Endocrine Disorders
PCOS
What is PCOS?
Polycystic Ovary Syndrome (PCOS) is a common hormone condition. Having polycystic ovaries means there are multiple small cysts in the ovaries, called follicles, which contain the eggs. Hormones are chemical messages in the body, and an imbalance of hormones (androgens and insulin) is thought to cause PCOS.
What causes PCOS?
Approximately 12-18% of females of reproductive age are affected by PCOS. There is still a lot of research needed to find out the exact cause of PCOS, however, the following are thought to play a role:
- Genetics.
- Hormonal imbalances during our development in the womb before birth.
- Lifestyle and environmental factors.
What are the symptoms of PCOS?
PCOS may cause a range of symptoms and they can vary among individuals. Not all symptoms are experienced by one individual, but some of the following may be present:
- Irregular periods.
- Heavy menstrual bleeding.
- Acne.
- Weight gain.
- Excess hair growth (especially on the face, stomach, or back).
- Difficulty falling pregnant.
- Emotional challenges – depression, anxiety, and low self-esteem.
- Body image issues.
- Sexual health issues.
- Impact on quality of life.
- Early-onset type 2 diabetes.
Diagnosing PCOS
Investigating PCOS usually involves a combination of ultrasound scans, blood tests, and a review of your medical history. For a PCOS diagnosis, at least two of the following three criteria need to be met:
- Polycystic ovaries on ultrasound.
- Irregular or no periods.
- High levels of androgens (male hormones) or androgenic symptoms such as acne, excessive male pattern hair growth, or male pattern hair loss.
Your fertility doctor will exclude other similar diseases before diagnosing PCOS.
PCOS and fertility
A PCOS diagnosis can mean you have trouble having a baby, however once diagnosed and treatment commences, the chance of pregnancy is similar to the rest of the population.
Irregular periods can affect ovulation, not only making it harder to get pregnant but also resulting in fewer opportunities to fall pregnant than if you had a regular menstrual cycle.
The hormones that control appetite and hunger (insulin) are also not regulated effectively in the body, making it harder to maintain a healthy weight (i.e. easily gain weight and have trouble losing weight), which can affect your chances of having a baby. Since PCOS can often be associated with metabolic issues, this can also affect the chances of a healthy pregnancy and can increase the risk of a miscarriage.
Treating PCOS
At Flinders Fertility, we are very mindful of your clinical and emotional needs. We try to maximise the chances of achieving a healthy pregnancy naturally by helping you with lifestyle modifications. We have a multidisciplinary team to identify and address your needs and will work with you toward positive changes (if needed) in your life. Some of the following aspects we might focus on are:
- Weight loss: regular exercise and a change of diet in order to reduce weight can have a significant impact on balancing hormones and restoring regular periods.
- Insulin sensitisers, such as Metformin, can reduce the impact of insulin resistance and can assist in weight loss.
- Ovulation-inducing medication, such as Clomid or Letrozole can be used to stimulate the ovaries.
- IVF treatment may still be necessary if the above treatment options are not suitable or successful.
At your appointment, your fertility doctor will consider your individual situation and can advise on what type of treatment will be best for you.
Want to find out more?
If you have been diagnosed with or suspect you may have PCOS, and that it may be affecting your ability to fall pregnant, you can arrange a fertility chat with our patient care team or book an appointment with Flinders Fertility Endocrinologist Associate Professor Dr Vasant Shenoy
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