What is polycystic ovary syndrome?

The exact causes of polycystic ovary syndrome (PCOS) are unknown, but it’s thought to affect one in 10 women of a childbearing age. It’s a very common health condition caused by an imbalance of reproductive hormones. This can be a problem for your ovaries, disrupting periods and causing fluid-filled follicles to appear around your eggs.

The wide-ranging symptoms usually appear when women are in their late teens and early twenties. Though there isn’t a cure for the condition, there are plenty of ways to make sure it doesn’t get in the way of you living your most confident life.

What are the causes and symptoms of polycystic ovary syndrome ?

The most common indicator that you might have polycystic ovaries is irregular or missed periods. Having fewer than eight periods a year, especially if they’re irregular, may mean there’s an imbalance of hormones in your ovaries. Luteinising hormone (LH) is what usually stimulates ovulation, but strangely an excess of it can have the opposite effect, preventing your period.

PCOS is closely associated with insulin production. Insulin is the hormone that regulates the amount of glucose in our bloodstream. Sometimes our bodies’ tissue can become resistant to it, requiring greater production to compensate for this. This extra insulin in our ovaries can cause them to over produce testosterone.

We usually associate testosterone with being a male hormone, but in fact all women produce a smaller amount of it in their bodies too. Testosterone can cause PCOS if we start to produce too much of it. The results of this can include an unusual distribution of hair across the body. For instance, hair on your head may begin thinning, while it grows thicker in other areas, such as on your face or chest. This extra hair growth is also known as ‘hirsutism’ and is one of the more obvious signs of PCOS.

Fertility, stress and menopause

Having fewer periods because of PCOS is one of the leading causes of infertility in women (many women don’t even realise they have it until they try to conceive). Fortunately this is very often treatable. Although sadly, women with the condition are more likely to miscarry and develop preeclampsia and gestational diabetes.

Stress is also thought to play a part in the condition. The same brain signals that trigger the stress hormone, cortisol, stimulate the hormones that are believed to overstimulate your ovaries. Women with PCOS also have higher levels of anxiety. This is often because of the uncomfortable symptoms. To break this cycle, make sure you’re getting enough sleep at night, reduce your caffeine intake and try to forge relaxing habits like meditation.

Most cases of PCOS appear in premenopausal women, but unfortunately that doesn’t mean that the menopause can cure it. You may still experience symptoms as your hormones change, and menopause may even occur later. Because perimenopause and PCOS are both related to hormone regulation, it can be sometimes difficult to diagnose the condition at this age. Many symptoms, such as missed periods and thinning hair, can be the same, so do visit your GP if you think you need more advice.

PCOS can run in families. If your mother, sisters or daughters experience similar symptoms, it may be more likely that you’ll have the condition. It’s important to know that there’s no singular gene to test for.

How to treat PCOS

There currently isn’t a known cure for PCOS, but there are many ways to manage symptoms. For women who may be overweight, losing just 5% of their weight can greatly reduce the symptoms and risks of the condition. However, with PCOS, that’s often easier said than done. Weight gain is both a symptom and a cause of the condition.

For irregular periods, you may often be prescribed the contraceptive pill or progesterone tablets to induce periods. There is also medication to encourage the monthly release of an egg for those who wish to get pregnant. While pregnancies may be more complicated for women with PCOS, lifestyle changes of diet and exercise can greatly improve your chances of conceiving. There are further options, like IVF, for those that this doesn’t work for. Fortunately, with some changes and help along the way, the majority of women with PCOS are able to become pregnant.

Unwanted hair can also be medicated against with prescriptions that block the effects of ‘male’ hormones, such as testosterone. Medicated creams are also available to slow down hair regrowth.

The impact of diet

Amending your diet can help ease the symptoms of PCOS, especially as poor eating is often thought to be responsible for the rising rates of the condition. Eating processed foods can contribute to inflammation within the body.  Carbs (especially refined sugars) wreak havoc with our insulin production. Aim for whole foods that are free from artificial preservatives, sugars and added hormones.

Try to balance unprocessed carbohydrates with good quality fats and plenty of protein to help with energy levels and insulin sensitivity. Mediterranean-style diets based on extra virgin olive oil, green leafy vegetables and oily fish have been shown to help fight inflammation in the body. This in turn can help fight the cycles of insulin production and weight gain.

Adding supplements to what we eat can help to combat inflammation too. Interestingly, both turmeric and liquorice root have anti-inflammatory properties and may also help insulin and hormone regulation. Trials suggest that liquorice root may offer some success specifically for PCOS.

As ever, your gut health will play a big role in your overall wellbeing too. Consider taking probiotic supplements or adding some of the ‘five K’s’ of kombucha, kefir, kraut, kimchi and kamut (sourdough) into your diet.

Regular exercise, especially low impact activities such as yoga,  Pilates and swimming, can help you to maintain a healthy weight and ease your symptoms.

How can I get a diagnosis?

If you think you have PCOS, it’s important to seek a diagnosis from your GP to avoid the long-term health implications.  PCOS cause conditions such as type 2 diabetes, high blood pressure and, in rare cases, endometrial cancer.

Doctors typically check three criteria – the first of which is noticing irregular or infrequent periods – and only two need to be present for a diagnosis. Your GP will also usually take a blood test to check for high levels of testosterone, but will take symptoms into account even if your blood test is normal. Finally, doctors may also decide to look at scans of your ovaries to check for follicles.

Ultrasounds aren’t always necessary if the condition can be confirmed by other symptoms.

The prevalence of the condition is increasing all over the world. While the condition can be uncomfortable, the right diagnosis and care can help you feel confident and healthy.


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