3 Signs You Could Have Polycystic Ovary Syndrome
25 August 2020
Maybe you’ve done a bit of reading about the symptoms and wondered if you might have Polycystic Ovary Syndrome (PCOS). In this post we’ll talk about what PCOS is, its symptoms and when you should see your doctor.
Do you have trouble with the following?
• irregular menstrual periods
• acne or
• excess hair growth on the face or body?
What is PCOS?
PCOS is a common cause of irregular menstrual periods and can be associated with acne, excess hair growth on the face or body, and hair thinning of the scalp even if the BMI is not raised. If you have PCOS you may have one or two or all of these symptoms and the severity of symptoms varies from person to person. The symptoms of PCOS usually start at puberty, although some women do not become symptomatic until they gain weight or become less active.
The name PCOS comes from the frequent findings of multiple small follicles in the ovaries, but its full underlying cause is not known. Levels of female hormones (oestrogens) may be normal, but excess male hormones (androgens) produced by the ovaries and fat tissue can contribute to acne, excess hair on the face or body and scalp hair thinning.
PCOS is also associated with mild insulin resistance. Insulin is the hormone responsible for drawing sugar out of the bloodstream and incorporating it into the body tissues. In PCOS, body tissues can become less responsive (or resistant) to insulin. In response, the body raises insulin levels in order to maintain normal blood sugar levels. The ovaries behave differently to other tissues, remain responsive to insulin and thus become over-stimulated affecting ovulation, frequency of periods, fertility and leading to the androgen-related symptoms described above.
Why is it important to be diagnosed if you have PCOS?
Over the long-term, insulin resistance and PCOS can be associated with a number of metabolic health risks particularly such as Type 2 Diabetes, cholesterol and high blood pressure. Thus if you are diagnosed with PCOS, your Endocrinologist will discuss lifestyle measures to minimise these risks.
Another health consequence is that infrequent periods in PCOS can be associated with thickening of the endometrium (uterine lining) which, if not treated, can lead to the build-up of abnormal cells. There are a range of treatment options available to manage period regularity and endometrial health.
Also, the irregular periods that can occur in PCOS reflect irregular ovulation which is important to address if you are trying to get pregnant. Your Endocrinologist will work with you to select the best treatment options depending on your combination of symptoms, plans for fertility and preferences.
What to do if you have any of three key symptoms of PCOS:
Irregular periods (either more or less frequent than one per month) can have different causes and should always be discussed with your doctor. If you have severe acne or severe hirsutism, even if you don’t have irregular periods, it is still a good idea to discuss these with your doctor as it possible that PCOS or another hormone imbalance could be contributing to these symptoms.
Polycystic Ovary Syndrome: What to Expect from the Diagnostic Process
If you have any of those symptoms listed above, it’s a good idea to see your GP. If your GP suspects PCOS, they may refer you to an Endocrinologist for further assessment and management.
How is PCOS Diagnosed?
PCOS is diagnosed by a careful discussion of your symptoms, examination, hormone blood tests and ultrasound of the pelvis. Ultrasound of the pelvis helps with the diagnosis of PCOS as well as checking thickness of the endometrium (the lining of the ovary). This is important because infrequent periods in PCOS can be associated with thickening of the endometrium which, if not treated, can lead to the build-up of abnormal cells. As PCOS can be associated with metabolic issues, some tests for cholesterol and glucose control are also included. Your GP may initiate some of these tests before referring you to an Endocrinologist.
Treatment Options in Polycystic Ovary Syndrome
PCOS is not curable but it is controllable and lifestyle management is key. With careful treatment and monitoring you have a good chance of avoiding many of the long term complications of PCOS and minimizing the symptoms.
If your GP or specialist is concerned that you have PCOS or another hormone disorder, they may refer you to see an Endocrinologist, or hormone specialist. Once a diagnosis of PCOS is established, you and your Endocrinologist will discuss different treatments and decide on a customised treatment regimen. This will be tailored to help with your particular combination of PCOS-related problems which may include irregular periods, excess hair on the face or body, acne, scalp hair thinning, fertility delay or need for contraception, and weight gain. The treatment approaches include lifestyle changes, oral medications, topical treatments and non-oral forms of contraception/menstrual period regulation.
Author of this blog: Sasha Nair
BSc (Hons, 1st class), BHB, MBChB, FRACP
After graduating from the University of Auckland and completing specialist endocrine training in Auckland in 2016, Sasha undertook a post-graduate fellowship in London at Homerton Hospital and University College of London Hospital.
Sasha has experience in general and reproductive endocrinology and with endocrine problems in pregnancy. Her areas of particular interest include PCOS (polycystic ovarian syndrome), disorders of sexual development, PMS, premature ovarian insufficiency and hypothalamic amenorrhoea.
Outside of clinical practice, Sasha’s other activities include medical research, writing, and coaching.
Clinics: Auckland – Remuera
Meet the team
If your GP or specialist is concerned that you have PCOS or another hormone disorder, they may refer you to see an Endocrinologist (hormone specialist).
We have 4 Endocrinologists at Fertility Associates and we would be happy to see you upon referral from your GP or specialist doctor. Virtual consults (via phone or video call) are available. You can read more about our Endocrinologist service here: https://fertilityassociates3-px.rtrk.co.nz/about-us/endocrinology/