Polycystic Ovary Syndrome (PCOS) I  Huahua hua kūao

Polycystic ovary syndrome (PCOS) is a common hormonal disorder affecting people with a uterus of reproductive age. It is characterised by irregular menstrual cycles, excess androgen levels, and polycystic ovaries. 

Symptoms of PCOS

The symptoms vary from person to person. You may have very few or mild symptoms, or you may be affected more severely by a wider range of symptoms.

Periods and fertility:

• Irregular, infrequent or no periods.
• Difficulty becoming pregnant.
• Many partly formed eggs in your ovaries.
• Excessive thickness of the endometrium (the lining of your womb/uterus) known as hyperplasia.

Hair, skin and body:

• Excess hair on face, chest or tummy (hirsutism).
• Acne on the face or body can be severe.
• 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:

• Anxiety 
• Depression
• Body image distress
• Low self-esteem
• Risk factors for disordered eating or eating disorders

When to see a doctor

• If you have irregular periods or no periods at all
• If you experience symptoms of excess androgens, such as hirsutism or severe acne
• If you have difficulty getting pregnant
• If you experience significant weight gain or are unable to lose weight despite diet and exercise

Diagnosis

To diagnose PCOS, a healthcare professional will:

• Review your medical history and discuss symptoms
• Perform a physical examination and assess signs of excess hair growth, insulin resistance, and other symptoms
• Recommend blood tests to measure hormone levels and rule out other conditions
• Advise a pelvic ultrasound to look for cysts on the ovaries

A diagnosis is typically made if at least two of the following three criteria are met:

1. Irregular or no menstrual periods
2. Elevated androgen levels (higher levels of testosterone) based on symptoms (eg, excess body or facial hair, acne, scalp hair loss), or a blood test (if you don't have any of the above symptoms).
3. Polycystic ovaries observed via ultrasound or blood test (for raised levels of anti-mullerian hormone)

Treatment options

Medical treatments: 

While there's no cure for PCOS, there are many effective ways to reduce the symptoms and long-term effects on your health including:

• Lifestyle changes: Weight loss through a balanced and nutritious diet and regular exercise can help improve symptoms.
• Medications for managing symptoms:some text
  • Hormonal birth control: Birth control pills can regulate menstrual cycles, reduce hirsutism, and improve acne.
  • Anti-androgen medications: These have a limited role in managing PCOS but may be considered if other therapies haven't been effective or can’t be used. Medications like spironolactone can reduce androgen levels and alleviate symptoms such as hair loss and hirsutism.
  • Metformin: Commonly used for type 2 diabetes, metformin can help improve insulin resistance and regulate menstrual cycles.
• Fertility treatments: For those trying to conceive, treatments may include medications to induce ovulation and assisted reproductive technologies. It's important that your healthcare provider or midwife knows you have PCOS so they can do regular checks and give you the best support during your pregnancy.

Self-care and lifestyle changes:

• Healthy diet: Focus on a low-glycemic index diet rich in whole foods, fruits, vegetables, and lean proteins.
• Regular exercise: Aim for at least 150 minutes of moderate exercise per week to help manage weight and improve insulin sensitivity.
• Stress management: Practices such as yoga, meditation, and mindfulness can help manage stress levels and improve overall well-being.
• Regular check-ups: Routine monitoring of blood pressure, cholesterol, and glucose levels to manage associated health risks.
• Managing excess hair: mechanical laser and light therapies are effective for removing excess face and body hair. These options should be considered for reducing hirsutism and its impact on your quality of life, depression and anxiety.

Conclusion

Managing PCOS effectively involves a combination of lifestyle changes, medical treatments, and regular monitoring. Early diagnosis and personalised treatment plans can significantly improve quality of life and reduce the risk of complications. By managing  your symptoms and seeking appropriate care, you can take greater control of your health and wellbeing.

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