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Understanding PCOS: More Than Just a Reproductive Issue


Polycystic Ovary Syndrome (PCOS) is a condition that affects many women, often misunderstood as solely a reproductive health issue.

Today, we recognise it as primarily a metabolic disorder, linked to how the body processes insulin and other hormones. Let’s break it down and explore what PCOS really is, its symptoms, and ways to manage it.



What is PCOS?

PCOS is characterized by hormonal imbalances that affect ovulation and other bodily processes. Genetic factors and obesity often lead to insulin resistance, where the body doesn’t respond effectively to insulin. This results in elevated insulin levels, causing hormonal disruptions, such as:

  • Overproduction of luteinizing hormone (LH), which interferes with ovulation.

  • Increased testosterone production, reducing the body’s ability to produce estrogen.

  • Eggs not fully maturing, leading to reduced or absent ovulation.


How Common is PCOS?

PCOS is very common, affecting around 1 in 10 women, though some studies suggest it may impact up to 1 in 4 due to mild or undiagnosed cases. However, having polycystic ovaries (visible on an ultrasound) doesn’t necessarily mean you have PCOS—it’s the combination of symptoms and hormonal changes that confirm the diagnosis.


Symptoms of PCOS

Symptoms vary widely, but common ones include:

  • Period Problems: Irregular, light, or absent periods.

  • Fertility Issues: Difficulty ovulating, which can impact conception.

  • Excess Hair Growth: Male-pattern hair growth on the face, chest, or abdomen.

  • Acne and Thinning Hair: Persistent acne and scalp hair loss.

  • Weight Gain: A higher tendency for weight gain or obesity.

  • Emotional Challenges: Depression or low self-esteem.

Symptoms can range from mild to severe and may change over time.



Diagnosing PCOS

Diagnosis involves evaluating symptoms, blood tests, and sometimes an ultrasound to check for cysts on the ovaries. To confirm PCOS, at least two of the following criteria must be met:

  1. Polycystic ovaries with multiple small cysts.

  2. Elevated male hormone levels.

  3. Irregular or absent ovulation.


Managing PCOS

While there’s no cure for PCOS, symptoms can be managed, and risks of long-term complications can be reduced.

1. Lifestyle Changes

  • Weight Loss: Losing even 10% of body weight can improve hormone levels and increase ovulation.

  • Low-Glycemic Diet: Focus on whole grains, fruits, vegetables, and foods that stabilize blood sugar levels.

  • Exercise: Regular physical activity enhances insulin sensitivity.

2. Treating Specific Symptoms

  • Hair Growth: Options include hair removal (e.g., laser, shaving) and medications like eflornithine or anti-testosterone pills.

  • Acne: Combined oral contraceptives such as Dianette® or Yasmin® may help.

  • Periods: Hormonal contraceptives or progestogen therapy can regulate cycles and reduce the risk of uterine cancer.

3. Fertility Support

For women trying to conceive, medications like clomiphene or metformin can stimulate ovulation.


Long-Term Risks of PCOS

Without proper management, PCOS increases the risk of:

  • Type 2 diabetes.

  • Cardiovascular diseases (e.g., high blood pressure, cholesterol).

  • Sleep apnea.

  • Pregnancy complications, including gestational diabetes and pre-eclampsia.


Preventing Complications

A healthy lifestyle is crucial in reducing long-term risks:

Final Thoughts

PCOS is more than just a hormonal disorder—it’s a condition that affects overall health and well-being. Understanding the symptoms, seeking medical advice, and committing to lifestyle changes can make a huge difference. Remember, you’re not alone. Support groups, healthcare providers, and a wealth of resources are available to help you manage PCOS and lead a fulfilling life.


Let’s keep the conversation about PCOS going—it’s time to empower women to take control of their health!



By Dr Purity Carr

GP & Menopause Doctor

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