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Polycystic Ovary Syndrome (PCOS)

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46 views8 pages

Polycystic Ovary Syndrome (PCOS)

Uploaded by

Danijela Gagovic
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Patient Information

Diabetes and Endocrinology – WISDEM Centre

Polycystic ovary syndrome (PCOS)


Polycystic ovary syndrome (PCOS) is a name given to a condition which
affects the way a woman’s ovaries work.

This happens due to the hormone imbalance in the pituitary gland and the
ovaries.

Polycystic ovaries (PCO) are very common, affecting around 1 in 5


women. Polycystic ovary syndrome is also very common, originally thought
to affect 1 in 10 women (10%) but has recently been found to be as many
as 1 in 5 (20%).

The term polycystic ovaries describes ovaries that contain many small
'cysts' (about twice as many as in normal ovaries), usually no bigger than 8
millimetres each, located just below the surface of the ovaries.

The ‘cysts’ in polycystic ovaries are not true cysts. They are not full of
liquid, they do not get bigger or burst, and they do not require surgical
removal and do not lead to ovarian cancer. They are actually follicles that
have not matured to be ovulated which is why the name of the condition is
confusing (www.verity-pcos.org.uk).

PCOS is associated with many risk factors which include:


• Obesity
• Diabetes
• Hirsutism (excess hair growth) or alopecia
• Increased cardiovascular problems
Patient Information

• Oily/acne prone skin


• Infertility/difficulty conceiving
• Sleep apnoea
• Low mood/low self-esteem/depression

According to the Rotterdam Criteria, to be diagnosed with PCOS you must


have two out of the three following features:
• Irregular or absent periods
• Excess androgen, clinical or biochemical (male hormone)
• Polycystic Ovaries on Ultrasound (PCO)

Common symptoms of PCOS:


• Irregular or no periods
• Excessive hair growth
• Acne
• Difficulty getting pregnant
• Weight gain
• Thinning hair

Will I need to have any investigations to diagnose PCOS?


Yes, to confirm PCOS. This usually consists of a blood test and an
ultrasound scan.

Irregular/Absent Periods:
• Your periods may not be regular from one month to the next month.
• They may be very heavy and prolonged.
• You may have no periods at all.

Polycystic ovary syndrome (PCOS) www.uhcw.nhs.uk 2


Patient Information

Why do my periods change with PCOS?


Because your ovaries are not getting the right hormonal signals from the
pituitary gland in the brain, therefore your ovaries are not able to ovulate
each month, and these may affect your periods and they may become
irregular or absent.

Polycystic ovaries

"Polycystic Ovary Syndrome” by BruceBlaus is licenced under CC BY-SA 4.0

Not all women with PCOS have polycystic ovaries.

Some women have a scan and polycystic ovaries are confirmed to one or
both ovaries, if a scan diagnoses PCO, you must have an additional
feature of the Rotterdam criteria to be diagnosed with PCOS.

Polycystic ovaries consist of:


• A ring of harmless follicles (an underdeveloped sac which an egg
develops) that is up to 8mm in size.
• Polycystic ovaries are confirmed by an ultrasound scan which
confirms more than 12 follicles on at least one ovary or an increased
ovarian volume (more than 10ml).
• These follicles are unable to release the egg and therefore ovulation
doesn’t take place.

Polycystic ovary syndrome (PCOS) www.uhcw.nhs.uk 3


Patient Information

How will they scan me?


The ovaries are most clearly seen by a vaginal ultrasound scan, but also
abdominal scans are used for those who cannot have a vaginal scan.

This is performed by a health care professional who is trained within this


field; they will insert a small ultrasound probe into the vagina, which
enables them to view the ovaries.

The vaginal ultrasound scan may be a little uncomfortable but no more


uncomfortable than a speculum examination for a smear test.

The scan should only last 5 minutes, and no special preparation is


required, only an empty bladder.

There should be no side effects of the scan and you can go home the
same day.

Are polycystic ovaries dangerous?


No, but may increase your risk of other factors.

Will I need surgery to remove the follicles?


No.

Are polycystic ovaries painful?


They shouldn’t be, so if pain is experienced it may be from ovulation or
from a cyst which will usually go without treatment.

Is there a cure for PCOS?


Advice will be given regarding lifestyle changes and if required medication
can be prescribed to help with symptoms associated with PCOS.

What causes PCOS?


