PCOS stands for Polycystic Ovarian Syndrome. It is a very common hormone disorder, affecting around 1 in 5 women. It can be hereditary and is one of the leading causes of female fertility problems. Lots of the symptoms of PCOS can be seen in other health conditions so it's important to speak to a doctor to get a proper diagnosis so you can treat the condition.

What are the three main features of Polycystic Ovarian Syndrome?

1. Polycystic ovaries or ovarian cysts – your ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs (but despite the name, you do not actually have cysts if you have PCOS)
2. Irregular periods – which means your ovaries do not regularly release eggs
3. Excess androgen levels – high levels of "male" hormones in your body, which may cause physical signs such as excess facial or body hair

In order to be diagnosed with PCOS, you need to have at least 2 of these 3 features. If you're worried that you might have any of the symptoms of PCOS, speak to your doctor or Fertifa patient advisor as soon as possible 💜

Symptoms of PCOS are usually noticed in your late teens or early 20s

The most common symptoms include:

• Irregular menstrual periods or no periods at all
• Difficulty getting pregnant (as a result of irregular ovulation)
• Excessive hair growth – usually on the face, chest, back or buttocks
• Weight gain
• Thinning hair and hair loss from the head
• Oily skin or acne
• If you have PCOS, there's a higher risk of developing other health problems when you are older, like type 2 diabetes or gestational diabetes, high cholesterol levels and high blood pressure.

We don't know what causes PCOS, but it does runs in families

PCOS is related to abnormal hormone levels in the body, including high levels of insulin - a hormone that controls blood sugar levels in the body. Many women with PCOS become resistant to insulin so end up producing even more insulin to overcome this. The imbalance of the hormone insulin contributes to the increased production and activity of other hormones like testosterone. PCOS often occurs in women who have a family history of the condition.

What's the best treatment for PCOS?

The easiest way to treat irregular periods is using an oral contraceptive pill (birth control pills)

Irregular and unpredictable periods can be unpleasant and a nuisance. Irregular ovulation can also increase the risk of endometrial thickening, which can sometimes lead to uterine cancer. If you don't want to get pregnant, the easiest approach is the use of a low dose birth control pill.

This will result in an artificial cycle and regular periods. If you cannot take the pill, there are alternative hormonal therapy's to induce regular periods, such as a progestogen for 5-10 days every 1-3 months.

An alternative is to use a progesterone secreting coil which releases the hormone progesterone into the womb, which protects it from thickening also often resulting in reduced or absent menstrual bleeding.

With treatment, most women with PCOS will manage to conceive

Treatment can include helping you to ovulate regularly, or if that is not successful you may be offered IVF treatment. PCOS is one of the leading causes of infertility in women. If you have irregular periods, it means that ovulation is also erratic, so it will take longer than average to get pregnant. If ovulation is not occurring, it is not possible to conceive without treatment.

If you have an irregular menstrual cycle, there are a number of treatments available that will aim to stimulate regular monthly ovulation to increase the chance of conception. But before staring any medication, it is first necessary to check that the fallopian tubes are open and that your partner’s sperm count is normal.

Once the initial fertility checks have been done, the first drug to try is usually a tablet called Clomid, which induces ovulation in about 75% of women. About 50-60% of those will to get pregnant after six months’ therapy.

If this does not work the alternative treatments include daily hormone injections of a drug that contains follicle stimulating hormone (FSH) or alternatively an operation performed by laparoscopic (“key hole”) surgery in which the ovaries are cauterized (sometimes called ovarian drilling) – both will induce ovulation in about 80% of women.

If you do have treatment to induce ovulation, it's important to monitor the developing follicles in the ovaries with regular ultrasound scans whilst taking the medication. This requires attending the fertility clinic on a regular basis in order to prevent the main side effect, which is a multiple pregnancy.

The contraceptive pill is also an effective therapy for acne and unwanted body hair growth

High androgen levels (high testosterone) can also affect the skin. Acne (spots) may occur on the face, chest or back. Some people also have unwanted hair growth on the face, chest, abdomen, arms and legs. These problems may be confined to small areas of the body, but sometimes they are more prominent, especially in women with darker hair or skin, simply because the unwanted hair is more noticeable than in fairer people.

A less common problem is thinning of hair on the head, although if this occurs it is rarely serious. Being overweight probably causes the worst problems for women with the polycystic ovary syndrome as obesity aggravates imbalances of the hormones that control ovulation and that affect the skin and hair growth.

The contraceptive pill helps balance out the hormones and helps control the excess hair growth and skin problems seen in people with PCOS.

Being overweight can make the symptoms of PCOS worse

It can be very hard to lose weight when you have PCOS. Unfortunately there is not a simple solution to weight loss in women who have PCOS. Having PCOS does not make you gain weight, but women with PCOS find it easy to put on weight and much more difficult to lose weight, as their metabolism works inefficiently to deal with food.

Regular physical exercise (at least 20-30 minutes of hard exercise 5-7 days per week) and leading a healthy lifestyle will increase the body’s metabolism and significantly improve the ability to lose weight and improve long term health. It's also important to maintain a healthy diet. There is also lots of information out there about the right diet and PCOS, but most simply, the right diet for you is one that is practical, sustainable and compatible with your lifestyle.

It is sensible to keep carbohydrate content down and to avoid fatty foods. It is often helpful to sit down with a dietician to work out the best diet for you.

There are lots of treatment options available for people with PCOS. Speak to your doctor, or if your a Fertifa patient get in touch with your care advisor, to discuss which is best for you and your circumstances 💜