Polycystic ovary syndrome (PCOS)

What is polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) affects how your ovaries work. It's caused by a hormonal imbalance that can affect your periods and make it harder to get pregnant. The small sacs in your ovaries that hold eggs (follicles) might not develop or release an egg each month, so you might not ovulate regularly.

It’s common in women and girls with:

• high levels of insulin, a hormone that helps your body use energy (glucose)
• high levels of male type hormones (androgens) such as testosterone
• obesity and diabetes.

Read more about the possible causes of PCOS on the healthdirect website.

Signs and symptoms

Common symptoms include:

• heavy, missing or irregular periods, or no period
• excess hair on your sideburn area, upper lip, chin, neck, chest, nipples, tummy and thighs (hirsutism)
• hair loss, thin hair on top of your head, or a receding hairline (alopecia)
• acne, skin problems and breast cysts
• mood problems, stress, anxiety and depression
• weight gain and low energy.

Symptoms can improve as your hormone levels change in the years leading up to menopause. But many women still get acne and excess hair growth afterward.

You could still have PCOS if:

• you don’t have any symptoms
• you get normal periods
• you’ve been through menopause.

Without treatment, PCOS can lead to long term health problems like type 2 diabetes, high blood pressure and heart disease.

Read more about polycystic ovary syndrome on the healthdirect website.

When to get help

It’s important to get help early. See your GP if you have any common symptoms, or if you’ve been trying to get pregnant for more than 12 months.

Before your appointment

Your GP will ask about your symptoms, how long you’ve had them, and how they affect you. It’s important to give them as much information as possible.

Before your appointment, write down:

• which symptoms bother you the most – you may not have time to explain all your symptoms
• how often you get your period
• how much you bleed, including how often you change your tampon, pad, cup or disc
• when you have pain, what it feels like and where in your body it is
• how intense the pain is each time – give it a score out of 10
• any changes in your weight, appearance or mental health.

Words you can use to describe your pain include:

• stabbing
• burning
• dull
• aching
• sharp
• constant
• throbbing
• shooting
• cramping.

If you’re trying to have a baby, tell your GP how long you’ve been trying and how often you have sex.

Let them know about any:

• medicines or supplements you’re taking
• past pregnancy issues or surgeries
• lifestyle choices or medical conditions that could make it harder to get pregnant, for example – smoking and drinking.

Diagnosis

To help find out what's happening, your GP might do:

• a pelvic exam, where they check inside your vulva, vagina and cervix
• blood tests to measure your hormone levels
• medical imaging tests like ultrasound and MRI, to check your ovaries and womb (uterus).

If you've had your period less than 8 years, they'll rely more on physical symptoms such as acne and facial hair, and how long you've had irregular periods. Because ovaries normally look polycystic during and after puberty, they won't do an ultrasound as part of your diagnosis.

You might need to see a specialist and have more tests to confirm your diagnosis.

Talk to your GP if you don’t agree with your diagnosis. If you need more help, see another GP for a second opinion.

Treatment

Your treatment will depend on your age, symptoms and whether you want to get pregnant.

It might include:

• diet and lifestyle changes
• counselling and therapy to manage stress, anxiety and depression
• medicine to manage your hormones, fertility, weight, skin, hair and mood
• minor surgery to help with ovulation and getting pregnant (laparoscopic drilling)
• fertility treatments.

Your GP or a dermatologist can recommend products and treatments for hair growth, hair loss and acne.

Care at home

You may be able to improve PCOS symptoms through diet and lifestyle changes.

It can help to:

• maintain a healthy weight
• stay active and get regular exercise
• get healthy sleep and reduce stress
• eat a healthy diet that includes fresh fruit and vegetables
• avoid smoking, drinking, caffeine and refined foods that are high in carbohydrate
• try therapies such as acupuncture, naturopathy and herbal medicine.

Many women manage skin and hair symptoms with:

• waxing, laser hair removal and electrolysis to reduce hair growth
• products that help you regrow lost hair, like Rogaine® (Minoxidil)
• acne creams and gels that unblock pores and stop oil, bacteria, redness and swelling.

You can also take paracetamol and ibuprofen or use a TENS machine for period pain.

Having a baby

Most women with PCOS can have healthy babies if they get the right treatment. It could take up to a year to get pregnant if your ovaries are releasing eggs. If you’re not ovulating, it may take longer.

Your GP can give you advice and refer you for fertility help if you need it.