Polycystic ovary syndrome (PCOS) - the facts

All you need to know about polycystic ovary syndrome, from its symptoms to possible treatments tod its likely impact on fertility and pregnancy.

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What is polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a fertility-impairing condition that is largely caused by an imbalance in the reproductive hormones that prevent 'normal' ovulation from taking place.

Low levels of follicle stimulating hormone (FHS) coupled with consistently high levels of luteinising hormone (LH) mean that while the ovarian follicles start to develop eggs in preparation for ovulation, they never reach maturity. As a result, these under-developed eggs remain 'trapped' on the ovaries where they form the cysts characteristic of this condition.

Increased levels of the hormone insulin (which is involved in controlling blood-sugar levels) also plays a role by stimulating excess testosterone production in the ovaries . In fact, it's believed that women who suffer with PCOS are somewhat insulin-resistant which is why higher levels are found in the body . This excess of testosterone can, in turn, prevent ovulation and cause some of the other symptoms characteristic of this condition.

What are the symptoms of polycystic ovary syndrome?

These differ from woman to woman however, common PCOS symptoms include:

• Irregular periods or no periods at all
  
  
• Either very light or very heavy periods
  
  
• Mild to moderate abdominal cramps
  
  
• Acne - often on the face
  
  
• Overweight - particularly around the mid-section
  
  
• Fatigue
  
  
• Excessive hair growth on the face, chest, forearms, lower abdomen and legs
  
  
• The appearance of excess ovarian cysts

How is polycystic ovary syndrome diagnosed?

While ultrasound scans and tests that investigate the balance of hormones in your blood will be used to confirm a diagnosis of PCOS, for the most part your doctor will make an initial diagnosis based on your medical history.

If you are having problems conceiving, experiencing irregular periods along with a number of the other characteristic symptoms of PCOS such as acne, weight gain and excessive hair growth, it's likely that your doctor will suggest polycystic ovary syndrome as a likely cause.

How is polycystic ovary syndrome treated?

Initially, your doctor may recommend managing the condition through lifestyle changes such as reducing the amount of fat and sugar you consume and, if you're overweight, bringing your BMI down to a healthier level. For many women making small changes to their lifestyle of this nature can make a big difference in reducing the physical symptoms of the condition (both externally and internally), helping the hormones to rebalance and ovulation to recommence.

In certain cases your doctor may also recommend a course of drug treatments to help manage the condition. However, the approach they take to this will vary largely depending on your individual requirements.

For those who aren't trying to conceive the contraceptive pill may be considered as an option to help balance and control hormonal fluctuations. Alternatively, for those who are trying for a baby, fertility enhancing drugs such as Clomifene and Gonadotrophins can be used to regulate hormones and stimulate ovulation. For women who haven't responded to drug therapies, surgery (in particular a laparoscopy procedure called ovarian diathermy) can be used.

How will polycystic ovary syndrome affect my chance of conceiving?

As one of the characteristic symptoms of PCOS is issues with the menstrual cycle centred on irregular or absent ovulation, it follows that fertility can be impaired for many women who suffer with this condition. This is largely because the balance of hormones needed to encourage the healthy development, and facilitate the release of an egg during each menstrual cycle is not available.

However, while polycystic ovary syndrome can make conceiving difficult, it is by no means impossible. If you follow the 'lifestyle advice' offered by your doctor and make use of the fertility boosting treatments they recommended your chance of conceiving and carrying a healthy pregnancy can be markedly improved.