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PCOS - Polycystic ovary syndrome, woman hormone sickness lettering on paper in womans hands

Polycystic Ovary Syndrome (PCOS)

What is Polycystic Ovary Syndrome (PCOS)?

PCOS is the acronym commonly used for Polycystic Ovary Syndrome.  In the past, the condition was also referred to as Stein-Leventhal Syndrome.1 PCOS is a condition that is thought to affect around 1 in 52 or possibly 1 in 101 women within the reproductive age band in the UK. It affects how the ovaries function and can cause pain, fertility issues and other concerns.2

Polycystic means ‘many cysts’ and sufferers of PCOS will usually have at least 12 cysts present on their ovaries.  The hormone production balance is altered, causing an increase in production of the male hormone, testosterone, which can result in visible symptoms such as excessive body and/or facial hair.  PCOS also hinders menstrual cycles, causing irregular periods or a complete lack of ovulation.1

What causes PCOS?

 It is not clear what causes PCOS but there are a few possibilities:2,1

  • high insulin levels
  • high levels of Luteinising hormone (LH).
  • hereditary factors – it may run in some families although this has not yet been confirmed
  • being overweight

What are the symptoms of PCOS?

PCOS can result in numerous and varied symptoms and women with PCOS may experience one or many of these symptoms which include:1,3

  • irregular periods or no periods
  • heavy periods
  • lack of ovulation
  • excessive facial and/or body hair
  • fertility issues
  • acne and oily skin
  • pain around the ovaries, pelvis and lower abdomen
  • weight gain
  • thinning hair
  • hyperpigmentation of the skin – acanthosis nigricans (dry, dark patches of skin that usually appear in the armpits, neck or groin)
  • chloasma – brown or greyish patches of pigmentation (colour) usually on the face
  • PMT (Pre-Menstrual Tension)
  • depression and mood disorders

Long term problems with PCOS can also be linked to high cholesterol and type 2 diabetes.1

However, some women have ovaries that are polycystic without the typical symptoms of PCOS and some women with PCOS do not have multiple cysts in the ovary1 so it can be difficult to diagnose in some women.

Testing

Your doctor may offer to screen for impaired glucose tolerance, type 2 diabetes and cardiovascular risk factors to ensure that you don’t have these conditions.5

The testing process may include blood tests to check hormone levels such as a test to measure the male hormone testosterone and luteinising hormone (LH), a physical examination and/or a pelvic ultrasound.2

There are many similarities in the symptoms of PCOS and hypothyroidism.  Whilst a direct connection has not been confirmed, the parallels in the symptoms can cause confusion when it comes to diagnosis.  Ovaries that appear to be ‘polycystic’ can be symptomatic of hypothyroidism and therefore thyroid disorders should be ruled out before testing for PCOS.4

Treatment

Lifestyle changes such as an improved diet and maintaining a healthy weight can help ease the symptoms of PCOS.2, 5 Your GP may refer you to a gynaecological specialist for the management and treatment of this condition.5

In certain cases, medication may be prescribed by your GP or specialist to alleviate the signs of excess hair growth and/or acne, manage pain or regulate periods.2

Treatment is often prescribed to overcome fertility issues as well as to manage other symptoms.

Medications may include Eflornithine cream,6 Clomiphene (Clomifene),7 Letrozole (Femara)6 or Glucophage (Metformin)6. These medications are generally used to stimulate the ovaries. The possible side-effects of these medications should be discussed with your medical professional.

In extreme cases, surgery such as Laparoscopic Ovarian Drilling may be required. This is a minimally invasive procedure involving small incisions in the abdomen. During this procedure heat or a laser is used to destroy the cysts on the ovaries that are causing the symptoms.6

Prognosis

There isn’t a cure for PCOS but with multiple treatment options, symptoms can usually be managed.


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http://www.healthunlocked.com/thyroiduk


References

  1. NHS
    Polycystic Ovary Syndrome – Overview
    https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/
  2. info
    Polycystic Ovary Syndrome
    Dr Mary Harding
    https://patient.info/womens-health/polycystic-ovary-syndrome-leaflet
  3. NIH
    Polycystic Ovary Syndrome (PCOS)
    https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/symptoms
  4. Thyroid disorders and polycystic ovary syndrome: An emerging relationship
    Rajiv Singla, Yashdeep Gupta,1 Manju Khemani,2 and Sameer Aggarwal3
    Indian J Endocrinol Metab. 2015 Jan-Feb; 19(1): 25–29.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287775/
  5. NICE
    Polycystic Ovary Syndrome –
    Scenario: Management of polycystic ovary syndrome in adults
    https://cks.nice.org.uk/polycystic-ovary-syndrome#!scenario
  6. NHS
    Polycystic ovary syndrome – Treatment
    https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/
  7. Usefulness of intermittent clomiphene citrate treatment for women with polycystic ovarian syndrome that is resistant to standard clomiphene citrate treatment
    Akihisa Takasaki et al
    Reprod Med Biol v.17(4); 2018 Oct
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6194245/

 

Date updated: 20.01.22 (V1.3)
Review date: 25.03.22

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