What is pcos?

Polycystic ovaries have at least twice as many developing follicles as normal ovaries. However, many of these follicles do not mature to the point of releasing an egg (ovulation). This causes a build-up of immature eggs (fluid-filled sacs) in the ovaries and irregular, or no, ovulation to occur. Because they have more follicles than is usual, polycystic ovaries are slightly larger than normal ovaries.

A syndrome is a collection of different signs and symptoms that are all part of the same underlying medical condition. Women with polycystic ovary syndrome (PCOS) rarely have all of the possible signs and symptoms. PCOS is therefore difficult to diagnose. The doctor will take account of your symptoms and will usually check your hormone levels (through a blood test) and your ovaries (through an ultrasound scan).

Genetic component:

If someone else in your family has it, you have a greater chance of having it too.

Excess insulin:

Many women with PCOS are resistant to insulin – the hormone that helps with storing and using sugar – which means they need a larger amount of it to maintain normal levels of sugar in their blood. In turn, high insulin levels increase the production of androgens.

Excess weight:

It isn’t clear what comes first, but women with excess weight are at higher risk of having PCOS and women with PCOS have a higher risk of being overweight.

Hormone imbalance:

Certain hormonal imbalances are common among women with PCOS. These include:

• higher levels of testosterone
• higher levels of the hormone that stimulates ovulation (luteinising hormone, LH)
• low levels of sex hormone-binding globulin (SHBG) – a protein in the blood, which binds to testosterone and reduces the effect of testosterone
• some women with PCOS also have higher levels of prolactin – a hormone that stimulates the breast glands to produce milk

Low-grade inflammation:

Inflammation is a response to infection in which white blood cells produce substances to fight the infection. Women with PCOS have been shown to have low-grade inflammation, which stimulates polycystic ovaries to produce androgens.

• have more body hair than is usual for you
• have irregular periods or no periods at all
• have difficulty in getting pregnant

• be overweight
• have acne

These symptoms can vary from mild to severe. They can be caused by other conditions, too.
If you have PCOS symptoms, you may have a greater risk of developing long-term health problems such as:

• heart problems
• diabetes

• high blood pressure
• cancer of the lining of the womb (known as endometrial cancer)

Before you begin trying to conceive, it is a good idea to visit your doctor and get tested. Your doctor will review your medical history and talk about any conditions you have that might affect your fertility, such as thyroid disease, diabetes, endometriosis and lupus. If for example, you have epilepsy or high blood pressure, your doctor may advise you to get control of the disease before you try for a baby.

Depending on your family’s medical history, your doctor may want to test if you or your partner are carriers of any genetic conditions. Your doctor will also check your vaccinations are up-to-date. They will also recommend that women planning a pregnancy get the flu shot as contracting the flu can lead the severe complications, such as pneumonia or preterm labour. If you have any concerns or are planning to start trying for a baby, inform your doctor so that you can talk about any concerns you may have.