What is polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a condition which can affect a woman’s menstrual cycle, fertility, hormones and aspects of her appearance. It can also affect long-term health. This information is about the effects on your long term health and does not cover specific treatment options for PCOS.

What are polycystic ovaries?

Polycystic ovaries are slightly larger than normal ovaries and have twice the number of follicles (small cysts). Polycystic ovaries are very common affecting 20 in 100 (20%) of women.

Having polycystic ovaries does not mean you have polycystic ovary syndrome. Around 6 or 7 in 100 (6–7%) of women with polycystic ovaries have PCOS.

What are the symptoms of PCOS?

  • Irregular periods or no periods at all
  • Difficulty becoming pregnant
  • Having more facial or body hair than is usual
  • Loss of hair on your head
  • Being overweight, rapid increase in weight, difficulty losing weight
  • Oily skin, acne
  • Depression and mood swings.

The symptoms may vary from woman to woman. Some women have mild symptoms, while others are affected more severely by a wider range of symptoms.

What causes PCOS?

The cause of PCOS is not yet known. PCOS sometimes runs in families. If any of your relatives (mother, aunts, sisters) are affected with PCOS, your own risk of developing PCOS may be increased.

How is PCOS diagnosed?

Women with PCOS often have different signs and symptoms and sometimes these come and go. This can make PCOS a difficult condition to diagnose. A diagnosis is usually made when you have any two of the following:
  • irregular, infrequent periods or no periods
  • more facial or body hair than is usual for you and/or blood tests which show higher testosterone levels than normal
  • an ultrasound scan which shows polycystic ovaries.

What kind of menstrual problems are common ?

  • Period problems occur in about 7 in 10 women with PCOS.
  • You may have irregular or light periods, or no periods at all.
  • However, your risk of developing cancer of the uterus (womb) may be increased if you have no periods for a long time.
  • Regular periods will prevent this possible increased risk to the uterus.
  • Therefore, some women with PCOS are advised to take the contraceptive pill as it causes regular withdrawal bleeds similar to periods.
  • If this is not suitable, another option is to take progestogen hormone for several days every month which will cause a monthly bleed like a period.
  • Sometimes, an intrauterine system (IUS), which releases small amounts of progesterone into the womb preventing a build-up of the lining, can be used.

What fertility problems I may face?

  • PCOS is one of the most common causes of infertility.
  • The chance of becoming pregnant depends on how often you ovulate. You may not ovulate each month,and some women with PCOS do not ovulate at all.
  • If you do not ovulate but want to become pregnant, then fertility treatments may be recommended by a specialist and have a good chance of success.
  • But remember, you are much less likely to become pregnant if you are obese. If you are obese or overweight then losing weight is advised in addition to other fertility treatments.

Do I need any operation ?

  • If you donot respond to fertility enhancing drugs , you may require operatio to increase your chances of pregnancy

How is exscess hair growth & Acne treated?

  • Unwanted hair can be removed by shaving, waxing, hair-removing creams, electrolysis, and laser treatments. These need repeating every now and then, although electrolysis and laser treatments may be more long-lasting but are expensive.
  • Diene is commonly prescribed to regulate periods, to help reduce hair growth, to reduce acne, and is a good contraceptive.
  • Drugs take 3-9 months to work fully. You need then to carry on taking them otherwise hair growth will recur.
  • Treating acne - The combined contraceptive pills, especially Dianette® often help to improve acne.

What are the long term health problems of PCOS ?

  • Insulin resistance and diabetes
  • High blood pressure
  • Heart disease in later life
  • Cancer of the endometrium (lining of the womb)
  • PCOS does not increase the chance of breast, cervical or ovarian cancer.

What is the treatment for polycystic ovary syndrome?

  • There is no cure for PCOS. However, symptoms can be treated, and your health risks can be reduced.
  • Aim to lose weight if you are overweight
  • Treating hair growth
  • Treating acne
  • Treating period problems
  • Fertility issues

How to reduce long-term health risks?

Have a healthy lifestyle
  • Eat a healthy balanced diet. This should include fruit and vegetables and whole foods (such as wholemeal bread, whole grain cereals, brown rice, wholewheat pasta), lean meat, fish and chicken. You should decrease sugar, salt, caffeine and alcohol
  • Eat meals regularly especially including breakfast
  • Exercise regularly (30 minutes at least three times a week).
You should aim to keep your weight to a level which is normal

If you are overweight, it would be helpful to lose weight and maintain your weight at this new level

The benefits of losing weight include:
  • a lower risk of insulin resistance and developing diabetes
  • a lower risk of heart problems
  • a lower risk of cancer of the womb
  • more regular periods
  • an increased chance of becoming pregnant
  • reduction in acne and a decrease in excess hair growth over time
  • improved mood and self-esteem.

How do I lose weight?

  • Trying to lose weight may initially seem overwhelming. It is important that you find the right motivation for you and that you are ready to make changes to your lifestyle .
  • You can lose weight by reducing eating and by increasing the amount of exercising.

How much physical activity should I do?

  • Moderate intensity physical activity for a minimum of 150 min. per week. If you are trying to lose weight, this may need to be increased to 225-300 min. per week.
  • Aim to include some type of physical activity every day for at least 30 min. and build this up over time. This can also be broken up into smaller sessions (10-15 min. sessions) spread out over the day.
  • Daily lifestyle activities such as climbing stairs whenever possible, walking greater distances (i.e. parking further away or getting off the bus a stop or two earlier), walking during lunchtime, walking down the hall instead of emailing, gardening and house cleaning should be done .
  • It is important that you try to make this a key priority in your life as it will affect your long-term health.
Have regular health checks

Women with PCOS over the age of 40 should be offered a blood sugar test once a year to check for signs of diabetes.

If you are obese (BMI over 30) or have a family history of diabetes, you may be offered testing for diabetes earlier than age 40.

If you have not had a period for a long time (over 4 months), it is advisable to see your doctor.

Is there a cure?

There is no cure for PCOS. Medical treatments aim to manage and reduce the symptoms or consequences of having PCOS. Medication alone has not been shown to be any better than healthy lifestyle changes (weight loss and exercise).


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