Polycystic Ovary Syndrome (PCOS) is one of the most common female hormonal disorders which affects approximately 10% of reproductive age women of all races and nationalities. It is a condition which can affect a woman’s menstrual cycle, fertility, hormones, and aspects of her appearance and additionally can affect long-term health.
Symptoms
Symptoms of PCOS may vary from woman to woman. Some women have mild symptoms while others are affected more severely. The symptoms may include:
- Irregular periods or no periods at all
- Difficulty becoming pregnant (reduced fertility)
- Presence of more facial or body hair than is usual (hirsutism)
- Loss of hair on your head
- Being overweight
- Rapid increase in weight
- Difficulty losing weight
- Oily skin and acne
- Depression and mood swings
Causes
There is no known cause for PCOS, but it is linked to insulin resistance.
Diagnosis
PCOS can be diagnosed by any combination of blood test results, an ultrasound scan or from a history of symptoms. Sometimes, the cysts may not be seen during a scan but a diagnosis can still be made using symptoms and blood test results. A diagnosis is usually made when any two of the following observed:
- Irregular, infrequent periods or no periods
- More facial or body hair than is usual for you and/or blood tests which show higher testosterone levels than normal
- An ultrasound scan which shows polycystic ovaries
Treatment
There is no treatment, as such, for the condition. Symptoms are treated according to individual patient’s circumstances, but most of symptoms are long-term health issues.
Metformin
This medicine can reduce symptoms. Excess hair and irregular periods will improve, and ovaries will start to release eggs, improving fertility.
Hair growth and acne
Unwanted hair can be removed by waxing, using hair-removing creams, electrolysis, and laser treatments. In addition, a cream called eflornithine (Vaniqua) may be prescribed. Dianette and Yasmin are commonly prescribed for the treatment of acne.
Infertility
Ovulation can be stimulated artificially using drugs. If the tablets fail, hormone injections can be used to stimulate the ovaries. For women unresponsive to medical treatment, surgery in the form of laparoscopic ovarian diathermy (using heat to cut tissue) can be used on each ovary.
What could PCOS mean for long-term health?
If blood glucose does not stay normal, this can lead to diabetes. One or two in every ten (10 to 20%) of women with PCOS go on to develop diabetes at some time. High blood pressure, heart disease, cancer, depression and mood swings, snoring and daytime drowsiness are common long-term issues.
Is there a cure?
There is no cure for PCOS. However, medical treatments aim to manage and reduce the symptoms or consequences of having PCOS.
With thanks to Dr Gulerana Shoaib, Specialist Gynaecologist, MCROG, FCPS.