Polycystic ovary syndrome (PCOS) | Huahua hua kūao

Also known as polycystic ovarian syndrome (PCOS)

Polycystic ovary syndrome (PCOS or huahua hua kūao) is a hormonal condition that affects how your ovaries work.

Key points about PCOS

  1. PCOS is associated with increased levels of 2 hormones in your body: insulin and testosterone (male-type hormones).
  2. Symptoms range from mild to severe. They can include irregular or heavy periods, acne, excess facial or body hair, scalp hair loss and weight gain.
  3. The 3 diagnostic features of PCOS are irregular periods, excess testosterone and polycystic ovaries. If you have 2 of these you may be diagnosed with PCOS.
  4. There are things you can to to reduce the symptoms and the long-term effects on your health.
  5. Living with PCOS can be challenging, so getting good support and taking care of your emotional wellbeing is important.

What is PCOS?

If you’re of childbearing age, you generally produce an egg from an ovary every month. This process requires a fine-tuned response from a complex hormonal system. If you have PCOS, more testosterone and insulin is produced than is needed.

This excess hormone stops the release of eggs from your ovary, but it doesn't stop them being produced. The eggs continue to build up in your ovaries, which is why the condition is referred to as polycystic ovaries (many cysts in your ovaries).

Who gets PCOS?

PCOS can begin at puberty or even in early to mid-20s. It is the most common hormonal condition affecting women of childbearing age, about 8–13 out of every 100 people.

You may not know you have PCOS until you have difficulty getting pregnant.

What causes PCOS?

The cause of PCOS is not yet known but it might run in families. If any of your relatives are affected with PCOS, your risk of developing it may be increased.

The symptoms are related to increased hormone levels, mainly testosterone and insulin.

  • Testosterone is a hormone produced by the ovaries. If you have PCOS, your ovaries produce much more testosterone than they need to. This excess is what causes many of the symptoms of PCOS.
  • Insulin is a hormone that controls the level of glucose (a type of sugar) in your blood. If you have PCOS, your body may not be able to use the insulin as it should (this is known as insulin resistance(. As a result, the level of glucose in your blood becomes too high. To try to lower your blood glucose levels, your body produces even more insulin. High levels of insulin can lead to weight gain, irregular periods and fertility problems.

What are the symptoms of PCOS?

The symptoms vary from person to person. Some have very few or mild symptoms, while others are affected more severely by a wider range of symptoms.

Common symptoms of PCOS

Periods and fertility

  • irregular, infrequent or no period
  • difficulty becoming pregnant
  • multiple cysts on your ovaries
  • endometrial hyperplasia.

Hair, skin and body

  • acne on face or body, can be severe
  • excess hair on face, chest or tummy  (hirsutism)
  • hair loss or thinning of hair on your head (alopecia)
  • being overweight or experiencing a rapid increase in weight
  • having difficulty losing weight.

Mental/emotional health

Hormonal changes and dealing with the symptoms of PCOS can cause:

These feelings can affect your overall quality of life. Read more about PCOS and emotional wellbeing.

Related conditions

Having PCOS may increase your chance of developing:

How is PCOS diagnosed?

PCOS can be a complex condition to diagnose because there are many symptoms, and you don’t have to have all of them to be diagnosed with PCOS. Very few people have the same set of symptoms, and the symptoms can change at different stages of your life.

To diagnose PCOS, your doctor will assess your symptoms, medical history and physical appearance. You may need to do some tests to confirm it and/or rule out other medical conditions.

Diagnostic criteria for PCOS

To make a diagnosis of PCOS, 2 out of 3 of the following are required:

1. Irregular periods or no periods.

2. Higher levels of testosterone, as shown by:

  • a blood test or
  • symptoms such as:
    • excess body or facial hair
    • acne
    • scalp hair loss.

3. Polycystic ovaries visible on ultrasound (only done if you have been having periods for 8 years or more).

If the first 2 criteria are both present, an ultrasound scan is not usually required.

How is PCOS managed?

While there is no cure for PCOS, with the right support you can greatly reduce the symptoms and long-term effects on your health. Because PCOS can have many symptoms, a range of treatments might be necessary to manage the condition well. The key to managing PCOS well is working in partnership with your healthcare team to find the best strategies for you. PCOS support groups can also be inviable sources of helpful information.

Managing PCOS with lifestyle

healthy lifestyle has been shown to be the most effective approach to managing PCOS successfully and reducing the severity of symptoms. A healthy lifestyle includes eating a balanced and nutritious diet, being as active as possible, maintaining a healthy weight and minimising harmful habits such as smoking and excessive drinking. Learn more about managing PCOS with lifestyle.

Managing PCOS with medicines

Medication alone has not been shown to be any better than healthy lifestyle changes in managing PCOS. You may be able to successfully manage your symptoms and the long-term health risks without medical intervention.

There are a number of medicines used to manage the different symptoms of PCOS, including acne, excess hair growth, problems with your periods and fertility issues. Some medicines may help more than one symptom. PCOS affects everyone differently and, if required, your doctor will work out which medicines best meet your needs. Read more about managing PCOS with medicines.

Managing your emotional wellbeing

PCOS can be a challenging condition to live with and it can affect your mental wellbeing. This may be due to a combination of hormonal influences and dealing with the symptoms of PCOS. It’s not uncommon to experience low self-esteem, poor self-image, anxiety and depression – all of which can affect your overall quality of life. Read more about PCOS and emotional wellbeing.

Managing fertility

Having PCOS does not mean you can't get pregnant. PCOS is one of the most common, but treatable, causes of infertility. If you have PCOS, the hormonal imbalance interferes with the growth and release of eggs from your ovaries (ovulation). If you don't ovulate, you can't get pregnant. Your doctor or a fertility specialist can talk with you about ways to help you ovulate and to raise your chance of getting pregnant.  

Managing excess hair

Sometimes excessive hair growth is best managed with both medical treatment and electrolysis or laser therapy. Your doctor can advise what’s best for you. 

How can I reduce the risk of PCOS-related complications?

PCOS can increase your chances of developing health problems later in life, so you need to have regular medical check-ups. Some PCOS symptoms lessen after menopause, but this is likely to be the time many of the long-term associated conditions appear.

To reduce your risk of complications: 

Learn more

Polycystic ovary syndrome – what it means for your long-term health Royal College of Obstetricians and Gynaecologists, UK, 2015
Ask PCOS Monash University, Australia, 2018

References

  1. International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018 Monash University, Melbourne, Australia, 2018
  2. Understanding polycystic ovary syndrome BPAC, NZ, 2008
  3. Long-term consequences of polycystic ovary syndrome Royal College of Obstetricians and Gynaecologists, UK, 2014  
  4. Clinical practice: polycystic ovary syndrome New England Journal of Medicine, 2016
Credits: Health Navigator Editorial Team. Reviewed By: Dr Peter van de Weijer, obstetrician and gynaecologist Last reviewed: 15 Oct 2020