PCOS - Polycystic Ovarian Syndrome

Most women with this condition don’t have regular cycles or periods, which makes it tricky to pinpoint when they ovulate. A woman with PCOS may experience irregular periods outside of the normal menstrual cycle (more or less often than once every 23-35 days). Or she may experience no periods at all - a condition known as amenorrhea. In some cases, women may experience extremely heavy periods or unpredictable intermittent bleeding.

Normally, when women ovulate it triggers a burst of the hormone progesterone. But when an egg isn’t released - as is the case with PCOS - it interrupts the normal progression of hormones needed for a woman to successfully ovulate.

This has a snowball effect: if ovulation doesn’t occur (anovulation), the ovaries continue to produce only two of the three necessary hormones - oestrogen and testosterone. This interrupted cycle is why a woman with PCOS may have no period at all or experience only infrequent bleeds.

Due to an increase in male-type hormones (androgens), a woman with PCOS may experience an increase in facial or body hair. This is known as hirsutism. Hirsutism is likely to continue until androgen levels are lowered, so your fertility specialist will tend to this ASAP.

Areas of hair growth differ between women, but may include:

• a darkening and/or thickening of facial hair
• hair on the arms, legs, abdomen, back or chest
• an increase in pubic hair

Similar to hirsutism (excessive body hair), high testosterone levels in women with PCOS can lead to male-pattern balding. This will continue to be an issue until testosterone levels are lowered. Again, your fertility specialist will be on the case.

Acne or oily skin is a common first symptom of PCOS. It can come as a surprise to women who are well past puberty, and really affect their self-esteem. Our counsellors are here for you if you need to vent or talk.

Acne is most likely to flare in hormone-sensitive areas such as the cheeks, jawline and neck. It might range from small bumps under the skin to larger, painful lumps that take a long time to clear.

PCOS makes it difficult for the body to appropriately use the hormone insulin. Insulin normally helps to convert sugars and starches from our food into energy the body can use.

In a woman with PCOS, the body becomes resistant to insulin and it builds up in the bloodstream. This leads to an increase of sugar and starch in the body—which results in weight gain. In turn, high insulin levels can trigger the release of more male-type hormones. Thankfully, these hormones don’t tend to increase a woman’s overall body fat. Though they can cause weight gain in specific areas such as the abdomen.

Happily, women with PCOS can help ease their symptoms by committing to a healthy lifestyle. Maintaining a healthy weight and increasing your daily exercise are two important - and manageable - first steps. Exercise and weight loss will help reduce any further health risks linked to the condition.

Statistically, around 75% of women with PCOS are overweight, with 50% of those women being obese.

The encouraging part? Overweight women with PCOS can reduce the effects of their symptoms by losing just 5-10% of their body weight!

Studies show that this small amount of weight loss can combat symptoms by:

• reducing insulin resistance by up to 50%
• restoring ovulation
• improving fertility
• increasing overall emotional health

For overweight women experiencing PCOS symptoms, we encourage you to focus on losing even a kilo or two. It really can make a difference.

Metformin is a medication that helps the body’s response to insulin. It’s commonly prescribed to treat Type-2 Diabetes. It’s also used in women with PCOS whose systems are over-producing insulin and testosterone.

Metformin works by increasing the body’s sensitivity to insulin, helping it to accept the normal amount produced. Metformin can only be prescribed by your medical practitioner, so it’s a good idea to make an appointment with a fertility specialist if you haven’t already.

It may seem counterintuitive, but taking some form of hormonal birth control may improve your chances of maintaining (or regaining) a regular period. The oral contraceptive pill works using two synthetic hormones - progestin and oestrogen - to lower and regulate hormone levels. It also lowers androgen (male hormone) levels. As a result, the oral contraceptive pill can help combat PCOS symptoms such as increased body hair and acne.

Although less commonly prescribed than Metformin, anti-androgen medications work to block the effect of androgens in women with PCOS. Their aim is to reduce symptoms such as acne, increased body/facial hair and scalp hair loss.

Just remember to have a thorough chat with your doctor before starting a new medication. This way, they can explain in-depth how the medication works and outline any potential side effects. Keep in mind, you may need to stop certain PCOS medications before trying to get pregnant.

If you are struggling to deal with the symptoms of PCOS, please take heart - you are not alone. Research shows that women with PCOS experience higher levels of anxiety and depression than the general population. So please - reach out to our friendly counselling team if you need some extra support to see you through.

Some women react to their PCOS diagnosis with a form of grief. This is completely normal and understandable. You may experience emotions such as shock, anxiousness, numbness, disbelief, anger and frustration - which can impact your overall emotional health. Certain PCOS symptoms such as weight gain and an increase in body or facial hair can also lead to poor self-image and self-esteem.

When you’re struggling with your mental health, it can be difficult to find the motivation to follow a healthy lifestyle. But hang in there if you can. Remember, even minor exercise and weight loss can greatly improve your PCOS symptoms - which in turn may brighten your mood.

At Monash IVF, we understand that conditions like PCOS can be tough to deal with. That’s why we offer our patients comprehensive counselling services. Checking in with one of our experienced counsellors can help you reduce stress and maintain good mental health.