Polycystic ovary syndrome (PCOS)

What is Polycystic ovary syndrome (PCOS)?

PCOS is a hormone imbalance that affects about one in 10 women. This condition is associated with increased levels of two hormones in the body – insulin and androgens (male-type hormones) – that cause symptoms such as absent or irregular periods, excessive facial and body hair, pimples, weight gain and challenges with fertility.

Symptoms

Women with PCOS may experience different symptoms, and they can range from mild to severe. Symptoms can also change at different stages of your life.

Symptoms may include:

• irregular or no periods
• excess hair on your face or body or both (hirsutism)
• hair loss (alopecia)
• skin conditions such as pimples, acne or a darkened rash
• stress, anxiety and depression
• weight gain.

Causes

We don’t know the exact cause of PCOS, but genetics and family history play an important role. It’s estimated that up to a third of women with PCOS have a relative who has PCOS (e.g. mother, aunt, sister or daughter).

About 85% of women with PCOS have insulin resistance. It’s thought that having increased levels of insulin in the body causes the ovaries to work differently, which can lead to production of higher levels of androgens (male-type hormones). This hormone imbalance causes various symptoms.

PCOS can affect women of all weight ranges. But a heavier weight can increase the hormones responsible for PCOS symptoms. Weight loss can normalise hormone production and lead to improvements in PCOS symptoms.

Diagnosis

If you suspect you have PCOS, it’s important you see your doctor.

Your doctor will review your medical history and assess your physical symptoms, weight and BMI (body mass index). They may also recommend certain tests to rule out other conditions.

PCOS may be diagnosed if you have two or more of the following symptoms:

• Irregular or no periods.
• Features of ‘clinical androgen excess’ (e.g. pimples and excess hair growth) or higher than normal androgen levels (shown in your blood test).
• Polycystic ovaries visible on an ultrasound.

You might be referred to a specialist, such as an endocrinologist (hormone specialist) or gynaecologist, for more detailed assessments.

An early diagnosis and support from a team of specialists can help manage the symptoms of PCOS and reduce the risk of long-term health problems, such as diabetes and cardiovascular disease.

Fertility and pregnancy

Many women with PCOS have children naturally, but some need medical help to get pregnant.

Learn more about how to improve your chances of becoming pregnant and ways to reduce potential risks during pregnancy.

Treatment and management

Depending on your symptoms, you can seek help from a range of healthcare professionals, including an endocrinologist, gynaecologist, dietitian, dermatologist, exercise physiologist, fertility specialist and psychologist. Your doctor can help coordinate your care and refer you to specialists where needed.

Having a healthy lifestyle is the most effective way to manage PCOS and reduce the severity of symptoms. This includes eating a balanced diet, maintaining a healthy weight, being physically active and reducing or stopping harmful habits such as smoking and excessive drinking.

For some women, a healthy lifestyle alone will not improve symptoms. They may also need medicine to manage different symptoms, such as the combined oral contraceptive pill for acne, excess hair and irregular periods.

It can be hard to manage your weight if you have PCOS. But research shows that even a weight loss of 5% to 10% can improve symptoms. Learn more about how you can improve your physical health and emotional wellbeing.

When to see your doctor

See your doctor if:

• you have been trying to lose weight without success
• your PCOS symptoms are affecting your daily life
• your PCOS symptoms are not improving despite treatment.

For more information, resources and references, visit the Jean Hailes PCOS web page.