How to diagnose and treat PCOS

Living with Polycystic Ovary Syndrome

Polycystic Ovary Syndrome, also known as PCOS, is a common condition that affects the regular functioning of the ovaries - where the eggs are produced and stored in a woman’s body.

PCOS is caused by a higher than normal level of male hormones called androgens being produced by the ovaries. This high level of androgens leads to the eggs not developing properly or being released fully from the ovaries which causes small fluid filled sacs known as cysts to form in the ovaries.

Although these cysts are not harmful, they are benign and non-cancerous, PCOS can lead to irregular periods, and fertility problems as well as a range of other concerns which may impact a woman’s life and her confidence.

There are a number of ways of managing PCOS symptoms, although it is not completely curable. We are going to look at the common signs of PCOS, how it is diagnosed and how you can manage it.

What are the first signs of PCOS?

PCOS has a range of signs and symptoms. It is important to remember that not everyone who has polycystic ovaries will experience all of these symptoms and speaking to a qualified doctor who will give you a full assessment is the only way to get a definite diagnosis. Each symptom can also vary in severity from mild to severe and PCOS symptoms will look slightly different in everyone.

The most common signs of PCOS are:

Irregular periods or no periods at all - this is a sign of irregular or no ovulation and can therefore lead to difficulties in getting pregnant.
Excessive hair growth (also known as hirsutism) - in particular on the face, chest, back or buttocks. More than 70% of women with PCOS experience excess hair growth
Weight gain - especially around the stomach. Around 80% of women with PCOS find they gain weight which they struggle to lose.
Thinning hair or hair loss from the head - Excess androgen production causes pattern baldness.
Oily skin and acne - Hormonal imbalance can cause the skin to produce more oil than normal which can lead to blocked pores and acne.

In most cases, PCOS develops around the time of a girl’s first period. But it can also develop later in your 20s or 30s. Many women don’t discover they have it until they are having trouble getting pregnant.

Although women with PCOS may have difficulties in getting pregnant, and also have a higher risk of experiencing miscarriage, this is often treatable and your doctor will be able to prescribe medication to help you to conceive. Very few women with PCOS are unable to conceive at all.

How common is PCOS?

It is difficult to know exactly how many women have PCOS as many women don’t discuss the symptoms with their doctor until they are having trouble conceiving or are worried about sudden weight gain. It is estimated that up to 10% of women in the UK may have PCOS - with over 50% not experiencing any significant symptoms. Internationally, the overall figure is slightly lower, the World Health Organisation suggests that around 3.4% of women globally have PCOS.

PCOS is very common and you should not delay in speaking to a doctor specialising in women’s health if you have any concerns.

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How to diagnose PCOS

PCOS should be diagnosed by a doctor specialising in women’s health, who will be able to give you a full assessment, factoring in any symptoms you are experiencing.

Your doctor will likely suggest a series of tests, including a trans vaginal ultrasound scan to show any cysts on your ovaries, blood tests to analyse your hormone levels and look for any other markers such as high cholesterol or high blood sugar, they will also complete a pelvic exam to assess the health of your reproductive organs.

Through these tests, your doctor will be looking for these key indicators:

Irregular periods
High androgen levels
Cysts in your ovaries

Typically doctors diagnose PCOS in anyone that has two of these three symptoms, unless there is another obvious cause.

At Cadogan Clinic, our Women’s Wellness Clinic can help you by booking you in for an appointment with a consultant gynaecologist, carrying out all of your tests and providing your medical letters and results so you can understand and take control of your reproductive health.

Is PCOS genetic?

Although specific genes connected to polycystic ovary syndrome haven’t been identified, there is strong evidence that PCOS may be a genetic condition. If you have a direct relation (such as your mother, sister, grandmother or aunt) who has PCOS, you are more likely to have it as well. This also means you may be more likely to pass it on to your children as well.

Although PCOS can be passed on through genes, it is not contagious and you cannot spread it to other people, through contact.

Can you have 'flare ups' of symptoms?

Some women find that their PCOS symptoms can worsen during high stress, or with a poor diet or lack of exercise. It is important to make sure you understand what can make your PCOS symptoms worse and control this through your lifestyle choices.

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Do you need regular check ups with PCOS?

Your doctor will likely want to see you for a check up once a year if you have PCOS. This will be to monitor the health of your ovaries and to make sure your symptoms aren’t getting worse. They will also be able to help you manage any lifestyle factors which are contributing to your polycystic ovaries and offer support to prevent flare ups.

If you are experiencing problems with your weight, they may also recommend doing an annual diabetes screening to ensure your PCOS isn’t impacting other areas of your health.

How to cure PCOS permanently

Unfortunately, it is not possible to cure PCOS completely. As it is caused by a hormonal imbalance which cannot be permanently reversed. However, by managing your lifestyle and making sure your doctor is aware of any changes in your symptoms over time, it is possible to dramatically improve polycystic ovary syndrome.

Your doctor may recommend medication such as the contraceptive pill which will help to regulate your periods. If you are trying to conceive, they may prescribe clomifene which encourages an egg to be released from the ovaries every month, making the chances of getting pregnant higher. Your doctor may also prescribe metformin which lowers insulin and blood sugar levels which can also be heightened in women with polycystic ovaries.

Lifestyle changes to help manage your PCOS symptoms

If you have PCOS, it is important to manage your lifestyle to prevent uncomfortable flare-ups and to maintain your reproductive health. The key things to maintain are

A healthy diet, with a good range of fruit and vegetables - this will help to control your insulin, blood sugar and cholesterol levels which can all be influenced by PCOS
Exercise - this will help to manage any weight gain you may experience. Although many people with PCOS struggle to lose weight easily, regular exercise will help to control your weight.

By keeping a healthy diet and exercising regularly, you will help to prevent your symptoms from flaring up making your PCOS easier to manage. This is especially important, if you are trying to get pregnant.

PCOS is a very common, although under diagnosed condition which affects the ovaries. It can cause uncomfortable and undesirable symptoms such as weight gain and hair loss and make getting pregnant more difficult. If you are concerned about your reproductive health, or think you may have polycystic ovary syndrome, book in to our Women’s Wellness Clinic to get the support you’re looking for from a consultant gynaecologist.

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