What You Need to Know About Polycystic Ovary Syndrome

What is polycystic ovary syndrome (PCOS)? Learn more about this common hormonal disorder that affects five to 10 in 100 women.

Posted on

25 April 2017

| Last updated on 2 January 2018

What You Need to Know About Polycystic Ovary Syndrome

PCOS is a condition which can affect a woman’s menstrual cycle, fertility, hormones and appearance. PCOS can also affect long-term health. Although PCOS is treatable it cannot be completely cured.

PCOS is a condition associated with hormonal imbalances that cause the ovaries to overproduce androgens (male hormones). Multiple small follicles develop in the ovaries that appear as cysts hence the term ‘polycystic’. These cysts are actually immature follicles that fail to mature and ovulate. In a normal cycle, each month several follicles start to develop, but just one fully develops and goes on to ovulate.

What is a polycystic ovary?

Polycystic ovaries are slightly larger than normal ovaries and have twice the number of follicles (small cysts). There are usually 12 or more tiny cysts that are 2-9mm in size, seen on ultrasound scan. Polycystic ovaries are very common affecting 20 in 100 women. Having polycystic ovaries does not mean you have polycystic ovary syndrome.


Diagram showing normal & polycystic ovary	Ultrasound appearance of polycystic ovary

What causes PCOS?

The cause of PCOS is not yet known. PCOS sometimes runs in families. If any of your relatives (mother, aunts and sisters) are affected with PCOS, your own risk of developing PCOS may be increased.

What are the symptoms of PCOS?

The symptoms of PCOS can include:

irregular periods, infrequent periods or no periods at all
difficulty becoming pregnant (reduced fertility)
having more facial or body hair than is usual for you (hirsutism)
loss of hair on your head (male pattern baldness)
being overweight, the rapid increase in weight, difficulty losing weight
oily skin, acne

How is PCOS diagnosed?

Women with PCOS often have different signs and symptoms. The diagnosis of PCOS is made when a woman has two of the following three characteristics

Inability to release an egg from the ovaries on a regular (monthly) basis, i.e. irregular, infrequent periods or no periods.
More facial or body hair than is usual for you and/or blood tests which show higher testosterone (male hormone) levels than normal.
An ultrasound scan which shows polycystic ovaries.

To confirm the diagnosis and exclude other conditions your doctor may measure your blood hormone levels.

These include:

FSH & LH to be done on the 2nd or 3rd day of your period
Sex hormones including testosterone
Sex hormone binding globulin
Blood glucose, insulin levels

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What treatments are available?

Your treatment will depend upon your symptoms and goals. Treatments may include

Menstrual problems- oral contraceptive pills to regularise periods.
Fertility problems- ovulation induction treatment, e.g. Clomiphene, letrozole, gonadotropins (injections), ovarian diathermy (ovarian drilling), assisted conception (e.g. IVF) as indicated by the severity of the problem.
Drugs that improve the body’s sensitivity to insulin, such as metformin.
Hirsutism- treatment for hirsutism may include medical and cosmetic treatments. Cosmetic treatments are shaving, waxing, bleaching, plucking, depilatory agents, electrolysis, laser.

What are the long-term health implications of PCOS?

You are at greater risk of developing the following long-term health problems if you have PCOS:

• Insulin resistance and diabetes

• High blood pressure

• Heart disease

• Cancer - with fewer periods (less than three a year), the endometrium (lining of the womb) can thicken and this may lead to endometrial cancer in a small number of women

• Snoring and daytime drowsiness (sleep apnoea)