PCOS: treatment & management | Sydney gynaecologist Dr Mahadik

PCOS

PCOS | Dr Anu Mahadik | Gynaecologist Sydney

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.

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

PCOS test | Dr Anu Mahadik | Gynaecologist Sydney

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 acne
  • Polycystic ovaries on ultrasound
PCOS: treatment & management | Sydney gynae Dr Mahadik

PCOS | Dr Anu Mahadik | Gynaecologist Sydney

Frequently Asked Questions about PCOS

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.
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.
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.
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.
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.
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.

Sydney Obstetrician Norwest and St George Private Hospitals

Consulting in Westmead and Kogarah

My consulting rooms are in Westmead. If you are preparing for your antenatal care and looking for the best and most suitable solution, you can count on my practice to help you. 

If you live in the Sydney CBD, or south of Sydney, you may be best served by coming to my rooms in Kogarah, at St George Private Hospital Medical Suites.

I am affiliated with Norwest Private Hospital, St George Private Hospital and Westmead Private Hospital. 

Westmead Private Hospital welcomes over 2,300 babies into the world each year. They demonstrate a leading and innovative approach to outcome-focused care for women and their families prior to, during and after childbirth.
New parents will enjoy the modern conveniences and perks of a luxury hotel when they experience Westmead Private Hospital’s maternity unit, which has a strong emphasis on assisting new families in the journey of parenthood, with comprehensive postnatal education provided by their maternity team.
They have the unique advantage of being co-located with both Westmead Hospital and Westmead Children’s Hospital. This allows us to provide our patients with the highest standard of private care whilst having access to tertiary level care facilities if required (*access to Neonatal Intensive Care at Westmead Hospital and Westmead Children’s Hospital is dependent on bed availability).

The Maternity Unit comprises:

  • 8 birthing suites
  • 46 bed antenatal/ post natal unit
  • 14 cot Special Care Nursery
  • 8 spacious Parenting Suites (additional costs apply)
  • Women’s only Infant Feeding Support Centre supported by experienced clinicians
  • Education Centre
  • Bathing Centre
  • Rooftop garden for the whole family to enjoy
  • All private rooms with ensuite

Guaranteed Private Room
Westmead Private Hospital is pleased to offer all of our maternity patients the guarantee of a private room following the birth of their baby.  One support person is welcome to stay free of charge.

More information on the maternity services at Westmead Private Hospital.

I come from a family of doctors and it has always been my intuitive first choice to become an Obstetrician and Gynaecologist. I basically grew up in it, with my father being one of the co-founders of a series of IVF clinics in India. Care for mothers and the babies they are expecting has always been my first nature and I am grateful for being able to serve my patients in their journey.
So if you are in that phase where you are not sure how to choose a private obstetrician in Sydney, let’s have a chat so we can plan your antenatal care together.

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