Polycystic ovary syndrome (PCOS) is a complex hormonal disorder that affects individuals assigned female at birth, particularly during their reproductive years.
PCOS is characterised by a range of symptoms that can significantly impact physical health, emotional wellbeing and fertility. Despite its prevalence and impact, PCOS remains a somewhat enigmatic condition, with ongoing research aimed at unravelling its complexities.
What is PCOS?
Polycystic ovary syndrome, often abbreviated as PCOS, is a complex condition that has a number of different factors that can contribute to its development. Medically, it is a multifactorial endocrine disorder that affects the ovaries.
PCOS can present in various ways which can be different for different people living with the condition. It is typically recognised by hormonal imbalances, irregular periods and the growth of small cysts on the ovaries which can be seen on ultrasound.
Causes of PCOS
The exact cause of PCOS remains unclear, but it is believed to be a combination of genetic and environmental factors. Several potential contributing factors include:
- Hormonal imbalances: PCOS is associated with imbalances in reproductive hormones, particularly elevated levels of androgens (male sex hormones such as testosterone) and insulin. Insulin resistance, a condition where the body’s cells become less responsive to insulin, is common in people with PCOS.
- Genetics: There appears to be a genetic component to PCOS, as it often runs in families. Specific genetic variations may lead people to develop PCOS.
- Lifestyle factors: Obesity and sedentary lifestyle are also associated with an increased risk of developing PCOS. Excess weight can increase insulin resistance and hormonal imbalances, worsening PCOS symptoms.
PCOS symptoms
PCOS can present a variety of symptoms, which may vary in severity. Common signs and symptoms include:
- Irregular menstrual cycles or absence of periods.
- Excessive hair growth (hirsutism), often in a male-pattern distribution.
- Acne and oily skin.
- Weight gain or difficulty losing weight.
- Thinning hair or male-pattern baldness.
- Insulin resistance and associated symptoms such as difficulty controlling blood sugar levels.
- Difficulty conceiving (infertility) due to irregular ovulation.
- Mood swings, depression, or anxiety.
“While there is no cure for PCOS, various treatment options are available to manage its symptoms and reduce the risk of complications.”
Diagnosing PCOS
Diagnosing PCOS typically involves a doctor taking your medical history, giving you a physical examination and undertaking some tests. Following these investigations, other factors in receiving a PCOS diagnosis include:
- Irregular periods.
- Clinical or biochemical signs of excessive levels of male sex hormones (hyperandrogenism).
- Polycystic ovaries identified on an ultrasound.
Treatment options
While there is no cure for PCOS, various treatment options are available to manage its symptoms and reduce the risk of complications. Treatment may include:
- Lifestyle modifications: Adopting a healthy lifestyle, including regular exercise and a balanced diet, can help manage weight, improve insulin sensitivity and alleviate symptoms of PCOS.
- Medications: Hormonal contraceptives (such as birth control pills) may be prescribed to regulate menstrual cycles and reduce androgen levels. Anti-androgen medications can help alleviate symptoms such as excessive hair growth and acne. Metformin, a medication used to treat Type 2 diabetes, may be prescribed to improve insulin sensitivity.
- Fertility treatments: If you are struggling with infertility due to PCOS, fertility treatments such as ovulation induction with medications like clomiphene citrate or assisted reproductive technologies (such as in vitro fertilisation) may be recommended.
- Surgery: In some cases, if you haven’t responded to other treatments, you may be offered ovarian drilling surgery to induce ovulation.
A complex disorder
PCOS is a complex endocrine disorder that affects millions of individuals worldwide. While the exact cause of PCOS remains elusive, ongoing research continues to shed light on its underlying mechanisms and improve treatment options. By raising awareness, providing support and advancing research efforts, people with PCOS can be supported to manage their condition and improve their quality of life. If you think you may have, or are worried about PCOS or its management, please consult a qualified healthcare provider.
Additional information
If you are living with PCOS, access to reliable information and support networks can help. Several evidence-based websites offer resources, educational materials and community forums for people living with PCOS. The following organisations provide valuable support for individuals with PCOS and their families:
- Verity: Verity is a UK-based self-help group for those with PCOS. The group was established to share the truth about the condition and improve the lives of individuals living with PCOS. They have a private Facebook group and information on PCOS. https://www.verity-pcos.org.uk/
- PCOS Challenge: A US-based non-profit organisation dedicated to raising awareness of PCOS and providing support and resources for those affected by the condition. Their website offers educational materials, community forums, and advocacy opportunities for individuals with PCOS. https://pcoschallenge.org/
This article was originally published on The Menopause Consortium.
