Polycystic ovary syndrome (PCOS)
Diagnosis and treatment of polycystic ovary syndrome: irregular cycles, hyperandrogenism and metabolic health, with an individual plan.
What polycystic ovary syndrome is
Polycystic ovary syndrome is the most common hormonal disorder in women of reproductive age: it affects roughly one in ten. It combines, in different proportions for each woman, irregular ovulation — periods that are delayed or disappear —, signs of excess androgens — acne, increased hair growth, hair loss — and a metabolic component, insulin resistance, which is the least visible part and one of the most important long term.
Two things worth knowing: having cysts on an ultrasound isn't the same as having PCOS — the name is misleading — and PCOS isn't something you either «have or don't have» for life in the same way: it's managed, and managed well, it's something you can live with comfortably.
When to book an appointment
- Periods that are delayed by weeks or disappear for months.
- Persistent acne or increased hair growth in unusual areas.
- Difficulty getting pregnant with irregular cycles.
- Weight gain that's hard to explain, especially around the abdomen.
- You've been told «you have polycystic ovaries» and no one has explained what that means.
How we investigate it
Diagnosis combines your menstrual history, an examination, hormonal and metabolic blood tests and an ultrasound. Ruling out other conditions that look similar matters just as much. And the metabolic component is investigated from the start — glucose, insulin, lipids — because treating PCOS also means preventing future problems.
How we treat it
No two cases are alike, and treatment depends on what bothers you and what you're looking for. The common foundation is lifestyle — diet and exercise, with support from Nutrition at the centre itself when it helps —; on that basis, the cycle is regulated, acne or excess hair is treated, or ovulation is induced if you're trying to get pregnant. The plan is yours, not the label's.
Frequently asked questions
Will PCOS stop me getting pregnant?
Not necessarily. It is a common cause of difficulty ovulating, but with treatment most women with PCOS achieve pregnancy. If that is your case, it is addressed specifically from the first appointment.
An ultrasound showed polycystic ovaries. Does that mean I have PCOS?
Not on that finding alone. A polycystic appearance of the ovary is common and by itself is not a diagnosis: cycle disturbances or hormonal signs are also needed. It is worth confirming it properly before accepting the label.
How is polycystic ovary syndrome detected?
With three criteria, of which two are needed: irregular cycles or absence of ovulation, signs of excess androgens — acne, excess hair, hair loss or blood test results — and polycystic-looking ovaries on the ultrasound scan. Other causes, such as thyroid problems or high prolactin, have to be ruled out first.
What happens if polycystic ovary syndrome is left untreated?
Beyond irregular cycles, it is associated with insulin resistance, a higher risk of type 2 diabetes and cholesterol abnormalities, and persistently very infrequent periods call for protection of the endometrium. Treating it is not only about your period: it is also about your metabolism in the long term.