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Polycystic ovary syndrome (PCOS)

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PCO stands for polycystic ovaries and is a term for the appearance of the ovary on an ultrasound scan, where there are many small follicles in the ovaries. The follicles lie in a row of pearls at the outer edge of the ovary. Women with PCO may not have significant symptoms. In fact, many women live their whole lives without noticing. The typical picture of PCO is often that the follicles start to grow, but at an early stage in the menstrual cycle, they stop and ovulation fails.

However, some women with PCO do have a normal ovulation from time to time, so there is a chance of conceiving naturally.

The difference between PCO and PCOS


PCO is diagnosed by ultrasound. PCOS stands for polycystic ovary syndrome and means that in addition to having the characteristic polycystic ovaries, you also have signs of:    

  • Increased levels of male sex hormone and/or  

  • Tendency to increased hair growth (hirsutism), i.e. facial hair growth and/or increased body hair, while the hair on the head may become thinner  

  • A tendency to blemished skin (acne) 

  • Infrequent or absent ovulations i.e. irregular often long cycles > 35 days   


The extent of skin and hair problems depends on the sensitivity of each woman to male sex hormones. 

What causes PCO(S)?


Genetic factors - i.e. an inherited component - leads some women to be more predisposed to developing PCOS than others.  

PCO and obesity


Women with PCO have an increased tendency to gain weight, with the extra kilos being located particularly around the abdomen.  


Half of women with PCOS are overweight, and being overweight can worsen symptoms.   


Having PCOS and being overweight reduces sensitivity to insulin (insulin resistance). Insulin is produced in the pancreas, and if sensitivity is reduced, the pancreas produces a greater amount of insulin to compensate. This "overproduction" of insulin affects one's sex hormones in a complex interaction that leads, among other things, to irregular periods, failure to ovulate and increased production of the male sex hormone.   


It is therefore important to improve insulin sensitivity by maintaining a normal weight (BMI < 25) and exercising. This can increase insulin sensitivity, which is the most optimal way to achieve a better hormonal balance and to prevent i.e. reduce the risks of developing type 2 diabetes (diabetes mellitus) and cardiovascular disease.   


We have the possibility to offer a consultation with your own dietician, who can elaborate on the above, provide motivation and advise lifestyle changes like a healthier diet and more exercise (min. 30 minutes daily).  


Medical treatment of reduced insulin sensitivity  


If, as a result of PCOS, you have developed insulin resistance (whether you are thin, normal weight or overweight), you can use a drug for Type 2 Diabetes (Metformin). This medicine increases sensitivity to insulin. However, not everyone benefits from Metformin.   


The contraceptive pill can be used to regulate the menstrual cycle.   


We recommend that you consult your doctor or us about the possibility of these treatments.  

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