Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome can effect fertility for women
Polycystic ovary syndrome can effect fertility for women

Polycystic ovary syndrome is a condition that can affect a woman’s ability to produce eggs. PCOS is linked with higher levels of circulating insulin, which is characteristic in type 2 diabetes.

A UK study in 2012 showed that the risk of type 2 diabetes for women with PCOS was notably higher.

What is polycystic ovary syndrome?

PCOS is a condition that affects women’s ovaries causing an abnormal number of cysts to appear on the surface of the ovaries.

The cysts are follicles which contain undeveloped eggs. The cysts are follicles which contain undeveloped eggs. The condition often results in an irregular release of eggs. In some women, PCOS may prevent any eggs being released.

Having a higher than normal level, or activity, of male hormones is also a relatively common feature of PCOS.

PCOS is a treatable condition and a healthy lifestyle is a key part of this.

What are the symptoms of PCOS?

The symptoms of PCOS may include one or more of the following:

  • Irregular or loss of periods
  • Fertility problems
  • Weight gain
  • Hirsutism (excessive hair growth)
  • Thinning of or loss of hair
  • Acne

How common is polycystic ovary syndrome?

Diabetes UK states that PCOS is a common condition affecting about 1 in 5 women at some point in their lives.

How is PCOS diagnosed?

The NHS states that the appearance of two or more of following three conditions can lead to a diagnosis of PCOS:

  • A number of cysts developing around the edge of the ovaries (polycystic ovaries)
  • Failure in ovulation (release of eggs)
  • A higher than normal levels of male hormones or more active male hormones than normal

A diagnosis of PCOS will typically involve a number of tests which may include blood tests, blood pressure checks and ultrasound scans.

NICE guidelines recommend that all women with PCOS receive a screening to assess their risk of type 2 diabetes.

Yearly screening is recommended for: [353]

  • Women with a family history of type 2 diabetes
  • If obese – BMI of 30 kg/m2 or more (25 kg/m2 or more if of Asian background)
  • If gestational diabetes has occurred

What causes PCOS?

Insulin resistance and weight gain are two contributing factors to PCOS. Insulin resistance typically causes the body to produce more insulin than normal (hyperinsulinemia). Higher levels of insulin can then cause ovaries to produce too much testosterone which can impair normal ovulation from occurring.

Increased levels of insulin can also cause weight gain which is typically associated with the development of both type 2 diabetes and PCOS.

Despite being generally regarded as a male hormone, all women produce testosterone, albeit in lower quantities than men.

Treatment for PCOS

Treatments for PCOS can vary. Lifestyle changes will be recommended, particularly in overweight patients. Lifestyle changes help with reducing insulin levels and improving symptoms such as weight gain, hair growth and acne.

Medication may also be prescribed to help with different symptoms.

The type 2 diabetes medication Metformin may be prescribed for some women but only if recommended by a specialist.

Specific contractive pills or anti-androgen drugs may be advised if hormones are not correctly balanced.

Treatment for infertility from PCOS

A low carbohydrate lifestyle is effective for reducing insulin levels. This helps with weight loss and is likely to have additional benefits on other symptoms of PCOS.

A research study, from 2013, compared a moderately low carb diet with a standard low fat diet. The results showed that the low carb diet conclusively improved insulin, cholesterol and testosterone levels compared with the low fat diet. [354]

Treatment for infertility from PCOS

Fertility problems can also be treated by the following means:

  • Clomifene is a fertility medication that can help to induce ovulation.
  • Laparoscopic ovarian drilling (LOD) is a surgical procedure that can restore ovulation
  • In vitro fertilisation (IVF) may be required if the above are not successful or not appropriate
Explore Polycystic Ovary Syndrome