PCOS: what are the signs you might have this common condition?
Quick facts
- Polycystic ovary syndrome (PCOS) is caused by a hormone imbalance that impacts the ovaries.
- Your ovaries contain follicles in which eggs develop. In PCOS, eggs don’t always develop or get released, which can lead to missed or irregular periods.
- Because of its impact on ovulation, PCOS is one of the most common reasons women are unable to conceive (more on this below).
Why should I care about PCOS?
Aside from its impact on fertility, leaving the condition untreated can lead to symptoms worsening with time. PCOS is also associated with an increased risk of type 2 diabetes and high cholesterol levels developing later in life, which can have an impact on your heart and other organs in the long run.
Who gets PCOS?
Globally, between 4–20% of women have the condition. It can show up at any age after puberty, although most women discover they have PCOS in their 20s and 30s, after experiencing difficulty falling pregnant.
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What are some other risk factors?
Family history
Your chance of developing PCOS increases if someone in your family has had it.
Obesity
Being overweight can hold risk because of the increased amount of insulin in the body. Higher levels of insulin impact hormones like testosterone, which can affect fertility.
Can PCOS impact my fertility?
Women with PCOS have a higher risk of developing pregnancy complications. These include miscarriage, high blood pressure disorders and gestational diabetes (diabetes that occurs during pregnancy). With the right treatment though, most women with PCOS can get pregnant.
What symptoms should I look out for?
Speak to a doctor if you’re experiencing:
- Irregular periods or no periods at all
- Difficulty getting pregnant
- Excessive hair growth
- Weight gain
- Thinning hair or hair loss
- Oily skin or acne
- Darkening of skin along neck creases, in the groin, and under your breasts
- Skin tags (small excess flaps of skin)
How is PCOS diagnosed?
Your doctor will want to rule out other conditions which can have similar symptoms to PCOS, such as a thyroid disease or menopause.
Examination
A doctor will measure your blood pressure, body mass index (BMI), and check to see if you have an enlarged thyroid gland. They will also examine your skin for acne, discolouration, excess hair, and thinning hair on your head.
Pelvic exam
Your doctor may perform a pelvic exam to look for signs that your ovaries are enlarged/swollen, and to see if there are any other unusual findings.
Blood tests
It’s important to do a blood test to check for abnormal hormone levels. These may be related to PCOS or something else (eg thyroid disease).
Ultrasound
This examination looks at your ovaries to see if there are any cysts. It also checks the lining of the uterus for signs that might indicate PCOS or another condition.
Once your doctor has run some of these checks and ruled out other conditions, they may diagnose you with PCOS. You’ll need to have at least two of the following symptoms to receive this diagnosis:
- Irregular periods (periods that come too often, not often enough, or not at all)
- Higher levels of androgens in your blood tests
- Signs you have high levels of androgen hormones even if your blood test was normal (these include extra hair on your face, chin or body, thinning hair or acne)
- Multiple cysts on one or both of your ovaries
How is PCOS treated?
In each case, a doctor should walk you through your options and make you aware of the risks and/or side effects associated with each treatment.
Changes to your lifestyle
Achieving and maintaining a healthy lifestyle through diet and exercise can significantly improve PCOS symptoms and long-term risks. If you are overweight, losing weight can help make your menstrual cycle more regular and improve your fertility. It can also reduce the risk of complications during pregnancy.
Medication
The contraceptive pill can be prescribed to induce periods or help your cycle become more regular.
A doctor might prescribe clomiphene or metformin, which can stimulate ovulation.
If you’re trying to conceive and medication doesn’t work, IVF is another option. This is where your egg is fertilised with sperm in a laboratory and then placed in your uterus to implant and develop.
There are medication options that can help with acne, excessive hair growth and hair loss. These work by blocking the effects of hormones such as testosterone. A cream called eflornithine can be used to slow down the growth of facial hair, which can also be treated with laser removal.
Surgery
Ovarian drilling can help with fertility problems related to PCOS. In PCOS, the surface of the ovary is thickened, which is believed to prevent spontaneous ovulation. In this procedure, under general anaesthetic, a surgeon will make a small incision near your navel. They’ll then insert a microscope along with fine instruments to remove the tissue from your ovaries responsible for producing androgens. This corrects your hormone imbalance and, as a result, can help restore ovulation.
Find out how you can improve your fertility and reduce the risk of complications.
