Polycystic Ovary Syndrome Management (PCOS)

What Is PCOS?

Polycystic Ovary Syndrome (PCOS) is a condition in which a woman has an imbalance of female sex hormones that may lead to menstrual cycle changes, cysts in the ovaries, trouble getting pregnant, and other health changes.

Polycystic ovary syndrome (PCOS), is a heterogenous group of disorders affecting approximately 12-18% of women of reproductive age.

PCOS is linked to changes in the level of certain hormones. It is not completely understood why or how the changes in the hormone levels occur. The changes make it harder for a woman's ovaries to release fully grown (mature) eggs. Normally, one or more eggs are released during a woman's menstrual cycle. This is called ovulation. In PCOS, mature eggs are not released from the ovaries. Instead, they can form a large number of small follicles in the ovary.

For more information about PCOS, visit Jean Hailes for women’s health - Evidence-based guideline for the assessment and management of polycystic ovary syndrome.

Women who have PCOS may have problems such as:

  1. Irregular, infrequent or heavy menstrual periods.
  2. Amenorrhoea (the absence of menstrual periods) - some women with PCOS do not menstruate.
  3. Increased weight especially around the abdominal area.
  4. Excessive facial or body hair growth.
  5. Acne.
  6. Infertility - related to less frequent or absent ovulation.
  7. High blood pressure.
  8. High cholesterol.
  9. Pre-diabetes and diabetes.

Testing For PCOS

The presence of 2 out of 3 criteria (polycystic ovaries on ultrasound, excess of male hormones, menstrual problems) is used to diagnose PCOS. Testing for PCOS by one of our Fertility Specialist’s generally includes:

  1. A physical examination, including a pelvic examination. This may reveal swollen ovaries and/or a swollen clitoris (very rare).
  2. Ultrasound scan of the ovaries.
  3. Measuring weight and body mass index (BMI).
  4. Blood tests to check hormone levels. These tests may include testing your Estrogen level, Follicle Stimulating Hormone (FSH) level and Lutenizing hormone (LH) level.

FSH a reproductive hormone that should be produced during certain times in each ovulatory cycle, in order for optimal ovulation to occur. LH is a hormone that is vital for reproduction. It is produced by the pituitary gland. LH helps regulate menstrual cycles and ovulation.

Other tests that may be done include:

  1. Fasting glucose (blood sugar) and other tests for glucose intolerance and insulin resistance.
  2. Pregnancy test (serum HCG).
  3. Prolactin level. Prolactin is a hormone that plays a role in fertility by inhibiting follicle stimulating hormone (FSH) and gonadotropin-releasing hormone (GnRH), the hormones that trigger ovulation and allow eggs to develop and mature.
  4. Thyroid function tests.
  5. Imaging tests or surgeries to look at the ovaries including vaginal ultrasound and pelvic laparoscopy.

Treatment Of PCOS

PCOS treatments with respect to treating fertility issues include:

  1. Adopting a healthy lifestyle - if you are above the healthy weight range lifestyle modification including diet and exercise is the first line of treatment. Significant benefits have been demonstrated with 5-10% weight loss in overweight women with PCOS.
  2. Pharmacological management using Metformin.
  3. Laparoscopic ovarian drilling.
  4. Assisted conception, Ovulation Induction (OI) and In Vitro Fertilisation (IVF).

After considering your clinical profile and personal preferences, one of our Fertility Specialist will advise on what treatment best suits you situation. However, based on the complex nature of the disease, our Fertility Specialist may also recommend an interdisciplinary care program, with multiple health professionals.

Possible Treatment Risks

  1. Please go to In Vitro Fertilisation (IVF).
  2. Please go to Ovulation Induction (OI).

Find Out How Flinders Fertility Could Help You

At Flinders Fertility we recognise that a website may not cover all your information requirements. That's why we offer a number of information options. So, if you want to find out more about PCOS, either:

  1. Call on (08) 8155 5333 to talk to one of our Fertility Specialists.
  2. Email us at enquire@flindersfertility.com.au.
  3. Seek a referral to Flinders Fertility from your Doctor.

If you require the aid of an interpreter please let us know, as well as any specific regional dialect that you may require.

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