What is PCOS?

PCOS is a hormonal disorder characterised by:

• Irregular menstrual cycles or missed periods.

• Higher levels of androgens (male hormones), leading to symptoms such as acne, excessive hair growth, and hair thinning.

• Polycystic ovaries, where the ovaries contain multiple small follicles (fluid-filled sacs) that may prevent regular ovulation.

Despite its name, not all women with PCOS have cysts on their ovaries, and not all women with ovarian cysts have PCOS.

What Causes PCOS?

The exact cause of PCOS is not fully understood, but several factors contribute:

• Insulin Resistance: Up to 80% of women with PCOS have insulin resistance, meaning their body struggles to use insulin properly, leading to high blood sugar and increased fat storage.

• Hormonal Imbalance: Elevated levels of androgens (testosterone) and luteinising hormone (LH) can disrupt ovulation.

• Genetics: PCOS often runs in families, suggesting a hereditary link.

• Inflammation: Women with PCOS tend to have higher levels of chronic inflammation, which may contribute to weight gain and metabolic issues.

Symptoms of PCOS

PCOS symptoms can vary, but the most common include:

• Irregular or absent periods.

• Excessive hair growth (hirsutism), especially on the face, chest, or back.

• Thinning hair or male-pattern baldness.

• Weight gain, particularly around the abdomen.

• Acne and oily skin.

• Darkened patches of skin (acanthosis nigricans), often on the neck, underarms, or groin.

• Difficulty losing weight despite diet and exercise.

• Mood swings, anxiety, or depression.

• Fertility issues due to irregular ovulation.

PCOS symptoms can appear during adolescence or later in life, often worsening with age if left untreated.

How Does PCOS Affect Weight and Metabolism?

One of the biggest challenges for women with PCOS is unexplained weight gain and difficulty losing weight.

• Insulin Resistance: Leads to higher blood sugar levels, increased fat storage, and a greater risk of obesity.

• Slower Metabolism: Many women with PCOS burn fewer calories at rest, making weight management more difficult.

• Cravings and Hunger: Insulin resistance can cause frequent sugar cravings and intense hunger spikes.

Even a 5-10% weight loss can significantly improve PCOS symptoms, regulate periods, and enhance fertility.

PCOS and Fertility: Can You Still Get Pregnant?

PCOS is a leading cause of ovulatory infertility, meaning it can make it harder to conceive naturally.

• Irregular ovulation: Many women with PCOS do not ovulate regularly, making conception difficult.

• Hormonal Imbalances: High androgen levels can interfere with egg development.

• Increased Risk of Miscarriage: Women with PCOS have a slightly higher risk of early pregnancy loss due to hormonal imbalances.

Fertility Treatments for PCOS

While PCOS can affect fertility, many women with PCOS successfully conceive with medical assistance. Common treatments include:

1. Lifestyle changes (weight loss, exercise, and diet).

2. Ovulation induction medications (such as Clomid or Letrozole).

3. Insulin-sensitising drugs (like Metformin) to improve ovulation.

4. Intrauterine insemination (IUI) or in vitro fertilisation (IVF) if other treatments fail.

How is PCOS Diagnosed?

There is no single test for PCOS, so doctors use a combination of:

1. Medical History and Symptom Check

2. Blood Tests: To measure hormone levels, including androgens, insulin, and thyroid function.

3. Ultrasound Scan: To check for polycystic ovaries and monitor ovulation.

A woman is diagnosed with PCOS if she meets two out of three criteria (known as the Rotterdam criteria):
✔ Irregular periods
✔ High androgen levels (confirmed by blood tests or physical symptoms)
✔ Polycystic ovaries seen on ultrasound

Managing PCOS: Treatment and Lifestyle Changes

There is no cure for PCOS, but lifestyle modifications and medical treatments can help manage symptoms and improve quality of life.

1. Diet and Nutrition

A low GI (glycaemic index) diet is highly recommended for PCOS as it helps control insulin levels and reduce inflammation.

• Eat more: Vegetables, lean proteins, whole grains, healthy fats, and fibre-rich foods.

• Reduce: Sugar, processed foods, white bread, pasta, and sugary drinks.

• Consider Supplements: Omega-3, magnesium, vitamin D, and inositol may improve PCOS symptoms.

2. Exercise and Physical Activity

Regular exercise can help with weight management, improve insulin sensitivity, and reduce symptoms.

• Best types of exercise for PCOS:
  ✔ Strength training (helps improve metabolism).
  ✔ Cardio workouts (walking, cycling, swimming).
  ✔ Yoga and Pilates (reduces stress and balances hormones).

3. Medications for Symptom Control

• Birth Control Pills: Regulates periods and reduces acne and excess hair growth.

• Metformin: Improves insulin resistance and can help with weight loss and fertility.

• Anti-Androgen Medications (like Spironolactone): Reduces excessive hair growth and acne.

• Fertility Medications: If trying to conceive, doctors may prescribe ovulation-inducing drugs.

4. Stress Management and Mental Health Support

PCOS can increase the risk of anxiety, depression, and body image concerns.

• Mindfulness, meditation, and stress management techniques can help.

• Seeking support from a psychologist or PCOS support group is beneficial.

PCOS in Australia: Awareness and Support

In Australia, organisations such as:

• Jean Hailes for Women's Health

• The PCOS Awareness Association

• Australian Government PCOS Guidelines

Provide support, research updates, and medical resources for women managing PCOS.

PCOS is a lifelong condition that affects hormones, weight, fertility, and long-term health. However, with the right lifestyle changes, medications, and support, symptoms can be well-managed. Women with PCOS can still lead healthy lives, lose weight, and conceive successfully.

If you suspect you have PCOS, it is important to seek medical advice, make lifestyle adjustments, and explore personalised treatment options to improve your well-being.