Polycystic ovary syndrome (PCOS), also known as Stein-Leventhal syndrome, polycystic ovarian syndrome or polycystic ovary disease, is an endocrine (hormonal) condition in which the ovaries are enlarged and contain many small, fluid-filled cysts.
It occurs when your ovaries produce too much of the male hormones (androgens) that they normally make in only small amounts.
Normally, during each menstrual cycle, many small ‘follicles’ (sacs) grow in your ovaries and form eggs. At mid-cycle, or ovulation, one egg is released from one of the ovaries and all the other follicles over-ripen and break down. However, in PCOS, ovulation does not occur and an egg is not released. The follicles do not break down, but fill with fluid and turn into cysts. The ovaries can then swell in size, sometimes becoming 2 to 5 times larger than normal.
Women with PCOS sometimes develop masculine characteristics such as excess face and body hair, acne, hair loss in the same pattern as male baldness and fat deposits around the abdomen.
PCOS is a relatively common condition. Doctors estimate it affects 5-10 per cent of all women who haven’t yet gone through the menopause. It is one of the leading causes of infertility, yet many women do not know they have it.
Doctors are still not certain. However, they know the condition is associated with being resistant to insulin (the substance in your body which helps regulate sugar levels). Because of this, doctors think PCOS might share some similarities with diabetes. Research suggests that the ovaries of women with PCOS produce more male hormones than normal because the women can’t process insulin properly. Doctors know that if insulin levels in the blood are too high, the ovaries react by producing more male hormones.
Symptoms can begin at any age. They may develop during puberty and the start of menstrual periods may be delayed or not happen at all. Girls may be overweight and have body hair growing in a male pattern, such as on the chest and face. Or they may have irregular and heavy vaginal bleeding.
Each woman’s symptoms may be different, but usually they will include some or all of the following.
There is no easy test for PCOS, so your doctor will need to assess your symptoms from your medical history and physical appearance.
If your doctor suspects you have PCOS, he or she will probably order investigations to confirm it and rule out other more serious medical conditions. These may include:
PCOS can increase your chances of developing health problems later in life. This is why it is important to have regular medical check-ups. Even though some PCOS symptoms may lessen after the menopause, this is likely to be the time when many of the long-term associated conditions appear. These can include the following.
Although PCOS cannot be cured, some of the symptoms can be controlled. Treatment will depend on your symptoms and how severe they are, and your feelings regarding pregnancy.
With all these medicines, you should be aware that they may take some time to work. Also remember that you will have to remove any existing hair growth, as medicines aren’t effective in getting rid of excess hair. Use a method such as bleaching, waxing or electrolysis.
Fertility treatment may include the use of drugs such as clomiphene citrate (e.g. Clomid) which stimulate the ovary to grow follicles so that an egg is released mid-cycle, or injections of synthetic hormones, similar to the ones you produce naturally.
As a treatment for infertility your doctor may suggest you have surgery called laparoscopic ovarian drilling, which uses either a hot needle or laser to cauterise the ovary in several places. This procedure can stimulate ovulation and increase your chances of conceiving. However, surgery is generally considered a last resort because scar tissue can form on the ovaries as a result, which may in fact reduce your ability to get pregnant.
Your doctor may suggest you follow a special diet to try to normalise your insulin levels and keep your cholesterol levels normal. Exercise and losing weight are very important and these measures alone successfully help some women with PCOS to become pregnant when they try to conceive. Exercise and diet are also the key factors in reducing your risk of metabolic syndrome, diabetes and heart disease.
Last Reviewed: 29 April 2009