Early Menopause - Polycystic Ovarian Syndrome (PCOS)

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PCOS

Polycystic Ovarian Syndrome (PCOS)

Normal Ovary and Polycystic Ovary PCOS is a hormonal disorder that affects five to 10 per cent of women of reproductive age.

If you have PCOS you may have:

Periods that are irregular, infrequent or heavy
Difficulty in becoming pregnant
Immature ovarian eggs that do not ovulate, forming small follicles
Weight gain and an increase of fat in your upper body
Excessive facial or body hair
Acne on both the face and the body
Prediabetes or diabetes
Higher levels of blood fats

What causes PCOS?

While the causes of PCOS are not yet clear, recent studies show that both lifestyle and genetic factors can be involved.

What happens with PCOS?

Hormonal changes

In a normal menstrual cycle your hormones fluctuate, but with PCOS your body has an imbalance of hormones. This imbalance may prevent ovulation, which means the ovaries don’t release eggs.

The male-type hormones, called androgens, which include testosterone, are present in low levels in all women. Women with PCOS often have extra androgens in the blood, which can result in increased facial and body hair and acne.

Your body also usually develops resistance to the hormone insulin, which regulates sugar levels. This can lead to an increased risk of diabetes.

What are the long-term risks associated with PCOS?

Long-term complications can appear in women of all ages. Women with PCOS have an increased risk of:

Infertility
Type 2 diabetes
Impaired glucose tolerance
High blood fats
Possibly heart disease
Thickening of the lining of the uterus

Fortunately, with early diagnosis and proper management, the long-term health risks can be prevented or delayed, or once PCOS is present, the health risks can be treated effectively.

Management of PCOS

There is no single treatment for PCOS, but its symptoms can be managed in the following ways:

Education

It is important that all women with this condition understand some key causes and vital treatments, which are emerging from the latest research.

Psychological support

Challenges including weight gain, hair growth and infertility can cause poor self esteem and depression. A positive frame of mind is critical to be able to change your lifestyle effectively. Seek help if needed.

Weight management

Weight management is really important. Healthy eating and regular physical activity are vital. For more information and advice, talk to a health practitioner or dietitian. Also see our information on Healthy Eating.

Management of irregular periods

Regular periods help prevent excessive thickening of the lining of the uterus. Long gaps between periods can also lead to abnormal cells building up inside the womb and it is recommended that at least four cycles per year are needed to prevent this. Medications including a low-dose contraceptive pill, progesterone and metformin can be given so that menstrual bleeding occurs regularly. The pill also provides contraception.

Management of insulin resistance

Most people who are overweight and have PCOS also have insulin resistance, although even thinner women with PCOS can be insulin resistant. Healthy eating and physical activity offer the best approach. Medications including metformin can also reduce insulin resistance, reduce hair growth, regulate periods and decrease the risk of diabetes. However, these medications need to be initiated under specialist endocrinology supervision.

Management of infertility

Firstly, it is important to consult your doctor to exclude other reasons for infertility. If infertility is a concern and you are overweight, then weight management and activity is the first line of treatment.

After this, medications may be used to start the release of eggs, including clomiphene and metformin . While a surgical procedure can cause temporary ovulation, it is not often performed, as medications are as effective, with fewer complications.

Management of increased facial hair growth and acne

Contraceptives, anti-androgen drugs and metformin can be used for the treatment of acne and excess facial hair. Cosmetic advice on waxing and laser hair removal is best taken initially from dermatologists or endocrinologists rather than beauticians.

Finally

A diagnosis of PCOS is not the end of the world. With support and accurate health advice, it can be managed well and you can live a comfortable and fulfilling life.