Polycystic ovary syndrome (PCOS) Dr Trisha Macnair PCOS affects up to ten per cent of women, although many don't realise they have it. It can cause problems ranging from weight gain to excess body hair to infertility.

In this article

What are the symptoms? What causes it?

What's the treatment? Long-term problems

Typical symptoms include:

• Irregular periods
• Pain from cysts on the ovaries
• Infertility
• High blood pressure
• Acne
• Central obesity (putting on weight around your middle)
• Male-pattern baldness
• Hirsutism (excessive body hair)

The cause of PCOS is not yet known, although there does seem to be a hereditary factor as PCOS often runs in families (interestingly, men in affected families often go bald during early adulthood, although the reason why is not yet known).

Research suggests that PCOS may be linked to problems with insulin and blood sugar levels, and the development of type 2, or non insulin-dependent, diabetes.

One theory is that the body becomes resistant to the effects of insulin, so higher and higher levels are produced to get the same effect (hence the link to diabetes). This over-stimulates the ovaries, causing high levels of the male-type hormones (androgens) to be produced.

Currently, women with PCOS are usually given treatments relevant to their particular symptoms. These include:

• Menstrual disturbance - oral contraceptives regulate periods and reduce levels of free androgens (male hormones) in the blood, so reducing hirsutism, but can make insulin problems worse
• Fertility problems - clomiphene (stimulates development of eggs or follicles in the ovaries); gonadotrophin drugs (stimulate follicle production); ovarian diathermy or laser treatment; assisted conception techniques
• Hirsutism and acne - anti-androgen drugs; cyproterone acetate and ethinyloestradiol; spironolactone, and androgen-blocking drugs, such as finasteride; cosmetic treatments such as electrolysis and laser hair removal
• Metabolic problems and risk of coronary heart disease - metformin, used to treat diabetes, can make cells more sensitive to insulin and improve uptake of sugar, reducing insulin production; also reduces male hormone production and may return periods to normal, as well as helping with weight loss

Weight loss through lifestyle changes is often difficult for women with PCOS, but keeping body mass index (BMI) within the normal limits of 19 to 25 can help to control blood sugar levels and insulin production.

Women with PCOS are at increased risk of type 2 diabetes, high blood pressure and cancer of the lining of the womb - endometrial cancer - and should review these problems regularly with their GP

This article was last medically reviewed by Dr Trisha Macnair in August 2007.