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What is PCOS?
Polycystic ovary syndrome (PCOS) is one of the main causes of infertility, affecting about one in 10 women in the UK. It influences how an individual’s ovaries work and can make it difficult to conceive. Symptoms can vary; some individuals may experience mild to severe symptoms, while others may show no symptoms at all. However, it’s important to be aware of these symptoms, so you know when to reach out to your doctor.
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Definition of PCOS
PCOS is a hormonal condition that affects ovarian function and can begin at any age after puberty, although women are often diagnosed in their 20s or 30s. Teenagers can also be affected by this condition.
PCOS may lead to irregular periods, which can disrupt ovulation and hinder the release of eggs. Additionally, it can cause increased levels of androgens, which are male hormones that can result in excessive facial and body hair. Enlarged ovaries are another possible result of PCOS, which may contain multiple harmless fluid-filled sacs, known as follicles, that surround the eggs. The exact cause of PCOS is unknown, and not everyone with the condition will exhibit symptoms.
The difference between PCOS and polycystic ovaries
While polycystic ovaries (PCO) and PCOS are related, they are not the same. PCO refers to the presence of multiple small cysts, or follicles, in the ovaries and is considered a physical characteristic. PCOS, on the other hand, is a hormonal disorder that affects women of reproductive age by disrupting hormone levels.
Not everyone with polycystic ovaries necessarily has PCOS, and having PCO alone isn't sufficient for a diagnosis. If you have any concerns, it's essential to consult your doctor.
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What are the causes of PCOS?
The exact cause of PCOS remains unclear, but several possible factors may relate to hormonal imbalances:
Genetic influence – There is evidence that PCOS may be hereditary. If a biological family member, such as your parent or sibling, has the condition, you may have an increased risk of developing it as well.
Insulin resistance – Insulin is a hormone produced in the pancreas and helps regulate sugar levels in your blood. Those with insulin resistance need to produce extra insulin to compensate, which may lead the ovaries to produce excess testosterone. This can disrupt follicle development and disrupt ovulation. Insulin resistance may also contribute to weight gain, worsening PCOS symptoms, as excess body fat can further increase insulin production.
Hormonal imbalance – PCOS is often caused by imbalances in hormone levels. This includes increased levels of androgen, like testosterone and high levels of luteinizing hormone (LH), which stimulates ovulation. However, if LH levels are too high, it can impair ovulation function. Additionally, low levels of sex hormone-binding globulin (SHBG), a protein that binds to testosterone and reduces its effect, can also contribute to the development of PCOS.
What are the symptoms of PCOS?
Some individuals may first notice symptoms of PCOS in their late teens or early 20s. Not everyone will exhibit signs of the condition, and symptoms can vary in intensity. It's essential to be aware of the symptoms and contact your doctor if you have any concerns. Symptoms include:
Irregular or absent menstrual periods
Difficulty conceiving
Bloating
Weight gain
Oily skin or acne
Thinning hair and hair loss from the head
Excessive hair growth on the face, chest, back or buttocks
If you experience any of these symptoms, get in touch with your doctor, so they can recommend a treatment plan to help manage them.
How is PCOS diagnosed?
Doctors consider several factors, including age, symptoms, and menstrual cycle regularity. Hormone tests may be conducted to determine whether excess hormone production is due to PCOS or another hormone-related condition.
Additionally, an ultrasound may be performed to identify if you have several follicles in your ovaries. Blood tests may also be done to measure hormone levels and screen for diabetes or high cholesterol, which can be associated with PCOS.
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Reviewed by Alex Swanton, Consultant at TFP Thames Valley Fertility.
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