Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders – affecting up to 1 in 5 women of reproductive age. However, unfortunately, it’s often not well understood. Because of this we wanted to provide a brief introduction to PCOS.
What is PCOS?
Polycystic ovary syndrome (PCOS) is a common condition that affects how a woman’s ovaries work and disrupts hormonal balance in the body. Lots of people with PCOS don’t know they have it or have few symptoms. For others PCOS can cause things like irregular periods, easy weight gain, acne and mood changes.
There are 3 main criteria for diagnosing PCOS. You need to have 2 of these to meet the criteria for PCOS.
- Absent or reduced ovulation – this means the ovaries aren’t releasing eggs as frequently as normal. One of the possible symptoms of this is irregular periods
- High levels of androgens (such as testosterone) – this is diagnosed on a blood test or through an examination if you have symptoms such as unwanted hair
- Polycystic ovaries – your ovaries become enlarged and contain many fluid-filled sacs (these are actually follicles rather than cysts). This can only be diagnosed on an ultrasound scan
What are the symptoms of PCOS?
For those people who develop symptoms of PCOS they will usually start to show in your late teens/early twenties. There are things you can do to manage the symptoms of PCOS — like diet, lifestyle changes and medications.
Some of the possible symptoms are below:
- irregular ovulation or absent ovulation
- irregular or absent periods
- heavy or very light bleeding when you have a period
- painful periods
- excessive hair growth — commonly on your face, back, buttocks, or nipples
- hair loss from your head
- weight gain or difficulty losing weight
- oily skin and acne
- difficulty getting pregnant — however most people with PCOS can still get pregnant
What causes PCOS?
The exact cause of PCOS is unknown but there are a couple of things that can increase your chances of having it:
Genetics – PCOS tends to run in families so your genes might play a role. If a close relative has PCOS and you have some symptoms it could be worth looking into.
Your weight – PCOS can make it easy to gain weight and can make it difficult to lose. However if you’re overweight it can make you more likely to get PCOS. More evidence is needed, but being overweight is thought to increase your levels of male hormones — which can affect your ovaries and the hormones they produce.
Your insulin levels – High levels of insulin (a hormone that helps control your blood sugar levels) can cause you to produce too much androgen hormones which is a key factor in PCOS. Insulin can be influenced by a high carbohydrate diet and an inactive lifestyle.
How to test for PCOS
If you have irregular periods or you aren’t ovulating then it’s worth speaking to a doctor.
Since PCOS is based on three main features (irregular periods, high levels of androgen hormones, and polycystic ovaries) diagnosing it will usually involve:
- Questions about your menstrual cycle — so it’s a good idea to track your periods
- A hormone test — especially your levels of androgen hormones like testosterone
- An ultrasound scan — to check if your ovaries have a lot of follicles in them (however this isn’t always necessary)
Since PCOS can increase your risk of some other conditions they may also test for:
- Blood pressure
- HbA1c levels — an indicator of your blood sugars over the last three months
- Lipid profile — to check your cholesterol and triglyceride levels
Before giving a diagnosis of PCOS your doctor will also look to rule out other conditions that can have similar symptoms.