The exact cause is unknown although it is related to hormonal imbalance,
insulin resistance and genetics (family history).

Polycystic ovary syndrome (PCOS) www.uhcw.nhs.uk 4


Patient Information

Excess androgens
Excess androgen is increased levels of male hormones (testosterone)
which can contribute to:
• Hirsutism (Excess hair growth)
• Oily/Acne prone skin
• Alopecia (hair loss)

How will we know if I have increased androgens?


You will have excess hair growth, which is thick, dark, coarse hair, possibly
on the lip, chin, chest, abdomen, and lower tummy, top of arms, thighs,
back and bottom.

How will you determine the severity of hirsutism?


You will be assessed in clinic using a tool called the Ferriman-Gallwey tool,
which looks at how severe the hair growth is on a scale of 1 to 4, the total
is then calculated, and your Hirsutism score is monitored.

What treatment will I be offered for my excess hair growth?


Unfortunately, the NHS will not fund laser/electrolysis treatment; you can
self-fund this as it is a recommended way to eliminate excess hair growth.

Medications can be prescribed to reduce excess androgens and


reduce/eliminate excess hair growth.

Treatment
Treatment for the diagnosis of PCOS varies depending on the presenting
symptoms and the possible risk factors.

You will be advised to make lifestyle changes to prevent symptoms getting


worse, particularly if you are overweight.

Polycystic ovary syndrome (PCOS) www.uhcw.nhs.uk 5


Patient Information

Weight Loss/Maintenance
If you are of healthy weight/BMI we advise you follow a healthy diet to
prevent weight gain which will prevent your symptoms worsening.

Obesity or increased weight can enhance symptoms of PCOS. Therefore,


we advise if you are overweight/obese we advise that you lose weight to
improve your symptoms.

We can:
• Refer you to a dietician for advice.
• Refer you to the weight management clinic.
• Prescribe medication to assist in lowering your BMI.

Weight loss will improve hormonal imbalance, improve ovulation, and


reduce the risk of diabetes and cardiovascular problems.

If you are struggling to conceive, reducing your weight and BMI will allow
you to go on to have fertility treatments.

Diabetes
PCOS increases your risk of becoming insulin resistant and of developing
Type 2 Diabetes in the future.

To reduce the risk, we advise:


• Weight loss
• Blood test to monitor glucose level
• May start you on medication to prevent insulin resistance

If you develop diabetes we will:


• Inform your GP
• Commence you on diabetic medications
• If you have not already seen, refer you to a dietician

Polycystic ovary syndrome (PCOS) www.uhcw.nhs.uk 6


Patient Information

Infertility
If you are diagnosed with PCOS and cannot conceive we may:
• Advise you to lose weight if you are overweight.
• We may commence you on medications to induce ovulation
(clomiphene).
• We may start you on a drug called metformin which lowers androgen
levels and alters ovarian function by improving insulin sensitivity in
the ovaries.
• Refer you to the reproductive medicine unit to discuss assisted
fertility options.

If you are diagnosed with PCOS but are not actively trying to conceive but
still have some of the symptoms, we may consider the combined
contraceptive pill which helps to regulate your periods and potentially
improve Hirsutism and acne.

If you have any concerns or queries relating to your PCOS diagnosis,


please don’t hesitate to contact us on 024 7696 6019:
Danielle Bate - PCOS Clinical Nurse Specialist
Professor Harpal Randeva - Clinical Lead.
Dr Puja Thadani - Clinical Fellow.

There are also support groups available to women with PCOS:


• VERITY
• PCOSAA
• PCOS UK
• PCOS CHALLENGE

The Trust has access to interpreting and translation services. If you need
this information in another language or format, please contact the
WISDEM Centre 0247 696 6027 and we will do our best to meet your
needs.
The Trust operates a smoke free policy.

Polycystic ovary syndrome (PCOS) www.uhcw.nhs.uk 7


Patient Information

Did we get it right?


We would like you to tell us what you think about our
services. This helps us make further improvements and
recognise members of staff who provide a good service.
Have your say. Scan the QR code or visit:
www.uhcw.nhs.uk/feedback

Document History
Department: Diabetes & Endocrinology
Contact: 26019
Updated: April 2023
Review: April 2025
Version: 2.1
Reference: HIC/LFT/2292/18

Polycystic ovary syndrome (PCOS) www.uhcw.nhs.uk 8

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