Polycystic ovarian syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a common hormonal disorder found in women that can cause infertility.

PCOS occurs when a woman’s levels of the sex hormones oestrogen and progesterone are out of balance. This causes the growth of ovarian cysts, which can lead to hormonal imbalances.

Other features of PCOS include having high levels of male hormones called androgens in your body, and the fact that you do not ovulate (your ovaries do not regularly release eggs) so you may struggle to fall pregnant.

The exact cause of PCOS is unknown, but research suggests that factors include a genetic link, possible abnormal foetal development and the presence of inflammation.

The condition is associated with abnormal hormone levels in the body, including having high levels of insulin — the hormone controlling sugar levels in the body.

What are its symptoms?

Symptoms of PCOS develop gradually, often starting in the early teens, after the first menstrual period. Symptoms may be especially noticeable after weight gain.

Signs can include:

  • Irregular periods
  • No periods
  • Difficulty falling pregnant
  • Excessive hair growth on the face, chest, back or buttocks
  • Weight gain
  • Hair loss from the head
  • Oily skin or acne
  • Insulin resistance and too much insulin
  • Depression or mood swings
  • Breathing problems while sleeping.

PCOS is associated with an increased risk of problems in later life, such as type 2 diabetes and high cholesterol levels.
Consult your doctor if you have severe vaginal bleeding, are struggling to fall pregnant, have diabetes symptoms or suffer from depression or mood swings.

How is it diagnosed?

There is no single PCOS test. A PCOS diagnosis is usually made on the basis of the symptoms meeting several criteria. Your doctor will talk to you about your medical history, do a physical exam, and run some tests.
The physical exam includes a check of your thyroid gland, skin, hair, breasts and belly. You will have a blood pressure check and a pelvic exam to find out if you have enlarged or abnormal ovaries.
You may have a pelvic ultrasound, which might show enlarged ovaries with small cysts. These are signs of PCOS, but many women with PCOS don't have these signs.
You may have blood tests to check for:

  • Human chorionic gonadotropin (hCG), to find out if you are pregnant
  • Testosterone
  • Prolactin, which can play a part in a lack of menstrual cycles or infertility
  • Cholesterol and triglycerides, which can be at unhealthy levels with PCOS.

What are your treatment options?

While a PCOS cure does not exist, it can be managed. Depending on the severity of symptoms, treatment methods include lifestyle changes (weight loss through healthy diet and exercise) and medication to address fertility problems and irregular or absent periods (such as the pill), unwanted hair growth, acne and high cholesterol.

There is also a minor surgery option called laparoscopic ovarian drilling (LOD), which may be a treatment method for fertility problems. Under general anaesthetic, your doctor will make a small cut in your lower abdomen and pass a long, thin microscope called a laparoscope into your abdomen. The ovaries are then surgically treated using heat or a laser to destroy the tissue that’s producing androgens.

Can it be prevented?

PCOS cannot be prevented but early diagnosis and treatment helps prevent long-term complications, such as infertility, metabolic syndrome, obesity, diabetes, and heart disease.

Lifestyle changes include following a healthy diet, regular exercise, weight loss if you are overweight or obese, and not smoking.

For more info
Infertility Awareness Association of South Africa

The accuracy of this information was checked and approved by physician Dr Thomas Blake in May 2015