Polycystic ovary syndrome (PCOS) is common, affecting one in 10 people with ovaries in the UK, with more than half experiencing no symptoms.
PCOS affects the normal functioning of the ovaries, which are vital reproductive organs responsible for producing hormones such as oestrogen and progesterone – which are key in regulating the menstrual cycle. The exact cause of PCOS is unknown, however having a family history may increase your risk.
How is PCOS diagnosed?
Three main features of PCOS include:
- Irregular periods – meaning the ovaries are not regularly releasing eggs.
- Excess androgen levels – high levels of “male” hormones in the body which may cause physical changes such as excessive facial or body hair.
- Polycystic ovaries – the ovaries become enlarged and contain many fluid-filled sacs that surround the egg.
During investigations your GP will ask about your symptoms and arrange a series of blood tests to measure your hormone levels. An ultrasound scan may be recommended to determine if you have an elevated number of follicles in your ovaries.
Symptoms of PCOS
Symptoms can vary from person to person, and may include:
- Irregular periods
- Difficulty getting pregnant (due to irregular ovulation or lack of ovulation)
- Excessive hair growth (usually on the face, chest, back or buttocks)
- Weight gain
- Thinning hair or hair loss on the head
- Oily skin or acne
- Darkening of the skin around the neck, groin and under the breasts
- Headaches
PCOS and weight
Many people with PCOS struggle with weight management and may find it challenging to lose weight. Several factors contribute to the relationship between PCOS and weight gain, including:
- Insulin resistance: Many individuals with PCOS have insulin resistance, a condition where the body’s cells don’t respond effectively to insulin. This can lead to an increase in insulin levels, promoting the storage of fat and making it difficult to lose weight.
- Hormonal imbalance: PCOS is characterised by an imbalance in reproductive hormones, including elevated levels of androgens (male hormones). This hormonal imbalance can influence metabolism and contribute to weight gain, especially around the abdominal area.
- Difficulty in losing weight: Insulin resistance and hormonal imbalances associated with PCOS can make it harder for individuals to lose weight through traditional methods such as diet and exercise.
- Increased appetite: Some people with PCOS may experience an increased appetite, possibly related to insulin resistance and hormonal fluctuations.
- Difficulty in regulating blood sugar: PCOS is often linked to difficulties in regulating blood sugar levels, which can lead to cravings for sugary and high-calorie foods.
PCOS and fertility
PCOS can cause irregular periods or no periods at all, which can make it difficult to get pregnant, and many individuals with PCOS may face challenges when trying to conceive. With treatment, most people with PCOS are able to get pregnant.
If you are experiencing fertility issues due to PCOS, there are several treatment options available. Speak to your GP to find out more.
Treatments for symptoms of PCOS
PCOS cannot be cured, however there are treatments available to help manage symptoms. The features of your PCOS will determine the types of treatment you receive. The Royal College of Obstetricians and Gynaecologists states “it is recommended that lifestyle changes, including diet, exercise and weight loss, are initiated as the first line of treatment for women with PCOS for improvement of long-term outcomes”.
Lifestyle changes that can help include:
- Regular physical activity: This will support your overall health, including your mental health. Try to aim for 150 minutes or moderate intensity or 75 minutes of vigorous intensity exercise each week, in addition to a couple of strength training sessions. It doesn’t have to mean joining a gym, activities such as a brisk walk, dancing, and riding a bike all count too. Find out more suggestions on the NHS website.
- Diet: Try to eat a healthy balanced diet which includes:
- Low GI carbohydrates for slow energy release to maintain blood sugar control – e.g. porridge oats, wholegrain bread or pasta, brown rice.
- Fruits and vegetables to increase fibre intake, opting for a range of colours.
Lean protein e.g. fish, chicken, tofu, soy-beans, lentils to help with hormone production and improve blood sugar regulation. - Good quality fats e.g. nuts, avocado, salmon.
- Also remember to keep hydrated with plenty of fluids.
- Manage stress effectively: High levels of stress can negatively affect the adrenal glands, prompting increased production of androgens such as testosterone. Stress may also contribute to unhealthy lifestyle choices. Prioritise your health by adopting healthy coping mechanisms for pressure and stress, and ensure you allocate time for relaxation and recovery.
If work-related stress is a challenge, don’t hesitate to seek assistance from your line manager or HR team. Utilise resources such as an employee assistance program (EAP) for confidential emotional support. If coping becomes overwhelming, schedule an appointment with your GP, who can provide guidance on additional interventions.
Below are some further treatments to help target specific symptoms of PCOS:
- Unwanted hair growth or hair loss: Some medicines are used to ‘block’ the effects of androgens, whilst others slow the growth of unwanted hair.
- Weight gain: Regular physical activity and eating a healthy balanced diet can help to manage weight. If you do feel you would benefit from additional support your GP will be able to advise on other options which may come in the form of dietary advice or medication.
- Oily or acne-prone skin: Look after your skin by regularly cleansing. Avoid exfoliating too regularly as this can encourage the production of sebum in the skin increasing the likelihood of spots.
- High cholesterol: Adhering to a Mediterranean based diet of oily fish, fruit, vegetables, and whole-grains can have a positive effect on your cholesterol levels. There are also medications available called ‘statins’ which can help with cholesterol regulation.
See the NHS website for more information about possible treatments.
Further support
Mind – Five steps to wellbeing.
Verity – PCOS charity.
PCOS Awareness Association – Resources and information.
Flo Health – PCOS and mental health.
The Association of UK Dietitians – PCOS and diet.
Sources:
www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment
www.verywellhealth.com/pcos-and-pregnancy-5192450
This information was published November 2023.
