What is Polycystic Ovarian Syndrome?
PCOS stands for Polycystic Ovarian Syndrome, which is a condition from which women suffer a variety of symptoms related to reproductive hormonal imbalances.
If you suffer from PCOS it means that you have a higher number of healthy but underdeveloped follicles in your ovaries. Because of these hormonal imbalances, egg development does not progress as with a typical menstrual cycle, as there is no lead egg maturing for release at the time of ovulation. The underdeveloped follicles are referred to as polycystic or ‘cysts’.
Symptoms of PCOS
The initial signs and symptoms of PCOS can be apparent in your mid-late teens as you go through puberty, but not all women will have the exact same symptoms and many do not experience all of them.
It likely that you will have been diagnosed with PCOS if you suffer irregular periods, prolonged periods or no periods at all. If the androgens (male hormones) in your body are imbalanced, you may also suffer from hirsutism, which can cause excessive hair growth on the face, neck, chest, back and buttocks. You may also experience weight gain, thinning hair, oily skin or acne and subsequently, you may find that you have difficulty conceiving when trying to start a family.
What causes PCOS?
The exact cause of PCOS is unknown, but it is thought to be linked to abnormal reproductive hormone levels. There may also be a genetic link to developing PCOS as it has been known to run in families. Therefore, your risk of developing PCOS may be increased if your female relatives (mother, aunt or sister) have been diagnosed.
Women with PCOS are found to have an imbalance in certain hormones, which can include:
- Higher levels of LH (Luteinising Hormone) – LH is made in the pituitary gland. If your LH levels are already high, there will be no LH surge during your menstrual cycle. Without this LH surge, ovulation cannot occur (no egg can be released) and this can appear to make your periods irregular or non-existent. Unfortunately, when your LH levels are too high – this can also cause your ovaries to produce higher levels of testosterone leading to hirsutism (excess hair growth).
- High Insulin – when your insulin blood levels are higher than normal, this can lead to weight gain and the possibility of developing diabetes (due to insulin resistance). It will also cause your ovaries to produce more testosterone and suppress FSH hormone production. Women need a 'normal' ratio of FSH:LH hormones for their ovaries to function within a menstrual cycle. Because high insulin can cause elevated levels of LH and also suppress the production of FSH, this means that there will be no eggs maturing in the follicles of your ovaries and no release of an egg within your cycle.
- Women with PCOS also have a higher risk of developing diabetes so your healthcare consultant may request you have annual tests to monitor your blood sugar levels.
- Higher levels of testosterone – often referred to as a male hormone, every woman has a level of testosterone in her body. When these levels become excessive, this can lead to problems with her reproductive system and can play havoc with menstrual cycles and ovulation. Excess levels can also cause hirsutism, acne and hair loss.
- Raised levels of prolactin – Prolactin is a hormone generated in your pituitary gland, located just below your brain. When your prolactin levels are high, they can prevent ovulation from occurring and your periods become irregular or disappear.
- Lower levels of SHBG – The SHBG (sex hormone-binding globulin) acts to bind excess testosterone to prevent it from causing problems. Therefore this means that having low levels of SHBG, can lead to increased testosterone levels. Reduced SHBG can also be caused by high insulin.
Your healthcare consultant will need to review your medical history and will ask you some questions about your symptoms to enable them to rule out other possible causes. Remember that infrequent or irregular periods can indicate that your ovaries don’t regularly release eggs.
You may need to undertake a range of hormone tests (blood tests) to find out whether the imbalance is caused by PCOS, other hormone-related conditions or indicates diabetes and high cholesterol.
A scan can indicate whether you have a high number of follicles in your ovaries which would mean that they are polycystic.
Unfortunately, there is no cure for PCOS but the symptoms can be managed with a change in lifestyle, which may include weight management, eating a healthy, balanced diet of fruit and vegetables, wholemeal bread, cereals and rice and lean meats, chicken and fish. Regular exercise is an important part of weight control.