What is PCOS?
PCOS is a common condition and affects approximately 1 in 5 women. It is not a disease, but a condition with symptoms that include weight gain, difficulties with conception, irregular or infrequent periods, and excessive hair (hirsutism). It is a complex condition to identify and very few women have the same symptoms.
If an ultrasound examination is undertaken, it may be that the ovaries appear ‘cystic’. However, the ‘cysts’ on the ovaries are actually follicles that contain eggs. Many women may have a cystic appearance of their ovaries on ultrasound without having PCOS, so it is slightly confusing and certainly PCOS is not diagnosed on the basis of an ultrasound examination alone.
Effects of PCOS
PCOS is a hormonal condition, and some of the hormones that are affected include insulin and androgens (male hormones), particularly testosterone. It is the male hormone which can cause acne and hair to grow in odd places. High levels of androgens and insulin affect the menstrual cycle and can prevent ovulation which means that a woman with PCOS may not ovulate regularly or at all, and therefore it may be difficult for them to conceive naturally. However, this is not always the case, and women with PCOS need to use contraception if they are not planning a pregnancy.
Women with PCOS suffer with depression and anxiety more commonly that women without PCOS. This may be due to the hormone changes themselves, but also coping with hirsutism, acne, weight gain, and fertility problems which can affect mood and exacerbate depression or anxiety.
What causes PCOS?
There is no clearly identified cause of PCOS, although there are associations that run within families, in women who have insulin resistance, women who are overweight, and women from certain ethnic groups.
The association with insulin resistance is complex because women with PCOS may have insulin resistance as a result of their family history or genes and therefore more likely to develop PCOS, but women who are overweight are more likely to develop insulin resistance as well, or there may be a combination of factors.
PCOS is diagnosed when at least 2 of the 3 following are met:
The ovaries show 12 or more follicles on one ultrasound imaging
There are high levels of male hormones (hyperandrogenism) in the blood or symptoms suggesting excessive androgens such as hirsutism and acne
There are irregular or no periods.
If you think you may have PCOS you can see your GP or any of the doctors at Clinic 66 and we will help with some investigations, which will usually include an ultrasound of the pelvis, blood tests, and a full history and examination including BMI (body mass index).
A good GP or any of doctors at Clinic 66 can help you manage your PCOS. It requires a multidisciplinary approach looking at diet, exercise, and sometimes medications. The key to management of PCOS is to understand and manage lifestyle accordingly.
In particular, weight loss in the overweight woman can have significant benefit on their PCOS and other aspects of her health including reducing the risk of developing Type 2 Diabetes and cardiovascular disease. Unfortunately, there is only one way to lose weight effectively and for the long term which is to burn off more calories than you take in.
Women with PCOS should aim to do 30 minutes of regular exercise in order to increase the heart rate such as brisk walking, cycling, rowing, and team sports. There are also some medications used to manage PCOS and these may include the oral contraceptive pill, Metformin, and sometimes other drugs which can affect the hormones, help with weight loss or reduce anxiety or treat depression.
If you think you may have PCOS, make an appointment; come and see any of our consulting doctors, we will help you make a diagnosis and create a management plan which will help you achieve what you want to achieve and improve your symptoms relating to PCOS.
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