What is Polycystic Ovarian Syndrome (PCOS)?

PCOS is a multi-system metabolic condition that affects up to 1 in 5  women in the UK. It can have a devastating effect on a woman’s self esteem as women can experience distressing symptoms including reduced fertility, excessive facial or body hair, weight gain, hair loss and acne. The combination of metabolic, hormonal, and psychosocial conditions can cause long-term medical issues as well as anxiety and depression.

Causes of PCOS

PCOS is a common condition that affects how a woman’s ovaries work. PCOS is caused by an imbalance of reproductive hormones. The hormonal imbalance creates problems in the ovaries. The ovaries make the egg that is released each month as part of a healthy menstrual cycle. With PCOS, the egg may not develop as it should or it may not be released during ovulation. PCOS can cause missed or irregular menstrual periods. Irregular periods can lead to infertility. In fact, PCOS is one of the most common causes of infertility in women.

The exact cause of PCOS is not fully known. It is thoughts that several factors, including genetics, play a role.

• High levels of androgens. Androgens are sometimes called ‘male hormones’, they control the development of male traits, such as male-pattern baldness. Women with PCOS have more androgens than normal. 
• High levels of insulin. Insulin is a hormone that controls how the food you eat is changed into energy. Insulin resistance is when the body’s cells do not respond normally to insulin. Many women with PCOS have insulin resistance which typically leads to weight gain.

Signs and Symptoms of PCOS

Not all women with polycystic ovaries have the syndrome and not all women with PCOS have all the symptoms, which can vary from woman to woman, but may include:

• Irregular menstrual cycle. Women with PCOS may miss periods or have fewer periods – less than 9 periods per year or go three months without a period.
• Too much hair on the face, chin, or parts of the body where men usually have hair.
• Acne on the face, chest, and upper back.
• Thinning hair or hair loss on the scalp.
• Weight gain or difficulty losing weight.
• Skin tags, which are small excess flaps of skin in the armpits or neck area.
• Darkening of skin in patches.

It can affect ability to conceive and can cause a lot of anxiety and low mood when women are trying for a baby. Women also find it hard to lose weight due to hormonal imbalance and insulin resistance, which also affects mental wellbeing, self esteem and confidence. Therefore it is unsurprising that women with PCOS are at a higher risk of having mental health problems. This is especially acute in this visual era of social media for a young woman in her teens and twenties where being hairy, spotty and overweight can have a devastating effect on her self esteem and quality of life. 

Diagnosis of PCOS

There is no single test to diagnose PCOS. To help diagnose PCOS and rule out other causes of your symptoms your GP will ask you about your periods and your medical history. They will look for any signs of PCOS and try to exclude any other conditions that are associated or can cause similar symptoms (for example, diabetes). You might be asked to have some of the following tests.

• Blood tests to measure your hormone levels, to check for other conditions to see if you have developed any complications.
• An ultrasound scan to see if you have cysts on your ovaries.

Treatment of PCOS

There are many treatment options and counselling out there but the great news is that by making certain adjustments to your lifestyle, the risk of any fertility and long term metabolic problems is greatly reduced.

Lifestyle changes: A 5% reduction in body weight can help regularise periods so try to lose some weight. Have a low GI diet and exercise to naturally get a hormonal balance.

Medication: Certain medication can be used to help improve regularity of periods, most typically this is the oral contraceptive pill.
Metformin that is often used to treat type 2 diabetes can also lower insulin and blood sugar levels in women with PCOS.
For women looking to conceive, other medication, such as Clomiphene, which stimulates ovulation and can be used to improve the chance of ovulation and therefore pregnancy.

Your doctor can also prescribe acne and excessive hair growth treatments. Hair laser removal has found to have a positive impact on the amount and the rate of hair growth.

Your PCOS Checklist

Do you have any of the symptoms in these three groups?

• Irregular periods
• Is your cycle less than 21 days or more than 35 days?
• Are you having less that 9 periods a year?
• Are you 16 years old and still not had your period?
• Are you 14 years old and have no period and no boobs, hips or pubic/underarm hair i.e. no secondary sexual characteristics?

• Do you have acne?
• Do you have excess facial or body hair?
• Is the hair on your head thinning?

• Do you have dark patches of skin e.g. in your armpits?
• Do you have a lot of skin tags?
• Are you overweight?
• Do you find it hard to lose weight?
• Have you been trying to get pregnant for more than 6 months?

If you suspect you have PCOS and can answer a ‘yes’ from two out of the three groups then it is important you speak to your GP or call Dr Harper on 0207 637 8820 or email to book a consultation.