PCOS

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Polycystic ovary syndrome (PCOS) is a condition that affects the ovaries. Read more to learn about symptoms, treatment and where else to go for help with PCOS.
What is PCOS?

Polycystic Ovary Syndrome, or PCOS, is a common hormonal disorder that affects women. It happens when a woman’s ovaries begin to develop fluid-filled sacs called follicles.

It causes a range of symptoms that affect everyone differently.

Some transgender men also have PCOS. If you have PCOS and want to understand the condition better or explore treatment options, you should talk to your doctor.  

What causes PCOS?

It’s not clear what the underlying cause of PCOS is, but we know it’s related to abnormal hormone levels in the body.

Many women with PCOS have insulin resistance. This is when the cells in your body do not absorb insulin from your blood properly.1

This can make your body produce more male hormones or androgens. It can also increase the levels of testosterone that are active in your bloodstream.

There are other hormonal imbalances that are common in women with PCOS, like higher levels of serum luteinising hormone and serum oestrogen.2 This is what causes most of the symptoms of PCOS.

Our genetics may also play a role, and some people may have PCOS because it runs in families. However, it can’t be tested for because the genes that trigger it haven’t been identified yet.3

What are the symptoms of PCOS?

There are a range of symptoms associated with PCOS. Some of the most common are:

  • Irregular periods, or missing your period altogether
  • Higher than normal levels of androgens (male hormones)
  • Polycystic ovaries, which are fluid-filled follicles in your ovaries.4
  • You must experience at least two of these symptoms to be diagnosed with PCOS.

    High levels of androgens can also cause some of the symptoms that people with PCOS experience. These include:

  • More body hair than average
  • Acne
  • A deeper voice
  • Painful periods
  • Pelvic pain.5
  • Is PCOS linked to other conditions?

    PCOS can increase the risk factors of developing many other conditions. Not everyone with PCOS will develop these conditions.

    Because of the insulin resistance common in women with PCOS, some are at risk of developing type 2 diabetes. One study of women with PCOS found that 19% of them developed type 2 diabetes, while only 1% of women without PCOS went on to experience type 2 diabetes.6

    Research has found that women with PCOS are at a higher risk of cardiovascular disease, which may be linked to insulin resistance and hormonal imbalances common in PCOS. Some other conditions related to PCOS include sleep apnoea (abnormal breathing during sleep) and mental health issues like depression and anxiety.1

    Women with PCOS are also three times more likely than the general population to develop endometrial cancer, but the risk is still relatively low.1 If you have PCOS, make sure to get regular screenings at your doctor’s recommendation and report any new symptoms.

    Does PCOS affect fertility?

    Because PCOS can stop ovulation, some women with PCOS may struggle to get pregnant.4 This doesn’t mean you can’t conceive, but you may need fertility treatment.

    One medication often prescribed to women with PCOS who are trying to get pregnant is clomifene. It works by helping your body to ovulate. There are other medications like metformin and letrozole which are not licensed for helping fertility in PCOS, but they are sometimes used ‘off-label’ if clomifene does not work for you.7

    Can PCOS affect your weight?

    Women with PCOS are more likely to be overweight or obese than average. This is often caused by insulin resistance and hormonal imbalances that often appear in PCOS. Being overweight can also often make PCOS symptoms worse.8

    If you’re struggling to lose weight, your GP may be able to refer you to a dietician, which is a specialist who focuses on eating behaviour.

    What are the treatments for PCOS?

    PCOS can’t be cured, but there are treatments to manage many of the different symptoms.

    If you’re struggling with heavy, painful or irregular periods, hormonal contraception like the combined pill may help. This can also help with symptoms like acne or excess hair growth.8

    There are other hormonal contraception options, like medroxyprogesterone and some types of IUS.8

    If you have complications related to PCOS, like diabetes or sleep apnoea, you may be referred to a specialist.

    Are there any side effects?

    All medications come with a risk of side effects. Often these side effects are temporary and happen while your body adjusts to the medication. Some side effects of the combined pill include nausea, headaches and tender breasts.9

    If you don’t want to take the medication you’re prescribed for PCOS anymore because of side effects, talk to your doctor. They may be able to recommend another treatment that suits you better.

    How else can you manage your PCOS?

    For some women, lifestyle changes can help reduce symptoms of PCOS. If you’re overweight, losing weight can improve your PCOS as well as your overall health. We have more advice about getting to a healthy weight on our website.

    Being active can also help reduce your chance of complications from PCOS.10 So finding a type of exercise you enjoy and doing it regularly can reduce your risks for the future. If PCOS is affecting your mental health, it may help to talk to a counsellor. These are specialists who are trained to listen.

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    Where can I get further advice and support?

    Mind

    Information and support for people affected by anxiety or depression, including an information helpline and online support community.

    NHS

    Information about PCOS, including symptoms, living with PCOS and treatments to manage PCOS.

    NHS Inform

    Information and support if you live in Scotland.

    Tommy’s

    Information and support for people trying to conceive, including those with PCOS.

    Verity

    Information and support for people with PCOS, including support groups.

    References
    1. Complications | Background information | Polycystic ovary syndrome | CKS | NICE. Accessed January 24, 2023. https://cks.nice.org.uk/topics/polycystic-ovary-syndrome/background-information/complications/
    2. Causes | Background information | Polycystic ovary syndrome | CKS | NICE. Accessed January 16, 2023. https://cks.nice.org.uk/topics/polycystic-ovary-syndrome/background-information/causes/
    3. Genetic Basis of Polycystic Ovary Syndrome (PCOS): Current Perspectives - PMC. Accessed January 16, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935309/
    4. Polycystic ovary syndrome - Symptoms. nhs.uk. Published October 27, 2017. Accessed January 17, 2023. https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/symptoms/
    5. Definition | Background information | Polycystic ovary syndrome | CKS | NICE. Accessed January 24, 2023. https://cks.nice.org.uk/topics/polycystic-ovary-syndrome/background-information/definition/
    6. Type 2 diabetes mellitus in women with polycystic ovary syndrome during a 24-year period: importance of obesity and abdominal fat distribution - PMC. Accessed January 17, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6964225/
    7. Polycystic ovary syndrome - Treatment. nhs.uk. Published October 20, 2017. Accessed January 24, 2023. https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/
    8. Scenario: Management - adults | Management | Polycystic ovary syndrome | CKS | NICE. Accessed January 20, 2023. https://cks.nice.org.uk/topics/polycystic-ovary-syndrome/management/management-adults/#managing-clinical-features-of-polycystic-ovary-syndrome
    9. Combined pill. nhs.uk. Published December 21, 2017. Accessed January 19, 2021. https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/
    10. Woodward A, Klonizakis M, Broom D. Exercise and Polycystic Ovary Syndrome. Adv Exp Med Biol. 2020;1228:123-136. doi:10.1007/978-981-15-1792-1_8

    Reviewed by: Mital Thakrar

    Review date: April 2023

    Next review: April 2026

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