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Mr Mostafa Metwally, Consultant Gynaecologist
Claremont Clinics: Tuesday PM
What is Polycystic Ovarian Syndrome (PCOS)?
Polycystic Ovarian Syndrome, commonly known as PCOS is a fairly common condition particularly in women who have difficulty conceiving or experience irregular periods. It is associated with an imbalance of some of the hormones that control the function of the ovaries.
Why is it called “Polycystic Ovarian” Syndrome?
Often an ultrasound scan will reveal that the ovaries contain small cysts (typically less than 1 cm in diameter), although they are not really cysts, rather underdeveloped follicles which contain the eggs. With the right treatment these follicles will resume growth and eventually release the egg (ovulation).
What are the symptoms of PCOS?
The symptoms are very variable. Some women have few or no symptoms, while others may experience period problems (irregular or absent periods), excessive hair growth, acne or infertility.
Does PCOS cause pain?
No, these small cysts do not cause pain and do not need to be surgically removed.
Why do women with PCOS sometimes experience problems with weight gain?
There is a strong relationship between weight and ovulation. Excessive weight gain can stop ovulation and trigger the other symptoms of PCOS. About 50% of women with PCOS may experience problems with weight gain which can affect insulin hormone production, in turn leading to more weight gain and an increased activity of some male hormones (androgens) that are responsible for acne and hair growth. Weight loss can lead to an improvement in all the symptoms of PCOS.
Are there any long-term risks associated with PCOS?
PCOS is similar in some respects to Type 2 Diabetes where there is a problem with production of the hormone “insulin”, this is known as insulin resistance. Insulin resistance is responsible for many of the hormone imbalances associated with PCOS. Excessive weight gain can make insulin resistance worse and if left untreated may increase the risk of Type 2 Diabetes and heart disease later in life.
Regular ovulation is also important to protect the lining of the womb from excessive growth that can lead to cell changes later in life. It is important to treat the condition either by regulating ovulation or by giving additional hormones to protect the lining of the womb.
How is PCOS treated?
There are options for treatment, the most important being weight loss if necessary. This can lead to improvement of most of the symptoms of PCOS and is usually achievable with lifestyle changes alone. Sometimes weight loss medication can be given by your GP.
Other lines of therapy will depend on whether or not you are trying for a pregnancy. If you are hoping to conceive, a drug called Clomid will likely be prescribed to help you ovulate. Sometimes other drugs such as Metformin which can improve insulin resistance, will be prescribed. Occasionally a keyhole surgical procedure known as “laparoscopic ovarian diathermy” which involves burning very small holes into the ovary can restore ovulation particularly if you do not respond well to drugs.
If you are not trying to get pregnant, then treatment is mainly to improve symptoms where some medications such as the oral contraceptive pill can be given to regulate your periods and improve hair growth and acne.
To book an appointment with Mr Metwally, just call our friendly Private Patient Team on 0114 263 2114.