PCOS (Polycystic Ovarian Syndrome) is a common hormone problem, and one of the leading causes of infertility in women. The term ‘polycystic ovaries’ describes the appearance of the ovaries on an ultrasound scan – they contain many small follicles (perhaps 15 or more) and the dominant follicle does not develop as easily. Many of the small follicles produce differing levels of hormones, usually testosterone rather than estrogen.
As many as ten percent of women of childbearing age have polycystic ovaries, but most don’t even know that they have it. If they are ovulating regularly, albeit with a longer cycle, it doesn't matter and is normal, but if they are not ovulating they have PCOS.
How do I know if I have 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 gestation diabetes if you do fall pregnant.
All these issues, 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.
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 and on ovulation.
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.
All these treatment options are available at Melbourne IVF. You can discuss the implications thoroughly with your fertility specialist before undergoing treatment.
> Meet Melbourne IVF specialists with special expertise in PCOS
