PCOS is a condition in which women have small, harmless cysts around the edge of their ovaries (polycystic ovaries).
The most common symptoms of PCOS include:
- Irregular periods
- Abcence of periods
- Weight gain
- Failure to conceive
- Hair loss or excessive hair growth
Not every women with PCOS suffer from all of the above symptoms and each of the symptoms can be mild to severe.
Symptoms are usually noticed in the late teens or early twenties and many women suffer only from menstrual problems or a failure to conceive.
There are risks in later life associated with PCOS and these include:
- Cardiovascular disease
- Endometrial cancer - women who have had irregular or absent or periods for a long period of time have an increased risk of developing cancer of the womb lining (endometrial cancer) however, endometrial cancer is still very rare, and certain treatments to regulate periods, such as the contraceptive pill can assist in reducing the risk.
- High blood pressure
- High blood cholesterol levels
The exact cause of PCOS is unknown however, the following factors can lead to its development.
- Resistance to insulin
- Weight gain
- Hormone inbalance
The diagnosis of PCOS can be based on symptoms and a general examination.
In order to confirm diagnosis, the following investigations are often undertaken:
- An ultrasound scan of the pelvis to look at the ovaries and the womb
- A blood test in order to measure the levels of androgens
- A glucose test - in certain cases
The following tests can also be undertaken in order to rule out other serious however, less common conditions that may be the cause of similar symptoms including:
- Androgen secreting tumours in the adrenal gland or ovary
- Congenital adrenal hyperplasia (CAH), which is a rare inherited condition resulting in abnormal production of androgens
- Thyroid gland problems
- Cushing's syndrome caused by overproduction of the steroid cortisol by the adrenal gland
Initially, the consultant gynaecologist is likely to suggest lifestyle changes, such as eating a healthy, balanced diet and exercising regularly, to help control your symptoms, reduce insulin resistance and improve your fertility.
Stress can also make your PCOS symptoms worse and managing stress levels and finding time to relax can also help control the symptoms.
Excess hair can be controlled with hair removing creams or by bleaching, shaving or waxing.
A number of drugs that can help the various symptoms of PCOS are available and these include:
Treatments containing benzoyl peroxide can be purchased from a pharmacist and can help reduce acne. General practitioners are also able to prescribe antibiotic tablets or creams to treat acne.
Oral contraceptive can assist as they prevent the ovaries from producing increased levels of testosterone and can improve both acne and excess hair.
Metformin increases the sensitivity of muscle cells to insulin and reduces insulin resistance. This means the body needs less insulin to control its blood sugar levels. Reduced insulin levels in the blood means your ovaries will produce less testosterone and as the testosterone levels drop symptoms such as excess hair and irregular periods will improve and the ovaries will start to release eggs, which will improve fertility.
Fertility drugs can stimulate the ovaries to release eggs and can be taken for up to a twelve months.
In some cases, the consultant gynaecologist may suggest surgery to control PCOS symptoms and improve fertility such as laparoscopic ovarian drilling.
This is a keyhole procedure used to destroy the testosterone-producing tissue on your ovaries and as levels of testosterone fall, your PCOS symptoms improve and ovaries start to release eggs again.
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