What is Polycystic Ovarian Syndrome (PCOS)?
PCOS (Polycystic Ovarian Syndrome) is a common hormone problem, and one of the leading causes of infertility in women. As many as twenty five percent of women of childbearing age have PCOS, but most don’t even know that they have it until they begin trying to get pregnant.
The term ‘polycystic ovaries’ describes the appearance of the ovaries on an ultrasound scan – they contain many small follicles (perhaps 10 or more) and the dominant follicle does not develop as easily. Many of the small follicles produce differing levels of hormones.
What are the symptoms of PCOS?
Symptoms of PCOS include irregular periods (or no periods at all), increased hair growth, acne, obesity and difficulty falling pregnant. You might experience very heavy yet infrequent periods, along with pain, bloating and tenderness.
Imbalances in hormonal production affect ovulation, which may occur irregularly or not at all. There may also be a mild increase in testosterone levels, causing darker and thicker hair growth and acne.
Hormonal imbalances also cause problems with sugar metabolism, leading to weight gain - and a higher risk of gestational diabetes if you fall pregnant.
How does PCOS affect my fertility?
The symptoms of PCOS including irregular or no periods, along with a documented increase in the risk of miscarriage, mean the chance of getting pregnant naturally is low if you have PCOS, and you should seek medical support.
It is important to remember that the presence of polycystic ovaries is not always bad news. Many younger women can have severe side-effects from the syndrome caused by the hormone imbalance associated with polycystic ovaries. However, as women age, the follicle number drops and the hormone imbalance corrects itself.
The result is that women who suffer polycystic ovary syndrome in their teens and twenties can sometimes end up having more eggs in their thirties without the syndrome and therefore a better chance of conception.
How do you test for PCOS?
An ultrasound scan can indicate the presence of many small follicles.
Blood tests can reveal changes, with higher levels of testosterone and LH (often in conjunction with a higher LH to FSH ratio) than women with normal cycles. These levels may vary considerably and are best assessed early in the menstrual cycle (if there is one). Blood tests may also indicate a change in blood glucose and insulin levels.
How do you treat PCOS?
There are a number of options available, depending on the main issue you are experiencing.
- Weight loss can be more difficult because of the higher levels of testosterone, but it has a very beneficial effect on balancing hormones and restoring regular periods in obese women. So exercise and a change of diet could have a significant impact.
- Insulin sensitisers, such as Metformin, reduce the impact of insulin resistance and can also assist in weight loss.
- Ovulation inducing drugs such as Clomiphene (Serophene or Clomid) can stimulate the ovaries.
- If you do not respond to Clomiphene, injectable drugs (FSH) can be used, but these require specialist facilities and close monitoring of the response to avoid severe side effects and multiple pregnancies.
- IVF treatment may be necessary in very difficult situations.
Where can I get help managing PCOS?
If you are experiencing any of the above symptoms and you would like help managing them, IVF Australia runs regular PCOS clinics at our Greenwich clinic and Westmead Clinic for women wanting more information on the diagnosis, assessment and management of PCOS. Please contact the clinics directly for more information or book an appointment with a PCOS fertility specialist.
The Polycystic Ovary Syndrome Association of Australia Inc (POSAA) is a ‘self-help’ association for women with PCOS and those who suspect they have it. The Association brings together sufferers, their families and friends, and medical professionals interested in supporting the group and PCOS patients.
The Association’s overall purpose is to offer support to women with PCOS, promote understanding and awareness of the syndrome and encourage research into PCOS. POSAA is proud to have been instrumental in the formation of the PCOS Australia Alliance and the subsequent launch of world-first guidelines for the diagnosis and care of women with PCOS. For more information, visit the POSAA website...
If you have been trying to conceive for more than 12 months (6 months if you are over 35) and know or suspect you have PCOS please call 1800 111 483 or book an appointment with a fertility specialist.
Appointments are available in the next couple of weeks and will cost approximately $150 for a couple after the Medicare rebate.
If you would like help managing the symptoms of PCOS you can discuss this with your GP or attend a PCOS clinic.