Obstetrics & Gynaecology
Polycystic Ovarian Syndrome (PCOS)

1. What is Polycystic Ovarian Syndrome (PCOS)?

Polycystic Ovarian Syndrome is a common hormonal disorder among women in their reproductive age. This disorder can cause the following problems:-

i. Menstrual disturbance
ii. Inability to conceive
iii. Obesity
iv. Diabetes
v. Facial and body hair
vi. Hormone disturbances

2. How does PCOS manifest?

The patient may have irregular monthly period with long periods of absence followed by heavy and prolonged bleeding.

3. What causes PCOS?

The cause of PCOS is not known but it is likely to be the result of both genetic (inherited) as well as behavioral factors. Women with PCOS often have a mother or sister with similar condition.

The main underline problem with PCOS may be related to hormonal imbalance. The ovaries make more androgens than normal which can affect the development and release of eggs during ovulation. High androgen levels in women can lead to:-

i. Acne
ii. Excessive hair growth
iii. Weight gain
iv. Problem with ovulation

Insulin production may be link to PCOS. Insulin is a hormone that controls the change of sugar, starches and other food into energy for the body to use or store. Women with PCOS have higher level of insulin in their bodies because of the inability in using it.

4. How many women have PCOS?

Between 1 in 10 and 1 in 20 women of child bearing age has PCOS. It can occur in girls as young as eleven years old.

5. What are the symptoms of PCOS?

The symptoms may vary from women to women. Some of the symptoms

i. Infertility. PCOS is one of the commonness causes of female infertility.
ii. Irregular menstrual cycles.
iii. Increased hair growth on the face, chest, stomach, back, thumbs or toes.
iv. Acne or oily skin.
v. Weight gain or obesity. Usually with extra weight around the waist.
vi. Male pattern baldness or thinning of hair.
vii. Lower abdominal pain.
viii. Anxiety or depression.

6. How is a diagnosis of PCOS made?

i. Enlarged ovaries containing numerous small cysts can be detected by ultrasound.
ii. High levels of androgens or male hormones can be detected in blood. This may or may not be associated with excess facial and body hair.
iii. Abnormal menstrual cycles.
iv. Obesity and weight gain may or may not be present.
v. In some cases, elevated insulin levels and insulin resistance leading to diabetes may be noted.
vi. Infertility.
vii. In rare cases, high cholesterol level and elevated blood pressure may be noted.

In short, the diagnose of PCOS is generally made on the basis of clinical signs and symptoms. It is also important to exclude other illnesses that have similar features such as low thyroid hormone blood levels (hypothyroidism) or elevated levels or milk producing hormone (prolactim). In addition, tumors of the ovary or adrenal glands can produce elevated male hormones that can mimic PCOS.
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