What is PCOS?

Polycystic ovarian syndrome (PCOS) is a common hormonal condition that affects up to 1 in 10 girls and women in their reproductive years. It may cause disruptions to the menstrual cycle, skin and hair changes, as well as cysts on the ovaries.

It is one of the leading causes of infertility, yet many women don't know they have it — many women with PCOS remain undiagnosed.

PCOS can’t be cured, but if you have it you and your doctor can manage many of the symptoms.

What causes PCOS?

Women with PCOS produce high levels of male hormones from their ovaries. These male hormones affect the menstrual cycle and cause other symptoms.

Women with PCOS often have enlarged ovaries. Their ovaries may have many cysts on them, which is where the name comes from.

The cause of PCOS is unknown, but it is thought this happens because increased levels of insulin affect how the ovaries work. You are more likely to develop PCOS if you have a close family member with the condition, there were increased hormones while you were in the womb, or due to your lifestyle or environment.

Immediate female relatives (daughters or sisters) of women with PCOS have as much as a 1 in 2 chance of having PCOS. Type 2 diabetes is also common in families of those with PCOS.

What are the symptoms of PCOS?

Women with PCOS can have a wide range of symptoms. Not every woman with PCOS will have every symptom, and each woman will have their own individual experience.

If you think you might have PCOS, it is important you see a doctor. An early diagnosis can help manage the symptoms of PCOS and reduce the potential long-term health risks.

PCOS symptoms include:

Excess hair growing on your face, chest, stomach or back (hirsutism)
Thinning hair or baldness (alopecia)
Irregular periods or no periods at all
Abnormal vaginal bleeding
Difficulty falling pregnant or not falling pregnant at all
Acne
Dark patches on the skin
Easy weight gain
Swollen belly
Mental health problems such as depression, anxiety, mood changes and low self-esteem

Your doctor may also look for:

High blood pressure
Symptoms and signs of diabetes

Women with PCOS have a higher risk than other women of developing health problems such as:

Type 2 diabetes
High cholesterol
Heart disease
Endometrial cancer
Sleep apnoea
Sexual health problems

How is PCOS diagnosed?

The diagnosis of PCOS is usually difficult because there is a wide range of symptoms and you don't have to have all of them to be diagnosed with the condition.

There isn't a simple test that rules it in or out.

You should see your doctor if you are feeling unwell and have any of the symptoms that could be caused by PCOS.

Your doctor will talk to you to try to understand your symptoms. They will examine you. You may be asked to have:

Blood tests to check hormone (such as testosterone), cholesterol and glucose levels in the blood
An ultrasound scan to look at the ovaries and check for the presence of multiple cysts (fluid-filled sacs)

How is PCOS treated?

Treatment depends on the main problems you have. It can involve medicines, cosmetic treatments and having a healthy lifestyle.

A healthy lifestyle is the main way to manage PCOS. Eating a healthy diet and getting regular exercise can help many of the physical and emotional problems caused by PCOS. Exercise can improve your mental health too.

Exercise can improve your mental health. Losing even a small amount of weight can help regulate your periods, improve your chance of becoming pregnant and reduce your risk of diabetes and heart disease.

There are a number of different medical therapies to help manage PCOS symptoms, such as period problems, fertility, excess hair, acne and weight gain. These therapies include the oral contraceptive pill, insulin-sensitising drugs, hormone therapies, weight loss drugs, antidepressants and anti-anxiety drugs. It’s important to mention that before you go on any medical therapies, you really understand “why?” and is it “worth it?”.

It's important to have regular health checks because of your increased risk of developing health problems later in life.

Talk to your doctor if you need help to control your weight. Your doctor can refer you to the right health professional for your situation, such as a dietitian or exercise specialist.

For more information on PCOS visit the Jean Hailes for Women's Health website.

Source: Health direct Government website

I have PCOS and I want to have a baby, what do I need to know?

Firstly, congratulations! This is really exciting. I would suggest you start chatting to your health practitioner about starting a family ~6 months before trying to conceive. This way you can come up with a fertility plan that suits you and your partner for this journey.

Sara Holton, Deakin University and Karin Hammarberg, Monash University

Most women want and expect to have children. But women who have a chronic health condition such as polycystic ovary syndrome (PCOS) often have concerns about childbearing, including whether they can become pregnant.

PCOS is a complex hormonal condition which affects up to one in five women of reproductive age. Most women with PCOS have elevated levels of a type of hormone called luteinising hormone, which brings about ovulation, and reduced levels of a hormone called “follicle stimulating hormone”, which is essential for pubertal development and the function of women’s ovaries and men’s testes.

Women with PCOS also have an underproduction of oestrogen (“female” hormones) and an overproduction of androgens (“male” hormones). This causes tiny cysts on the surface of the ovaries.

Due to these hormonal imbalances, women with PCOS often have irregular menstrual cycles because they don’t ovulate or ovulate only occasionally. So women with PCOS are more likely to have trouble conceiving than other women.

While most women who have PCOS become pregnant, they often take longer to fall pregnant and are more likely to need fertility treatment than women without PCOS.

In a recent study by Monash University, women with PCOS took part in an online discussion group. They talked about their concerns about pregnancy and what they could do to improve their chances of falling pregnant, the sort of information they would like about fertility and PCOS, and when they would like to receive this information.

Their greatest worry was about whether they would be able to get pregnant. They also wanted to know how best to prepare for pregnancy and what they should do before trying to conceive. They had trouble finding up-to-date, relevant and reliable information.

How to increase chance of pregnancy

As for all women, being in the best possible health before trying for a baby increases the chance of pregnancy and gives the baby the best start in life.

According to the international evidence-based guideline for the assessment and management of PCOS, adopting a healthy lifestyle – including being in the healthy weight range, not smoking, cutting back on alcohol, eating a healthy diet, getting plenty of regular exercise and enough sleep – is the first thing to do to improve a woman’s chances of becoming pregnant and having a healthy baby.

To get the right kind of advice and support, women planning to get pregnant should have a preconception health check with their GP. This is also an opportunity to discuss a plan of action in case the PCOS causes fertility difficulties.

For women with PCOS who are overweight or obese, a modest weight loss sometimes results in more regular ovulation, which increases the chance of pregnancy. For those who know they ovulate, having sex during the “fertile window” (the five days leading up to and including ovulation) boosts the chance of conception.

Source: Your fertility