Polycystic Ovarian Syndrome (PCOS) is recognized as one of the most common endocrine/metabolic disorders of females which is a hormonal condition that affects about 10% womenof reproductive age.

Polycystic ovary syndrome ("PCOS") is a condition that can cause  a range of symptoms including irregular periods, acne, extra facial hair, or hair loss from the head. Most, but not all, people with PCOS may have excess weight or obesity.

What causes PCOS?

About once a month, the ovaries are supposed to make a structure called a "follicle". As the follicle grows, it makes hormones and around Day14 it releases an egg. This is called "ovulation." But in people with PCOS, the ovary makes several small follicles instead of 1 big one resulting in hormonal imbalance. Then, ovulation doesn't happen every month like it should and ovaries usually make more testosterone than usual.

PCOS is attributed to varying symptoms including irregular periods with prolonged cycles, excessive acne, hair loss and difficulty in falling pregnancy. Despite being a relatively common condition, the differing symptoms of PCOS can make it difficult to diagnose, resulting in up to 70% of women with PCOS remaining undiagnosed. Women with PCOS are at higher-than-average risk of developing type 2 diabetes, sleep apnoea, fatty liver, and depression.

That’s why it’s important for women to learn what symptoms are like with PCOS. As it’s not a ‘one size fits all’ condition, you may be experiencing a symptom of PCOS and not be aware of it.

Let’s look at some common characteristics of periods with PCOS. What are the symptoms with PCOS?

Symptoms can include:

• Having fewer than 8 periods a year with possible heavy loss
• Growing thick, dark hair on the upper lip, chin, sideburn area, chest, or belly
• Acne (oily skin and pimples on the face)
• Hair loss and thinning from the head
• Trouble getting pregnant without medical help
• Weight gain and obesity

Should I see a doctor even if my symptoms are mild?

Yes. PCOS increases your risk of other health problems, including:

• Diabetes (high blood sugar)
• High cholesterol levels
• Sleep apnea, which is a sleep disorder that causes people to briefly stop breathing during sleep
• Depression or anxiety
• Eating disorders, such as binge eating or bulimia

Should I have tests?

Your doctor will decide which tests you should have based on your age, symptoms, and individual situation. Possible tests include:

• Blood tests to measure levels of hormones, blood sugar, and cholesterol
• A pregnancy test if you missed any periods
• Pelvic ultrasound – This uses sound waves to make pictures of your uterus and ovaries. Doctors sometimes use this test to help figure out if you have polycystic ovaries.

How is PCOS treated?

The aim of treatment is to correct the hormonal imbalance to achieve your goal which could be regular periods or get pregnant or get rid of annoying acne or hair loss.

There are several treatment options than can help with symptoms:

• Birth control pills – are one of the most commonly used treatment option. The pills don't cure PCOS. But they can improve many of its symptoms, like irregular periods, acne, and facial hair. The pills also lower your risk of uterine cancer.
• Anti-androgens – These medicines block hormones that cause some PCOS symptoms like acne and facial hair growth. The most commonly used one isspironolactone(brand name: Aldactone). It is not a contraceptive and you have to on taking birth control separately
• Progestogen – This hormone can make your periods regular, but only if you take it regularly. It also lowers the risk of uterine cancer. It can be used in various forms : oral tablets, regular 3 monthly injections or intrauterine progesterone device
• Metformin(brand name: Glucophage) – This medicine can sometimes help make your periods more regular. But it works only in about half of those who try it. In people with diabetes, it helps lower blood sugar levels. In people with prediabetes, it can help prevent diabetes.
• Medicated skin lotion or antibiotics to treat acne
• Laser therapy or electrolysis to remove extra hair

What can I do on my own?

If you have excess weight losing weight can improve many of your symptoms. Losing just 5% of your body weight can help a lot and may be enough to help you ovulate. We encourage you to start with something simple like walking 30-45 mins 3-4 times a week. We would recommend seeking an appointment with your GP and see a gynaecologist if required.

What if I want to get pregnant ?

Most people with PCOS can get pregnant but may need assistance if they fail to fall pregnant after 1 year of trying. If someone has extra body weight, losing weight can help make your periods more regular and improve the chances of getting pregnant. We would advise seeking an appointment with your GP and see a gynaecologist if you have been trying without success.

PCOS Painful Periods

Heavy periods can cause cramping (dysmenorrhea) but painful periods are a very common symptom of endometriosis. If you are experiencing pelvic pain during your period or between periods, it’s important to find the root cause. There are a number of options available to treat the underlying condition and manage your symptoms, so you don’t continue to suffer.

What will my life be like ?

It is possible to live a full and normal life with PCOS. But it is important to see a doctor. Treatments will help your symptoms and protect you from other diseases.

Talk to your doctor if you feel depressed or anxious, think you might have an eating disorder, or have problems with sex. There are treatments that can help with these problems, too.