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Polycystic Ovarian Syndrome


PCOS is a common condition that affects the way your ovaries work. It’s estimated to affect up to 10% of women.

The 3 main features (You need 2 out of the 3 to be diagnosed with PCOS) include:⁣⠀

⁣⠀

*Irregular or absent periods⁣⠀

*Excess of male hormone (androgens)⁣ causing excess hair growth or acne⠀

*Polycystic Ovaries⁣⠀

The ovaries store and release eggs and also produce sex hormones. Every month, an egg is released from one of your ovaries and this is called ovulation. Before the egg is released, it develops in a small fluid filled sac called a follicle.


Lots of follicles normally develop, but only one becomes a fully mature egg. In PCO, lots of follicles develop but none become fully mature and these follicles persist as cysts on your ovary.⁣ ⁣⠀


What causes PCOS?⁣⁠⠀

The exact cause is unknown, but it is thought to be a combination of things including:⁣⁠⠀

  • It can run in families⁣⁠

  • ⁣⁠High level of the hormone that causes you to ovulate (Luteinizing Hormone)⁣⁠

  • ⁣⁠Insulin resistance - Your cells may be resistant to insulin – the hormone that controls your blood sugar level, so your body produces more to keep your blood sugar levels normal. This increased insulin causes the ovaries to make too much testosterone and this can prevent you from ovulating.⁣⁠

Long term complications

PCOS is associated with long-term health conditions because of the hormone imbalance and changes to the amount of insulin in your body.

Complications include:


  • Insulin resistance and diabetes: This affects 2 in 10 women with PCOS. It occurs when the blood sugars are constantly high. If the diabetes remains untreated it can cause damage to the organs in your body.

  • Hypertension (High Blood Pressure): This is most likely related to being overweight and insulin resistance rather than PCOS itself. Having high blood pressure can lead to heart problems so it is important that it is treated.

  • Depression and Anxiety: Having PCOS can affect the way you view yourself and how you feel others view you too. It can affect your self-esteem leading to mental health problem

  • Snoring and daytime drowsiness: There is excessive fatigue and drowsiness. Women report poor sleep and episodes where they stop breathing for short periods of time during sleep (sleep apnoea). There is also associated snoring.

  • Cancer: There is a small risk of developing a cancer in the lining of the womb; endometrial cancer. Women who have less than 3 periods a year can have thickening of the lining of the womb and in a small percentage of women this can develop into cancer.

The risks of these occurring can be reduced dramatically with the various treatments used for PCOS.


Treatment options for PCOS

Unfortunately, there is no cure for PCOS, so treatment is aimed at managing the symptoms. The good news is that these symptoms can be managed through a combination of lifestyle changes and medicines.


Diet and Exercise

Treatment for PCOS usually starts with lifestyle changes like exercise, healthy diet and weight loss. We appreciate how difficult it is to make changes. It is easy to tell someone to lose weight but without giving practical steps and support people often feel lost and don’t know where to start.


Speak to your GP; you can be prescribed Moving Medicine, Weight Management Services, referred to see a dietician/nutritionist and also have regular reviews with practise nurse or GP to ensure you stay on target.


Medical Treatments

Treating periods: Hormonal contraception pills can help to regulate the menstrual cycle, protect the endometrium and relieve symptoms like excess hair growth.

Treating Fertility: A tablet called Clomiphene (clomid) is usually given to cause ovulation. Another medication called Letrozole can also be used.

Treating Hair Growth: Eflornithine cream can help slow down hair growth, Anti-androgens e.g. cyproterone acetate, can be used to block the effect of excess male hormone

Treating Insulin Resistance: Metformin is a drug normally used to treat type 2 diabetes. It helps your body respond more readily to insulin and better control your blood sugars. In PCOS, metformin can reduce the insulin resistance and high insulin levels that commonly occur, and in turn, can reduce high male hormone levels. This is not widely used.


Surgical treatments

This is an option for fertility if other options don’t work. Laparoscopic Ovarian drilling is a procedure where tiny holes are made in the ovary using either heat or laser to help restore ovulation.


If you would like to know more about PCOS you can read more at the website listed below. If you are concerned that you have it then please speak to your GP who may then refer you to a gynaecologist.


Website

RCOG: https://www.rcog.org.uk/en/patients/patient-leaflets/polycystic-ovary-syndrome-pcos-what-it-means-for-your-long-term-health/


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