Polycystic ovarian syndrome (PCOS) is a common endocrine (hormonal) condition affecting approximately 2.2-26% of women of reproductive age (1,2). Despite how common PCOS is, many people are unaware of what the condition actually is.
In this blog, you'll learn about:
Signs and symptoms of PCOS
Complications of PCOS
Causes of PCOS
PCOS diagnosis
Treatment options for PCOS
What are the signs and symptoms of PCOS?
PCOS is known as a syndrome, simply meaning multiple symptoms are experienced. Typically, the signs and symptoms of PCOS become more noticeable during late teenage years and early adulthood (3).
There are 3 main symptoms of PCOS, which include:
Irregular or absent periods
High levels of androgen hormones (It's normal for females to have androgens, but these are at a lower level than found in males)
Polycystic ovaries
Other symptoms and signs include:
Hirsutism (excessive growth of thicker and darker hair) on the face and body
Acne and oily skin
Hair loss on the head
Weight gain and difficulty losing weight
Difficulty getting pregnant
What are the complications of PCOS?
Whilst PCOS is an endocrine condition, it can have metabolic consequences in the body. Those with PCOS are at a greater risk of developing insulin resistance. This is suggested to be because high levels of androgens reduce sensitivity to insulin. Insulin is a hormone responsible for controlling blood sugar levels. It removes sugar from the bloodstream and moves it into body cells. However, some people with PCOS are less sensitive to their insulin. As a result, the body tries to compensate and produces more insulin in order to get the desired response. This is insulin resistance, and it's a risk factor for type 2 diabetes and metabolic syndrome.
PCOS can also impact fertility, such that some women may not ovulate regularly and may find it more difficult to conceive.
What causes PCOS?
The exact causes of PCOS are unknown, but genetics are suggested to play a role.
It's also thought that high insulin levels may cause a greater production of androgen hormones, such as testosterone (3).
How is PCOS diagnosed?
A diagnosis of PCOS is usually given if someone has at least 2 of the 3 main symptoms:
Irregular or absent periods
High levels of androgen hormones (confirmed through blood tests)
Polycystic ovaries (confirmed through ultrasounds)
How is PCOS treated?
Whilst there is no cure for PCOS, symptoms can be managed. It's important to speak to a qualified health professional, such as a GP, who can discuss appropriate management methods.
Medical approaches
A doctor may prescribe medications to target individual symptoms. Metformin may be prescribed to help improve insulin resistance. Contraceptive medication may be prescribed to help regulate periods. Other medications or options to manage symptoms such as hirsutism, acne or hair loss may also be discussed.
Dietary and lifestyle approaches
It's common for weight management to be mentioned in conversation when discussing PCOS management. It's suggested that losing just 5% body weight can have a significant impact on PCOS (4). Weight loss is suggested to improve insulin resistance, androgen levels and regularity of periods. However, those with PCOS often find it more difficult to lose weight. There may be a benefit of seeking support from a Registered (Associate) Nutritionist or Registered Dietitian. It can be tempting to follow diets that promise rapid weight loss. These diets are unsustainable and will likely cause weight regain, which isn't good for metabolic health. Support from a Registered (Associate) Nutritionist or Registered Dietitian will ensure weight loss is sustainable whilst meeting nutritional needs.
Whilst weight loss may be the desired approach for some, not everyone with PCOS either needs or wants to lose weight. Again, working with a Registered (Associate) Nutritionist or Registered Dietitian may be beneficial. They can advise on simple dietary changes to support PCOS and minimise metabolic complications, such as insulin resistance. Advice may include focusing on the balance of carbohydrates, proteins and fats in meals and snacks. Supplement recommendations may also be given depending on individual circumstances.
Health professionals may also discuss emotional wellbeing to see if additional support, such as counselling, cognitive behavioural therapy (CBT) or even medication is needed. The diagnosis and symptoms of PCOS can feel overwhelming, and can have a negative impact on mental health, including low self-esteem, depression and anxiety.
In summary
PCOS is a common endocrine condition that can cause physical symptoms such as irregular periods, hirsutism, acne and weight gain, as well as metabolic effects, such as insulin resistance. Seeking a diagnosis is crucial to ensure the appropriate support is provided to manage symptoms and overall health. Medication is available, but diet and lifestyle can also help to manage PCOS.