manage it (lifestyle factors):
Maintaining a healthy weight can help reduce some of the symptoms of PCOS. Weight loss in those who are over weight has been found to improve menstrual cycle regularity and even decrease androgen levels in some women (Sirmans & Pate, 2013).
The regular assessment of emotional wellbeing is important, as women with PCOS can have an increased likelihood of suffering from depression and negative body image.
Diet – due to the increased likelihood of insulin resistance, a diet high in fibre and low GI foods that raise the blood sugar slowly are recommended. Reducing carbohydrate consumption and increasing protein can help improve insulin sensitivity and reduce testosterone(Mehrabani et al., 2012).
Regular exercise can improve cycle regularity and any other menstrual cycle symptoms. It can also combat negative thoughts and improve emotional wellbeing.
How can you treat it?
As with other dysfunctions, there isn’t a ‘cure’, so treatment is focused on treating the symptoms.
Hormonal contraceptives can help improve menstrual cycle regularity and reduce the risk of ovarian cancer. Some can also be effective at treating hirsutism and acne.
Laser hair removal or certain medications can be used to target hirsutism.
The use of drugs such as clomiphene citrate can be taken to stimulate ovulation as can laparoscopic ovarian drilling.