Polycystic ovary syndrome

What is Polycystic Ovary Syndrome?

Polycystic ovary syndrome (PCOS) is a common endocrine condition among women of reproductive age. The enlarged ovaries contain small collections of fluid — called follicles.

About 7 in every 100 in the UK are affected.

The exact cause of PCOS is unknown but early diagnosis and treatment along with weight loss may reduce the risk of long-term complications, such as type 2 diabetes and heart disease.

What occurs in PCOS?

Infrequent or prolonged menstrual periods; excess hair growth; acne and obesity can all occur in women with polycystic ovary syndrome.

Infrequent or absent menstruation in adolescents may raise suspicion of this condition.

Polycystic ovary syndrome often begins soon after the commencement of periods (menarche).

In some cases, PCOS develops later in response to substantial weight gain.

What are the symptoms of PCOS?

At least two of the following must be present:

• Irregular periods. This is the most common complaint. Menstrual cycles longer than 35 days; fewer than eight menstrual cycles a year; failure to menstruate for four months or longer; and prolonged scanty or heavy periods.
• Excess androgen. Elevated levels of male hormones may result in excess facial and body hair (hirsutism), severe acne and oily skin, and male-pattern baldness (androgenic alopecia).
• Polycystic ovaries on ultrasound scan. Polycystic ovaries are enlarged and contain numerous small fluid-filled cysts.

What causes PCOS?

The exact cause of polycystic ovary syndrome is unknown, but these factors may play a role:

• Excess insulin. Excess insulin might affect the ovaries by increasing androgen production, which may interfere with the ovaries’ ability to release eggs.
• If your mother or sisters have PCOS, you have a greater chance of having it, too. Researchers are looking into the possibility that certain genes are linked to PCOS.

What are the risks of PCOS?

Having polycystic ovary syndrome increases the risk of developing;

• Type 2 diabetes
• High blood pressure
• High Cholesterol
• Infertility
• Sleep apnea
• Depression and anxiety
• Abnormal uterine bleeding
• Cancer of the uterine lining (endometrial cancer
• Gestational diabetes or pregnancy-induced high blood pressure

What tests do I need?

There’s no specific test to definitively diagnose polycystic ovary syndrome.

• Blood tests to measure the levels of several hormones such as testosterone, glucose and to exclude possible causes of menstrual abnormalities such as thyroid problems.
• An ultrasound exam to check the appearance of the ovaries and the thickness of the lining of the uterus.

What treatment options are available?

Polycystic ovary syndrome treatment is based on managing individual concerns, such as infertility, hirsutism, acne or obesity.

Lifestyle changes

Weight loss through a low-calorie diet combined with moderate exercise activities. A 5% reduction in body weight improves symptoms.

Medication

• Menstrual cycle regulation.

The oral contraceptive pill decreases male hormone production and regulates abnormal bleeding.

The progesterone only pill and progestin-containing intrauterine device (mirena) are alternatives.

Metformin is an oral medication for treating type 2 Diabetes and helps to improve ovulation and regulate menstrual cycles. It also slows progression to type 2 Diabetes by aiding weight loss.

• Ovulation induction. Medication such as Clomiphene is given to stimulate the ovaries if you are having difficulty conceiving. Gonadotropins – follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are administered by injection.
• Reduction in excessive hair growth.

The contraceptive pill reduces male hormone levels

Spironolactone blocks the effects of androgens on the skin

Eflornithine (Vaniqa) is a cream that slows female facial hair growth

Your individual treatment will be discussed during your consultation

For further information please visit www.pcos-uk.org.uk