PCOS Awareness Month falls in September each year, and today is the last day of this important month. It’s a time to highlight the condition, which could affect female fertility if left untreated. Dr Raewyn Teirney, leading Sydney Fertility Specialist and Gynaecologist, shares the facts around PCOS with us.
PCOS Awareness Month – What Exactly Is PCOS?
PCOS, or Polycystic ovarian syndrome is a really common hormone problem among teenage girls and women (approximately six to eight percent of women worldwide). Many women experience it even after menopause, when they are no longer ovulating. The reason these women experience it later in life is likely to be linked with insulin resistance, which may lead to Type II Diabetes. Other medical names for PCOS are Syndrome X and Metabolic Syndrome.
PCOS is associated with an increase in male hormones (called androgens). This imbalance can cause issues with your menstrual cycle, as well as skin issues like acne or hirsuitism (increased hair). It is when tiny cysts form on the ovaries – the result of follicles that did not mature to help release an egg into the Fallopian tubes. Polycystic ovaries also indicate good ovarian reserve meaning there are a good quantity of egg numbers in the ovary.
What Are The Symptoms Of PCOS?
PCOS is not painful. In fact, many women and girl who have it don’t even know they have it. There are classic symptoms though. These include:
- Difficulty Maintaining a Healthy Weight
If you are struggling to keep your weight within a healthy BMI and you’re doing all the right things in terms of the food you eat and exercise, you might wish to see your GP or a fertility specialist to check if you have PCOS. While slim women can be affected, we do see the condition mostly in women who are overweight.
- Irregular Periods
If your menstrual cycle is quite irregular, it could be another sign that you might have PCOS. Your periods might come every three or four months and when you do have them, they’re really heavy. Some women affected may miss their periods altogether. This is because the ovulation process is hindered by the raised androgens. - Acne And Facial Hair
Women with PCOS tend towards acne or oilier complexions, as well as increased hair growth on the chin and upper lip, nipples and belly button. The increased male hormones cause an increased oil flow in the skin. When bacteria is present, acne can also show up.
- Thinning Hair
These androgens can also lead to thinning hair and hair loss. In some women who are affected, it can also cause alopecia.
- Skin Pigmentation
Pigmentation, usually around the neck, is a common indicator of PCOS. It is related to high levels of insulin and testosterone. - Skin Tags
Little tags of skin may present themselves on the face and body. This is again related to an insulin and male to female hormone imbalance.
- Fertility Struggles
Women who have PCOS may find it hard to fall pregnant. This is because the follicles that are responsible for releasing the egg into the fallopian tubes each month do not mature properly and therefore are unable to help release the egg. This is easily treated with medication in most cases, and will not require IVF. However, some women affected might have to go down the IVF path.
How PCOS Is Diagnosed
PCOS is frequently diagnosed quite quickly, if a woman presents with a combination of the classic symptoms aforementioned. However sometimes it isn’t that simple, especially if a woman is on the slender side, or only showing one of the classic symptoms. In such cases, we would conduct further testing, including a blood test to look for raised male hormone -androgens, plus perform an ultrasound to check for polycystic appearance on the ovaries. This is twenty of more follicles in an ovary. We would also perform tests associated with the insulin levels, sugar levels and weight/BMI.
To reach a PCOS diagnosis, we would look for two of the three below criteria:
- A blood test confirming increased male hormones (androgens), or the clinical signs of androgens, which are acne and increased hair growth on the face and body.
- Irregular, infrequent or absence of menstruation, which signals that ovulation is also infrequent.
- A pelvic ultrasound that shows at least one ovary has 20 or more small cysts.
If you think you could have PCOS, speak to your GP about having tests performed, so you can treat the condition.
