Polycystic ovary syndrome Dr Rob Hicks Polycystic ovary syndrome (PCOS) affects the ovaries and causes irregular periods or no periods at all.

In this article

What is polycystic ovary syndrome? Symptoms

Causes and risk factors Treatment and recovery

Advice and support

PCOS is a complex condition. Abnormal control of hormone levels result in tiny cysts developing in the ovaries, and eggs may not be released regularly.

Some women have no symptoms. Most, however, will have irregular periods or no periods at all. Often women with PCOS find it hard to get pregnant. The abnormalities in hormones can cause many other problems too:

• Acne and excessive body hair (hirsutism) may develop as a result of increased testosterone levels, and some women develop male-pattern balding.
• Women with PCOS often gain, and find it hard to lose, weight – more than half are overweight, usually with central or apple shaped obesity which is particularly linked to diabetes and heart disease.
• High blood pressure.
• A symptom, thought to be linked to insulin resistance is a diffuse velvety thickening and pigmentation of the skin, especially around the neck, armpits, groin, below the breast, and of the elbows and knuckles, known as Acanthosis nigrans.
• Many suffer embarrassment because of their appearance, and can become socially isolated and depressed.

The precise cause of PCOS is uncertain. Genetics may play a part as it often runs in a family but other factors are important too.

Women with PCOS have abnormalities in the production and metabolism of female and male sex hormones such as oestrogen and androgens, which can lead to raised levels of the male hormones in some. These abnormalities disrupt the activity of the ovaries which become enlarged, with a thick outer capsule beneath which cysts may form (these cysts result from problems with egg production and release).

There is also a lack of sensitivity to the hormone insulin (known as insulin resistance) which controls blood sugar levels. As a result the body pumps out high and higher amounts of insulin, which in turn causes raised levels of blood fats and an increased risk of thrombosis.

Being overweight aggravates this situation, so it can become a vicious circle – women with PCOS are especially likely to put on weight and this worsens the condition, so they put on more weight.

Around five to ten per cent of women have the syndrome. It develops during adolescence with the onset of periods.

Being overweight increases the risk of developing symptoms, so women are advised to determine their ideal weight and maintain it.

Losing just five to ten per cent of body weight may be all that's needed to correct the hormonal imbalance, thus restoring ovulation and fertility, and helping improve acne and hirsutism.

Hormone therapy is also used to regulate periods, and treat acne and hirsutism.

Other treatments include standard acne treatments and methods to remove excess facial and body hair, such as electrolysis.

Newer treatments include a drug called metformin that counteracts insulin resistance. Although this is not yet licensed, doctors can prescribe it if they feel it’s appropriate. There is also research underway into ovarian surgery.

Verity - PCOS self-help group
Email: membership@verity-pcos.org.uk
Website: www.verity-pcos.org.uk

This article was last medically reviewed by Dr Trisha Macnair in June 2009.