What You Should Know About PCOS

What You Should Know About PCOS

Between 5-10% of women of childbearing age have PCOS, a hormonal imbalance involving an excess of testosterone. Although not life-threatening, sufferers have to deal with many side effects, including the possibility it can be harder to conceive. In aid of Polycystic Ovary Syndrome Awareness Month, we reached out to Dr Shazia Malik, Consultant Obstetrician & Gynaecologist at The Portland Hospital part of HCA UK to explain the condition and how to spot the signs.

What is Polycystic Ovary Syndrome?

Polycystic Ovary Syndrome (PCOS) is characterised by a greater production of male hormones, enlarged ovaries and an excess of fluid-filled sacs called follicles. Before ovulation an egg will develop in a small area on your ovary known as a follicle. While many follicles can develop, only one becomes a mature egg. In women with PCOS multiple follicles start to grow, but none develop into an egg for ovulation. These can then become cysts that remain on your ovaries. ‘The hormonal imbalance can cause irregular menstrual cycles, problems with acne or increased hair growth on the face and body,’ Says Dr Shazia. ‘In some cases, PCOS can make it harder for women to conceive, but not always.’

Who is most likely to have PCOS?

‘One in ten women across the UK and between 5% and 10% of women of childbearing age (aged between 16-44) have PCOS,’ explains Dr Shazia. Although It is most common for women to receive a diagnosis in their 20s and 30s - a time when they have problems getting pregnant and choose to see their doctor, the onset can be any age after puberty. Unfortunately, it is still unknown why some women develop the condition and others don’t, but a hereditary link has been found and it is more frequent in overweight women. ‘It is related to hormone levels, including insulin production, but It’s not always easy to know if you have the condition. Up to 30% of those with PCOS can remain undiagnosed,’ says Dr Shazia. If you are experiencing symptoms, you should make an appointment with your doctor.

What are the symptoms?

Interestingly, a scan appearance of polycystic ovaries does not automatically mean you have the syndrome. ‘Over 50% of women with the condition report being symptom free,’ explains Dr Shazia. This means that apart from ovaries appearing polycystic on an ultrasound scan, there are no issues.’ To be diagnosed with PCOS you must also be exhibiting symptoms, the most common of which include: acne, irregular, infrequent or absent periods, weight gain and excess hair growth. ‘You may have a combination of, or all these symptoms and women trying to get pregnant can also face difficulties due to irregular ovulation and an increased chance of miscarriage.’

How is it diagnosed?

There is no single test to diagnose PCOS, but the process usually involves a discussion with your GP to go through your medical history - including the regularity of your periods. Your GP may then choose to carry out a physical exam which will include checking for signs of increased hair growth, irregular periods, insulin resistance and your weight.

And if they find any issues? ‘The next step is a pelvic exam, where a doctor will visually and manually inspect your reproductive organs for masses, growths or other abnormalities. They may also suggest a blood test so that they can measure your hormone levels,’ says Dr Shazia. Following this you could be sent for an ultrasound scan, where they’ll asses the appearance of your ovaries and the thickness of the lining in your uterus. ‘More often than not it will take a referral to a specialist clinic to confirm the diagnosis and make a plan on how best to manage your symptoms,’ she says.

And treated?

While there is no cure for PCOS, in most cases the symptoms can be managed. Different treatment options are available depending on the symptoms you’re experiencing. You should be prepared to make some substantial lifestyle changes, to best deal with the condition, Shazia explains: ‘In overweight women, the symptoms and risk of developing long-term health problems from PCOS can be greatly improved by weight loss. Losing just 5% of your body fat can lead to a significant improvement in PCOS.’ A low GI diet and regular cardio workouts are recommended, it is also important to monitor your sugar intake. If you’re dealing with missing or irregular periods, you may be advised to go on the contraceptive pill to help regulate your cycle.

Does it impact other areas of your health?

‘Unfortunately, PCOS isn’t just a fertility concern, it can have an impact on other areas of your health too,’ says Shazia.
Some conditions that can manifest as a result of PCOS are:

1. Type 2 diabetes: The insulin resistance that develops in women with PCOS puts them at risk of developing type 2 diabetes, in fact the risk for type 2 diabetes is four times higher in women with PCOS (especially in those who are overweight or have a family history of diabetes), and at least half of all women with PCOS develop pre-diabetes or diabetes before reaching the age of 40.

2. This risk: Is also increased in pregnancy and you will need to be tested for gestational (pregnancy) diabetes during pregnancy.

3. Cardiovascular disease: PCOS puts women at risk of high blood pressure, stiff and clogged arteries, along with encouraging high levels of bad cholesterol and low levels of good cholesterol.

4. Mood disorders: Anxiety, depression and eating disorders are unfortunately more common in women with PCOS. The reason why is unknown, some suspect the excess production of male hormones and other hormone imbalances are the cause of mood changes.

Should you change your diet?

In many cases, changing the way you eat is a big part of PCOS management, but it isn’t just about losing weight, many of the symptoms are a result of hormonal imbalances and these can be helped with a carefully tailored diet. Women with PCOS have been found to have differences in their pancreatic cells that cause an overproduction of insulin, a driving factor behind many of the associated symptoms like excess hair growth, and weight gain, so sticking to a healthy diet is essential. What food should you be eating? Many doctors suggest a diet rich in whole foods that are as natural and unprocessed as possible, such as fish, meat, vegetables, fruit, nuts and seeds,’ Says Dr Shazia. Look for foods with anti-inflammatory properties, like dark leafy greens, berries, grapes, beans, avocado’s and green tea. Sadly, refined carbohydrates are a no-go as they can cause your insulin levels to spike, so avoid them or reduce them as much as possible.

And what about dealing with acne and increased hair growth?

Oily skin, breakouts and excessive hair are a result of too much testosterone. ‘Sometimes the contraceptive pill can be very helpful with these symptoms – along with skin preparations for acne and/or specialist medication to reduce male hormone levels,’ notes Dr Shazia. However, this should not be considered a quick fix and needs to be done alongside diet and lifestyle changes. If you’re worried about increased amounts of body hair, consider booking in for laser or electrolysis, which will reduce hair growth over time.

Finally, how does it affect getting pregnant?

A common misconception is that women with PCOS cannot get pregnant.While irregular periods and hormonal imbalances can make it harder to conceive, the vast majority of women are able to have healthy babies. If you’re struggling to get pregnant Dr Shazia suggests seeing a fertility specialist who will be able to find the most effective treatment for you.

Visit ThePortlandHospital.com for more information.

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