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Poly Cystic Ovarian Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) affects 12-18% of women of reproductive age and up to 21% in some high-risk groups, such as Indigenous women. Almost 70 per cent of these cases remain undiagnosed.

The word Polycystic is a misnomer as it literally means ‘many cysts’ but in this condition, they are not cysts but partially formed follicles with eggs in them that may not ovulate. Insulin resistance is commonly seen in PCOS patients and there is also increased likelihood (50 %) of developing PCOS if you have a mother, aunt or sister with PCOS.

PCOS can be a complex condition to identify due to its varied symptoms and presentation.

  • irregular menstrual cycles – periods are prolonged and irregular
  • amenorrhoea (no periods) – some women may not have periods for months or years
  • excessive facial or body hair growth -Hirsutism
  • acne
  • scalp hair loss- male pattern baldness
  • Infertility -due to lack of ovulation
  • mood changes – including anxiety and depression
  • obesity-difficulty in losing weight

Diagnosis of PCOS involves your medical history, examination, blood tests and pelvic Ultrasound

To be diagnosed with PCOS, you need to have two out of three of the following:

  • oligo/anovulation
  • hyperandrogenism
  • clinical (hirsutism or less commonly male pattern alopecia) or
  • biochemical (raised FAI or free testosterone)
  • polycystic ovaries on ultrasound

Long-term health risks of PCOS include

  • insulin resistance and increased risk of type 2 Diabetes especially if overweight
  • cholesterol and triglyceride abnormalities
  • cardiovascular disease including heart attack and stroke
  • endometrial cancer may also occur due to prolonged amenorrhea and thickening of
  • the endometrium.

Treatment of PCOS

PCOS is a long-term condition and management depends on your specific symptoms and also to prevent long term associated conditions.

  • lifestyle modifications – eating a healthy low carb diet, and exercise are important
  • lose weight if overweight – even 5-10% of weight loss helps
  • medical treatment – with hormones or medications.

Losing weight helps to improve symptoms such as acne, mood changes, excessive hair and also helps to reduce your risk of developing type 2 diabetes and cardiovascular disease.

Medical treatments for PCOS treatments include:

  • the oral contraceptive pill.
  • insulin sensitizing medications – helps with weight loss and insulin resistance and also to regulate menstrual cycles and may induce ovulation and therefore fertility.
  • Medication to block hormones such as testosterone – these may be used to reduce excess hair growth or scalp hair loss
  • ovulation induction -if infertility is an issue.
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