Polycystic Ovary Syndrome (PCOS): Symptoms, Causes and Treatment

What is polycystic ovary syndrome (PCOS)?

PCOS is a complex hormonal disorder characterised by an imbalance in reproductive hormones, leading to various symptoms and potential health risks. The condition affects the ovaries, which are responsible for producing eggs and hormones such as oestrogen and progesterone.

What are the symptoms of PCOS?

1. Irregular menstrual cycles

   • Women with PCOS often experience irregular periods, which may be infrequent or prolonged.

2. Hyperandrogenism

   • Elevated levels of androgens (male hormones) can lead to symptoms like acne, excessive hair growth (hirsutism), and male-pattern baldness.

3. Polycystic ovaries

   • Many women with PCOS exhibit multiple small cysts on their ovaries, detectable via ultrasound.

4. Metabolic issues

   • PCOS is associated with insulin resistance, increasing the risk of type 2 diabetes and obesity.

5. Fertility problems

   • PCOS is a leading cause of infertility due to irregular or absent ovulation.

What are the causes of PCOS?

The exact cause of PCOS remains unclear, but several factors contribute to its development:

1. Genetics

   • There is a strong familial link in PCOS cases, suggesting a genetic predisposition.

2. Hormonal imbalance

   • Insulin resistance and elevated levels of androgens disrupt normal ovarian function.

3. Lifestyle factors

   • Sedentary lifestyle, poor diet, and obesity can exacerbate hormonal imbalances and insulin resistance, worsening PCOS symptoms.

What age group does PCOS affect?

PCOS typically affects women of reproductive age, which spans from puberty to menopause. However, the age range at which PCOS manifests can vary.

1. Adolescence

   • PCOS can occur in teenage girls, often presenting shortly after the onset of menstruation with symptoms like irregular cycles, acne, and excessive hair growth.

2. Reproductive age

   • PCOS is most commonly diagnosed in women in their 20s and 30s, during their prime reproductive years, often due to fertility concerns or other PCOS-related symptoms.

3. Perimenopause

   • PCOS can persist into the period before menopause, potentially worsening symptoms like irregular bleeding and insulin resistance.

4. Postmenopause

   • PCOS is less commonly diagnosed postmenopause. However, some women may continue to experience PCOS-related symptoms or metabolic issues, necessitating ongoing management and monitoring.

It's essential to recognie that PCOS can affect women at different stages of their reproductive lives, and the presentation of symptoms may evolve over time. Early diagnosis and intervention are crucial for managing PCOS effectively and reducing the risk of associated health complications. Therefore, women of all ages who experience symptoms suggestive of PCOS should seek medical evaluation and appropriate care from healthcare providers experienced in managing this condition.

What are the complications of PCOS?

If left untreated, PCOS can lead to several complications:

1. Infertility

   • Ovulatory dysfunction makes conception difficult.

2. Metabolic syndrome 

   • Insulin resistance increases the risk of type 2 diabetes and cardiovascular disease.

3. Endometrial cancer

   • Irregular menstrual cycles and unopposed oestrogen exposure raise the risk of endometrial hyperplasia and cancer.

4. Psychological impact

   • PCOS is often associated with anxiety, depression, and poor quality of life due to its physical symptoms and fertility challenges.

FAQs

How to diagnose PCOS?

Diagnosing PCOS involves a combination of:

1. Medical history

   • Doctors inquire about menstrual irregularities, hyperandrogenism symptoms, and family history of PCOS.

2. Physical examination

   • Signs such as excessive body hair, acne, and abdominal obesity may be observed.

3. Laboratory tests

   • Blood tests measure hormone levels, including testosterone, oestrogen, LH (luteinizing hormone), FSH (follicle-stimulating hormone), and insulin. Ultrasound imaging may reveal polycystic ovaries.

What is the treatment for PCOS?

1. Lifestyle modifications

   • Weight loss through diet and exercise can improve insulin sensitivity and hormone balance.

     

2. Medications

   • Oral contraceptives: Birth control pills regulate menstrual cycles and reduce androgen levels, improving symptoms like acne and excessive body hair.

   • Anti-androgen medications: Drugs like spironolactone can reduce excess hair growth and acne.

   • Insulin-sensitising agents: Metformin helps lower insulin levels, aiding in weight loss and regulating menstrual cycles.

3. Fertility treatments

   • Ovulation-inducing medications or assisted reproductive technologies (ART) may be recommended for women trying to conceive.

4. Psychological support

   • Counselling or support groups can help women cope with the emotional challenges of PCOS.

FAQ

Can PCOS be cured?

PCOS is a chronic condition that currently has no cure. However, appropriate management and lifestyle modifications can help many women control their symptoms and reduce associated health risks.

Is it possible for thin women to have PCOS?

Yes, thin women can have PCOS. While PCOS is often associated with obesity, it can affect women of all body weights, including those who are underweight or of normal weight. Thin women with PCOS may exhibit symptoms such as:

1. Irregular menstrual cycles

   • Infrequent, prolonged, or absent menstrual cycles.

2. Hyperandrogenism

   • Elevated levels of androgens can lead to symptoms such as acne, oily skin, and excessive hair growth. 

3. Polycystic ovaries

   • Multiple small cysts on the ovaries, detectable via ultrasound.

4. Insulin resistance

   • Metabolic issues like weight gain, difficulty losing weight, and an increased risk of type 2 diabetes.

It's essential to recognise that PCOS is a heterogeneous condition, meaning it can present differently in different individuals. While obesity and insulin resistance are common features of PCOS, they are not prerequisites for the diagnosis. Thin women with PCOS may have a milder form of the condition or exhibit fewer metabolic abnormalities compared to those who are overweight or obese.

PCOS in Singapore

PCOS is a common condition among women in Singapore, affecting their reproductive health and overall well-being. Awareness and early diagnosis are crucial for managing PCOS effectively. Women in Singapore are encouraged to seek medical evaluation if they experience symptoms suggestive of PCOS. 

Additional support

If you have any concerns about PCOS, feel free to reach out to Thomson Medical. Our team is here to assist you with any questions and provide the support you need.