Polycystic ovary syndrome (PCOS) is the most common female endocrine disorder, affecting approximately 10-20 % of all females. Upto 70% of women remain undiagnosed.

PCOS is a hormonal disorder that involves multiple organ systems within the body, and is believed to be fundamentally caused by insensitivity to the hormone insulin. Women with PCOS have a higher risk of metabolic syndrome and its cardiovascular sequelae.

It is important to note that not all women with PCOS have ovarian cysts, and not all women with multiple ovarian follicles/cysts have PCOS.

Although PCOS is one of the leading causes of infertility, the reproductive aspects of the disorder are secondary. PCOS is not limited to women of reproductive age.

Untreated, PCOS may have significant or even serious health consequences. These consequences include obesity, psychological problems, (poor self-esteem, negative body image, depression, anxiety), excessive body hair, loss of scalp hair, infertility, insulin resistance, metabolic syndrome, pre-diabetes, type 2 diabetes and potentially – cardiovascular disease.

Understanding the diagnosis of PCOS and what it means, empowers women who have this condition. It enables them to understand their condition and why they seem different to other women and girls. Diagnosing women with PCOS enables them to make the lifestyle decisions about diet and exercise and fertility issues which are imperative to the successful management of PCOS.

In most PCOS sufferers there is an excess of oestrogens and testosterone and a lack of progesterone. The source of the excess oestrogens may be from the environment ( ie BPA plastics- found in water bottles and canned food, from cleaning products and cosmetics), or it may be from the oral contraceptive pill or from the bodies inability to get rid of or balance their bodies own oestrogen.

Common symptoms and effects of PCOS include:

  • irregular or no menstrual periods (for women of reproductive age)
  • irregular ovulation, with or without monthly bleeding
  • acne
  • excess hair growth on the face and body
  • thinning scalp hair especailly in the temple regions.
  • accumulation of unruptured follicles on the periphery of the ovaries (mislabeled as “cysts”, often called polycystic ovaries)
  • central obesity and rapid weight gain
  • multiple ovarian cysts.
  • sugar , carbohydrate and chocolate cravings
  • Increased circulating hormones especially testosterone and insulin
  • Increased pigmentation, and skin tags in the axilla and inner thigh
  • signs of oestrogen dominance- possible fibroids after age 35yrs, fat deposition thighs and butt
  • Worsening PMS and premenstrual headaches

    Investigations for PCOS Spectrum are available, and careful analysis and interpretation of pathology test and possible radiological imaging is required for early diagnosis.

    Treatment choices of PCOS Spectrum
    a. Lifestyle treatments
    1. Low GI diet
    2. Regular exercise
    3. Psychological treatment
    4. Fertility planning.

    b. Herbal/ Vitamin and Mineral Treatments, Cosmetic treatments.

    Integrative Medicine Doctors (AIMA doctors) & Naturopaths often know more about these treatments than many doctors who tend to disregard them and move straight to prescription drug treatments, which are effective but may be more prone to long term side effects.
    Many doctors still seem to place little emphasis on lifestyle modification, and psychological treatments both of which are the foundation for successful management of PCOS.

    c. Drug Treatment for PCOS Spectrum
    1. •Oral contraceptive pills,
    2. •Acne – can be treated with the OCPill as above, and other prescription acne treatments.
    3. •Metformin which was previously not used unless diabetes was present, should be considered earlier when insulin resistance is evident.
    4. •Anti depressants especially those not associated with weight gain e.g. Lovan , Zoloft or Cymbalta may greatly improve mood and decrease anxiety.
    5. •Bio-identical progesterone