Gynaecology

The Science of Women

Polycystic Ovarian Syndrome


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Polycystic Ovarian Syndrome (PCOS) is the most common hormonal abnormality in women of reproductive age.
It is associated with infrequent and light menstrual flow, subfertility and often a high Body Mass Index (BMI).
Women with PCOS may have higher male hormone levels, Luteinizing Hormone levels and varying degrees of Insulin resistance.
The exact cause of PCOS is not known but there appears to be a family link.

 

How is PCOS diagnosed?

Women who have at least 2 of the 3 criteria are said to have PCOS
❖ Evidence of elevated male hormone levels like increase facial hair, pimples, and male pattern baldness
❖ Reduced menstrual frequency and flow as well as anovulation
❖ Ovaries that are enlarged with multiple small cysts (< 10mm)

 

What are the issues concerning PCOS?

❖ Irregular menstrual cycles : often few and far apart with little menstrual flow. Sometimes heavy menstruation occurs after a prolong period of absent menstruation
❖ Endometrial Hyperplasia and/or Cancer : there is a 5x chance of disordered womb lining with chronic irregular menstruation

    
❖ Anovulation and Infertility : a result of irregular menstruation and abnormal hormone levels
❖ Pregnancy Risks : PCOS predisposes to miscarriage as well as diabetes and hypertension in pregnancy
❖ Metabolic Disturbances : in older women with longstanding PCOS, there is a higher chance of developing hypertension, diabetes and raised cholesterol.

 

How is PCOS treated?

❖ Healthy diet and exercise aiming for 10% reduction of body weight.

❖ Hormonal medication to regulate menstruation.
❖ Clomiphene or Letrozole to help fertility, with some women requiring IVF.
❖ Laparoscopic Surgery on the polycystic ovaries (Ovarian Drilling)