PCOS has three main features, two of which are needed for a diagnosis.
The first is irregular or absent periods – your ovaries don’t regularly release eggs (ovulation) and you are less fertile.
The second is excess androgen – high levels of male hormones, causing hirsutism – excessive hairiness on the face, back or buttocks; weight gain, thinning hair; oily skin or acne.
And the third is polycystic ovaries – your ovaries become enlarged with many fluid-filled sacs (follicles), which may be unable to release eggs.
The cause of PCOS isn’t clear. It’s very common, affecting one in every 10 UK women, although more than half don’t have symptoms. PCOS isn’t directly inherited but sometimes runs in families.
PCOS is also associated with an increased risk of health problems in later life, including type 2 diabetes, high cholesterol, depression, high blood pressure and sleep apnoea. PCOS is linked to abnormal hormone levels, including high levels of insulin, a hormone that controls sugar levels.
Many women with PCOS are resistant to the action of insulin in their body, producing even higher levels to overcome this, which contributes to the increased production and activity of hormones like testosterone. Insulin resistance can also lead to weight gain, making PCOS symptoms worse, causing the body to produce even more insulin, with hormonal abnormalities, the exact reason for which is not known.
Ways to help
If overweight, symptoms and the risk of long-term health problems are improved by losing excess weight – just 5% gives significant improvements.
Hirsutism and hair loss may improve on some types of combined contraceptive pill and other medication, including spironolactone, flutamide or finasteride – ask your GP.
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