Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal disorders affecting women of reproductive age.

What is Polycystic Ovary Syndrome (PCOS)?

PCOS is a condition characterised by an imbalance in reproductive hormones, leading to various symptoms and potential complications. Women with PCOS often have higher levels of androgens (male hormones) and may experience irregular menstrual cycles, ovarian cysts, and issues with fertility. The exact cause of PCOS is not fully understood, but it is believed to involve a combination of genetic and environmental factors.

Symptoms of PCOS

The symptoms of PCOS can vary widely among women and may develop gradually. Common signs and symptoms include:

1. Irregular Periods
   • Women with PCOS often experience irregular menstrual cycles, including infrequent, prolonged, or absent periods. This is due to irregular ovulation or anovulation (absence of ovulation).
2. Excess Androgen Levels
   • Elevated levels of androgens can lead to physical signs such as hirsutism (excessive hair growth on the face and body), acne, and male-pattern baldness.
3. Polycystic Ovaries
   • The ovaries may become enlarged and contain multiple small cysts, which are fluid-filled sacs. These cysts can be detected through ultrasound imaging, and may cause discomfort in the lower abdominal region.
4. Weight Gain
   • Many women with PCOS struggle with weight gain or difficulty losing weight, often related to insulin resistance.
5. Insulin Resistance
   • Insulin resistance is a common feature of PCOS, leading to higher levels of insulin in the blood and an increased risk of developing type 2 diabetes.
6. Fertility Issues
   • PCOS can interfere with ovulation, making it more difficult for women to conceive. It is a leading cause of infertility.
7. Mood Changes
   • Some women with PCOS may experience mood swings, depression, or anxiety, possibly linked to hormonal imbalances.

Diagnosing PCOS

Diagnosing PCOS involves a combination of medical history, physical examination, and specific tests. Healthcare providers follow certain criteria to diagnose PCOS, commonly the Rotterdam criteria, which require the presence of at least two of the following three features:

1. Irregular or Absent Menstrual Cycles
   • A history of irregular or absent periods is a key indicator of PCOS.
2. Hyperandrogenism
   • Clinical signs (such as hirsutism or acne) or elevated androgen levels detected through blood tests.
3. Polycystic Ovaries
   • The presence of multiple small cysts in the ovaries, typically identified through ultrasound imaging.

Additional Tests

To rule out other conditions and confirm a PCOS diagnosis, healthcare providers may also perform the following tests:

1. Blood Tests
   • Blood tests to measure hormone levels, including androgens, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and insulin levels.
2. Pelvic Ultrasound
   • An ultrasound to visualize the ovaries and check for the presence of cysts.
3. Glucose Tolerance Test
   • A test to assess insulin resistance and the risk of type 2 diabetes.
4. Lipid Profile
   • A blood test to check cholesterol and triglyceride levels, as women with PCOS often have an increased risk of cardiovascular issues.

Treatment Options for PCOS

While there is no cure for PCOS, various treatment options are available to manage its symptoms and improve overall health. Treatment plans are tailored to individual needs and may include lifestyle changes, medication, and other interventions.

1. Lifestyle Modifications
   • Diet: Adopting a healthy diet rich in whole grains, lean proteins, and plenty of fruits and vegetables can help manage weight and improve insulin sensitivity.
   • Exercise: Regular physical activity, such as brisk walking, jogging, or strength training, can aid in weight management and reduce insulin resistance.
   • Weight Management: Achieving and maintaining a healthy weight can regulate menstrual cycles and improve overall health.
2. Medications
   • Birth Control Pills: Oral contraceptives can regulate menstrual cycles, reduce androgen levels, and alleviate symptoms such as acne and excessive hair growth.
   • Anti-Androgens: Medications like spironolactone can block the effects of androgens and reduce symptoms like hirsutism and acne.
   • Metformin: This medication, commonly used to treat type 2 diabetes, can improve insulin sensitivity and regulate menstrual cycles in women with PCOS.
   • Fertility Treatments: For women struggling with infertility, medications such as clomiphene citrate (Clomid) or letrozole can stimulate ovulation. In some cases, assisted reproductive technologies like in vitro fertilization (IVF) may be recommended.
3. Managing Insulin Resistance
   • Diet and Exercise: Lifestyle changes that promote weight loss and improve insulin sensitivity are essential for managing insulin resistance.
   • Medications: Metformin is often prescribed to improve insulin sensitivity and reduce the risk of type 2 diabetes.
4. Addressing Mental Health
   • Counseling and Therapy: Mental health support through counseling or therapy can help manage the emotional impact of PCOS, including anxiety and depression.
   • Support Groups: Joining support groups can provide a sense of community and shared experiences for women with PCOS.

Long-Term Health Considerations

Women with PCOS are at a higher risk for several long-term health issues, including:

1. Type 2 Diabetes
   • Insulin resistance associated with PCOS increases the risk of developing type 2 diabetes. Regular monitoring of blood glucose levels and maintaining a healthy lifestyle are crucial.
2. Cardiovascular Disease
   • Elevated cholesterol levels, high blood pressure, and insulin resistance contribute to an increased risk of cardiovascular disease. Adopting heart-healthy habits is essential.
3. Endometrial Cancer
   • Irregular or absent menstrual cycles can lead to the thickening of the uterine lining, increasing the risk of endometrial cancer. Regular monitoring and managing menstrual cycles with medication can reduce this risk.
4. Sleep Apnea
   • Women with PCOS are more likely to experience sleep apnea, a condition characterized by interrupted breathing during sleep. Weight management and medical treatment can help manage this condition.

Conclusion

Understanding Polycystic Ovary Syndrome (PCOS) is the first step toward managing its symptoms and improving overall health. Regular check-ups, a healthy lifestyle, and tailored medical treatments can significantly enhance the quality of life for women with PCOS. By staying informed and proactive, women can take control of their health and navigate the challenges of PCOS with confidence.

If you have any questions or concerns about PCOS or your reproductive health, Dr. Li and her team are here to provide compassionate and comprehensive care. Schedule your appointment today by calling 3219 6868 and take the first step towards managing your PCOS.

Dr Sharon Xian Li (MED0001402739)

Registered Medical Practitioner, Obstetrician and Gynaecologist

Bachelor of Medicine and a Bachelor of Surgery (MBBS)

Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists