Polycystic ovary syndrome

What is polycystic ovary syndrome?

It’s pretty common to have ‘polycystic ovaries’; about 20 per cent of women do. This means your ovaries contain lots of tiny cysts of about 8mm each. These cysts are the remains of follicles created each month which should contain an egg. But they haven’t developed properly because your hormone balance isn’t quite right.

Polycystic ovary syndrome is the name given to the 7% of women who also have other symptoms such as irregular periods (or none at all) and high levels of male hormones in their bodies.

PCOS is the leading cause of fertility problems in women – in fact, lots of women with mild symptoms only realise they have PCOS when they’ve tried and failed to get pregnant. Although it can’t be cured, the symptoms can be treated and most women go on to have a baby after some medical help and/or lifestyle changes.

How do I know if I’ve got it?

Not every woman gets every symptom, but here are the most common:

• Irregular periods, and sometimes none at all
• Fertility problems because you’re not ovulating (producing an egg) every month, if at all
• Hair growing on your face, or on your chest or back
• Hair loss from your head
• Being overweight or finding it difficult to lose weight
• Spots/acne on your face or very oily skin

How is it diagnosed?

If you have irregular periods and/or you’re struggling to conceive, see your GP, who will do  a blood test to measure your hormone levels and may order an ultrasound test to look at your ovaries and check for cysts.

You’ll normally be diagnosed with PCOS if you have two of these three symptoms:

• Irregular or infrequent periods.
• Blood tests show you have high levels of male hormones such as testosterone.
• The scan shows multiple cysts on your ovaries

What causes it?

No one really knows: genetics play a part as it tends to run in families. Women with PCOS also tend to have too much insulin in their blood, which throws your hormones off balance and causes irregular periods.

What can be done to help?

Polycystic ovary syndrome can’t be cured, but you can treat the individual symptoms – and the good news is that most women with PCOS can get pregnant with a little intervention.

Two thirds of women with PCOS are overweight or obese. If this is you, it’s a really good idea to lose some weight. Studies show weight loss of just 5% can significantly improve PCOS symptoms. 

The first-line treatment is usually a three or six-month course of clomifene, a drug that stimulates monthly ovulation in around 70% of the women who take it (not just those with PCOS). This may be given alongside metformin, a diabetes drug which can lower blood sugar levels/control insulin in women with PCOS. This would usually be under the supervision of a fertility clinic.

If that doesn’t work, your doctor might recommend surgery called laparoscopic ovarian drilling – which is actually fairly minor despite the alarming name. It’s keyhole surgery where the surgeon passes a thin tube called a laparoscope through your lower abdomen and uses a laser to destroy the tissue responsible for making male hormones. This may correct your hormone balance and could mean your ovaries start releasing eggs every month.

It doesn’t work for everyone, so the next thing to try is assisted fertility treatments like Intrauterine Insemination (IUI) or IVF. Your doctor will advise which is the best option for you.

If you’re not trying to get pregnant right now, but want to control your PCOS symptoms, you can take the contraceptive pill to regulate your periods. Some types of combined contraceptive pill can also control unwanted hair growth and/or hair loss, for example co-cyprindiol, Dianette, Marvelon and Yasmin.