Polycystic ovary syndrome (PCOS) is a hormonal condition that affects how your ovaries work.
Usually, about five follicles start to mature during each menstrual cycle. At least one follicle releases a mature egg at ovulation. A polycystic ovary starts to mature at least twice as many follicles as normal, most of which enlarge and ripen but do not release an egg.
Just under a third of women have polycystic ovaries. Some women go on to develop PCOS, which means they have other symptoms as well.
PCOS happens when the hormonal system gets out of balance, making ovulation rare or irregular. PCOS affects about seven per cent of women of child-bearing age. It is more common in women of south Asian descent.
Genetics are involved, as PCOS tends to run in families. Having higher than normal levels of the hormone insulin in your body is linked to PCOS.
You may have higher levels of insulin because you’re overweight, which often goes hand in hand with PCOS. Or you may have higher levels because your body has become less sensitive to the effects of insulin for some reason. This causes your body to produce more insulin than usual to regulate sugar levels in your blood.
Extra insulin causes an imbalance in the hormones that help to make your menstrual cycle run smoothly. Too much luteinising hormone (LH) is produced compared with follicle-stimulating hormone (FSH).
This causes your follicles to produce more of the male hormone testosterone than the female hormone oestrogen. Other glands in your body also start to produce increased amounts of testosterone. Too much testosterone prevents ovulation.
Symptoms can vary from mild to severe and not all women have the same range of problems. If you have polycystic ovaries you may have:
Irregular or non-existent periods because you’re ovulating irregularly or not at all
problems getting pregnant
Extra hair growth on your face, chest and belly
Depression or mood swings
Thinning hair or hair loss on your head
Oily skin or acne
How to treat PCOS
PCOS cannot be cured but you can have help to cope with your symptoms. You may be able to control PCOS without medication.
If you are overweight, your first step will be to get advice from your doctor about healthy eating and exercise. Reaching and staying at a healthy BMI can help to balance your hormone levels and improve your symptoms. Exercise and a healthy diet can also help to smooth out the mood swings caused by PCOS.
Tell your doctor if you are trying for a baby. Treatment for the acne that sometimes comes with PCOS won’t be suitable for you, as it would harm your baby if you conceived. Other treatments will depend on how severe your symptoms are and whether you want to have children. You are likely to be referred to a gynaecologist or a doctor specialising in hormone disorders, called an endocrinologist.
But research is getting closer to more successful options like IVM and Letrozole (Femara).
Letrozole is a medication intended for treating early stage breast cancer and to keep the breast cancer from returning (source: WebMD). They found that Letrozole had a positive affect on ovulation and less side effects than it’s counter Clomid. Letrozole for PCOS infertility has increasingly been prescribed to PCOS patients since the early 2000’s. Letrozole has also been prescribed to patients suffering from Endometriosis (Source: WebMD)
Can I get pregnant with PCOS?
The fertility drug clomifene is usually the first step, as it can stimulate ovulation. If it doesn’t work then you may be offered gonadotrophins. However, Gonadotrophins are more likely to overstimulate your ovaries and cause you to have a multiple pregnancy.
If you are obese or resistant to clomifene, the diabetes drug metformin may help. It increases your body’s sensitivity to insulin so your insulin and your testosterone levels fall. This helps your body to ovulate normally. This is a controversial treatment as the benefits may not outweigh the risks. It has unpleasant side effects, such as nausea and vomiting, but may help if used in combination with clomifene.
Surgery on your ovaries. A technique called laparoscopic ovarian drilling (LOD) can help some women to conceive if clomifene hasn’t worked for them. LOD is an effective, lower risk alternative to gonadotrophins.
Pregnant with PCOS?
You’ll have extra care during your pregnancy. That’s because having PCOS increases your chances of weight-related pregnancy complications including: Gestational diabetes, High blood pressure, pre-eclampsia.
Sadly, your chances of experiencing miscarriage are higher too. Being a healthy weight when you conceive can reduce these risks.
Can I prevent PCOS?
You can’t prevent PCOS from developing. Finding out that you have it as soon as you can and making lifestyle changes are the best ways for you to control your symptoms. If you have PCOS and are overweight, you can even reverse your symptoms through weight loss.
So, if your periods are irregular or non-existent, see your doctor as soon as you can