How common is polycystic ovary syndrome (PCOS)?
PCOS is actually pretty common; it is thought to affect five to 10 % of the female population. It is characterised by at least two of the following:
- Raised androgens (testosterone) on a blood test or clinical signs of it, such as excess body hair (hirsutism) or acne
- Thinning of hair (male pattern baldness)
- Irregular or no periods (oligomenorrhoea or amenorrhoea)
- Polycystic ovaries on ultrasound scan.
What causes PCOS?
No-one knows exactly what causes PCOS. About 25% of women have signs of polycystic ovaries on ultrasound, but only about a quarter of these women actually have PCOS.
PCOS is caused by a combination of insulin resistance and hormonal disturbance. In women affected by PCOS, the body does not respond as well to insulin (insulin resistance), so more insulin is produced. The raised insulin levels can make the ovaries produce increased levels of testosterone. This, in turn, causes problems with ovulation, and other symptoms such as acne and excess hair growth.
Increased insulin production also contributes to weight gain, making it a difficult cycle to break, as weight gain causes increased insulin resistance, and so on.
What problems can PCOS cause?
- Weight gain: People with PCOS find it hard to lose weight. The heavier they are, there is an increased likelihood of them developing other symptoms too
- Increased insulin resistance: This results in an increased risk of developing type 2 diabetes and an increased risk of cardiovascular problems
- Impaired fertility: Irregular periods can suggest impaired ovulation
- Anovulation (no ovulation / no periods): This can increase a woman's risk of uterine cancer, so your doctor may suggest you use a hormonal treatment, such as the progesterone-only pill to negate this risk
- Acne: Topical and oral treatments are available.
- Hirsutism (excess body hair) .
What can be done to help?
1. Lose weight
This can be hard to do, but will make a real difference. Try eating smaller portions, cutting out snacks and consuming less fatty, carbohydrate-rich foods . Exercise more to increase the number of calories you burn off. Even a general increase in daily activity can help.
This can be helped by waxing, hair removal creams or laser treatments. There are also some medical treatments that can be tried.
3. Improve other cardiovascular risk factors
For example, stopping smoking, reduce fats in the diet (cholesterol).
4. Your doctor may suggest yearly bloods (especially after the age of 40)
This can help by checking your cardiovascular risk factors and ruling out type 2 diabetes.
5. For fertility problems, weight loss can help
There are also a number of other ways in which women who are not naturally ovulating can successfully conceive, so please do speak to your doctor.
Dr Jennifer Kelly is a GP and founder of the Grace Kelly Ladybird Trust (for awareness and research into childhood cancers).