Polycystic Ovary Syndrome (PCOS) Management
What is PCOS?

Polycystic ovary syndrome (PCOS) is a complex hormonal condition that can cause menstrual cycle disruptions, skin and hair changes and cysts on the ovaries. Simply having polycystic ovaries on an ultrasound does not mean that you have PCOS. PCOS can occur at any point in your reproductive lives – from puberty to menopause. It is one of the leading causes of infertility.causes of infertility.

Frequently asked questions about PCOS

Who gets PCOS?

PCOS affects between 12-21% of Australian women of reproductive age. However, it is estimated that up to 70% of women with PCOS are undiagnosed.

The causes of PCOS are not yet well understood. It is thought:

  • There is a genetic component – yet to be identified
  • That insulin resistance may be a risk factor.

The excess of insulin in the blood (hyperinsulinemia) is thought to then cause the other problems of PCOS.

What are the symptoms of PCOS?

PCOS can present differently in each woman. Common symptoms include:

  • absent or irregular periods
  • acne
  • difficulties falling pregnant and infertility
  • excess facial and/or body hair
  • excess weight and obesity
  • insulin resistance and diabetes
  • thinning of hair or baldness
How can I get tested for PCOS?

There is no definitive PCOS test and it takes many women years to receive a diagnosis. Some tests that may be conducted include:

Test of hormone levels – Blood tests to check hormones like –

  • testosterone
  • sex hormone binding globulin
  • thyroid hormones and
  • prolactin

Tests to see how your body handles glucose

  • blood cholesterol and glucose levels.
  • 2-hour glucose tolerance test

Ultrasound of the ovaries.

Transvaginal or internal ultrasound that is used to examine the uterus and ovaries.

For a PCOS diagnosis to be made, you must have 2 of the following:

  • Infrequent or missing periods
  • Clinical evidence of hyperandrogenism such as high testosterone levels in the blood or visibly increased body hair or ance
  • Polycystic ovaries on ultrasound
Can PCOS be cured?

PCOS cannot be cured and is a life-long condition. However, it can be ‘managed’. Without such management women are at an increased risk of developing endometrial cancer, cardiovascular disease, high blood pressure and diabetes. PCOS management is life-long and complex. The acute systems must be addressed, such as the chronic issue of insulin resistance.

What can I do about excess body hair (hirsutism)?

Excess body hair (hirsutism) can be treated with the combined oral contraceptive pill, Spironolactone or other anti-androgen medications. Some women prefer to choose cosmetic measures to remove excess hair such as shaving, waxing, laser removal or bleaching the hair.

How can I lose weight with PCOS?

Excess weight can be managed with lifestyle modifications of diet and exercise. Weight loss reduces the risk of long-term complications of PCOS such as developing diabetes. Women with PCOS, however, often struggle to lose weight due to their hormone imbalance.

Will I get diabetes if I have PCOS? How can I improve my blood glucose levels?

Women with PCOS may have impaired glucose tolerance which can develop into insulin resistance and eventually diabetes. Regular blood tests, including GTTs, will help track your blood glucose levels and how your body handles sugar over time. If you have insulin resistance you can take steps to reverse it. You will not necessarily develop diabetes if you take action. You may be prescribed Metformin (a diabetes drug) even if you do not have diabetes as a preventative measure to control your insulin levels. This can help with weight loss too. A healthy diet and exercise, particularly exercises that focus on strength training, can improve your glucose tolerance and prevent diabetes.

Can I make my periods regular if I have PCOS?

Irregular menstruation can be managed with progestogens or the oral contraceptive pill to regulate hormone levels. These hormones also reduce thickening of the lining of the womb which is a common symptom in PCOS. Hormonal treatments are not appropriate if the woman is trying to get pregnant. Weight loss can help some women regain their periods, as can the use of metformin.

I have PCOS – can I still have kids? Am I infertile?

Many women with PCOS have children. It may be harder for you to conceive. For women who are interested in falling pregnant they may be advised to lose 5-10 % of their body mass through lifestyle changes. If this does not restore ovulation(help your ovaries to make an egg) after 3-6 months, medications that induce ovulation may be prescribed. Some women will require IVF treatment to help them fall pregnant.