Polycystic ovary syndrome (PCOS) is a long-term condition in women in which there is an abnormality in female sex hormones. This is associated with a range of health problems including increased facial and body hair growth, increased tendency to develop type 2 diabetes, irregular menstrual cycles and reduced fertility.
PCOS is common, affecting between 12-21% of women of reproductive age. [1] It is estimated that around 70% of women with PCOS do not know they have the condition. [1]
A monthly cycle of changes that a woman's body goes through to prepare for a potential pregnancy.
Female organs located on either side of the uterus. Each ovary produces eggs that travel along the fallopian tubes to the uterus.
2014 Ebola outbreak in West Africa. Centers for Disease Control and Prevention. Accessed 10 November 2014 from
2014 Ebola outbreak in West Africa. Centers for Disease Control and Prevention. Accessed 10 November 2014 from
Women are often diagnosed with PCOS in late adolescence or in their 20s. The symptoms vary, but they can include:
Women with PCOS can also be at greater risk of experiencing mental health problems such as:
PCOS is also associated with:
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
The pressure the blood places on the walls of the arteries, largely mirroring the contraction of the heart, and consisting of two readings. The higher reading is systolic blood pressure, when the heart contracts, and the lower is diastolic blood pressure, when the heart is relaxed.
A type of fat produced by the body that is necessary for metabolism.
A small, sensitive female sexual organ located at the point where the labia meet at the front of the vagina. It is analogous to the male penis.
A monthly cycle of changes that a woman's body goes through to prepare for a potential pregnancy.
The exact cause of PCOS is unclear. However, it involves abnormalities in a number of hormones, including:
These hormonal changes can prevent the ovaries from releasing fully mature eggs. Usually, once each menstrual cycle during ovulation, one or more eggs are released from the ovaries into the fallopian tubes. The eggs then pass to the uterus, where, if they are fertilized, can develop into an embryo.
In PCOS, eggs are not released, but instead form tiny cyst-like structures in the ovaries. Over time, these cysts can build up and the ovaries can become 'polycystic'. Because eggs are less likely to be released from the ovaries, women with PCOS are more likely to have problems with fertility.
The female reproductive organs showing a polycystic ovary.
Androgens are known as 'male' hormones, although small amounts are naturally produced in the female body. When levels of androgens are raised in women, this can lead to the development of features more common in males. This results in some of the symptoms experienced in PCOS, such as increased body hair, loss of hair on the scalp and acne.
Most women with PCOS have insulin resistance whether they are overweight or not. Metabolic syndrome is also increased in women with PCOS. Metabolic syndrome is a term given to the consequences of insulin resistance, which is a range of health problems including type 2 diabetes, high blood pressure (hypertension) and high blood cholesterol.
Insulin works by helping glucose (sugar) pass from the bloodstream into cells in the body. In PCOS, this process can be affected. This occurs because although the pancreas can still make insulin, the cells no longer respond the way they should (called insulin resistance). When glucose can no longer enter the cells and instead stays in the bloodstream, it can result in the pancreas making more insulin to try to control blood glucose levels. Eventually, type 2 diabetes can develop, in which the pancreas can no longer produce enough insulin to control glucose levels.
The pressure the blood places on the walls of the arteries, largely mirroring the contraction of the heart, and consisting of two readings. The higher reading is systolic blood pressure, when the heart contracts, and the lower is diastolic blood pressure, when the heart is relaxed.
The fundamental unit of life; the simplest living unit that can exist, grow, and reproduce independently. The human body is composed of trillions of cells of many kinds.
A type of fat produced by the body that is necessary for metabolism.
A closed sac in or under the skin that contains fluid.
The tube-like structures connecting a woman's uterus to her ovaries. Eggs released by the ovaries travel to the uterus via the fallopian tubes.
A simple sugar found in many foods (such as fruit) that functions as a major energy source for the body.
A chemical substance secreted in one part of an organism and transported to another part of that organism, where it has a specific effect.
A hormone secreted by the pancreas in order to regulate glucose levels in the body's cells, which is used for energy.
One of a group of steroid hormones involved in the development and maintenance of female sex characteristics. These are the primary female sex hormones.
Female organs located on either side of the uterus. Each ovary produces eggs that travel along the fallopian tubes to the uterus.
The phase of the female menstrual cycle during which an ovum (egg) is released from one of the woman's two ovaries.
An organ located behind the stomach that secretes insulin and glucagon into the bloodstream and digestive enzymes into the intestines.
The hollow organ of the female reproductive system that is responsible for the development of the embryo and fetus during pregnancy. Also known as the womb.
A type of hormone produced by the pituitary gland. In females, this hormone triggers the cyclical release of an egg, roughly each month. In males, it stimulates testosterone production.
The combination of abdominal obesity, high blood-sugar level, abnormal cholesterol level and high blood pressure that is associated with an increased risk of developing type 2 diabetes, heart disease and stroke.
You may be at greater risk of developing PCOS if:
Women from some cultural backgrounds are at increased risk.
There is no one test to diagnose PCOS. So to help make the diagnosis of PCOS, your doctor will usually assess for two out of the following three criteria:
A transvaginal pelvic ultrasound is generally only performed on women over 18 years of age. It is important to recognize that not every woman who has polycystic ovaries on ultrasound will have PCOS.
When diagnosing PCOS, your doctor will need to make sure that other health conditions are not causing your symptoms. They may also want to do tests to investigate how PCOS is affecting your general health.
Tests can include:
The male sex hormones.
The pressure the blood places on the walls of the arteries, largely mirroring the contraction of the heart, and consisting of two readings. The higher reading is systolic blood pressure, when the heart contracts, and the lower is diastolic blood pressure, when the heart is relaxed.
A type of fat produced by the body that is necessary for metabolism.
A simple sugar found in many foods (such as fruit) that functions as a major energy source for the body.
A hormone secreted by the pancreas in order to regulate glucose levels in the body's cells, which is used for energy.
A test used to assist in the diagnosis of type 2 diabetes through periodic evaluation of glucose levels in urine and/or blood samples, before and after consuming a set amount of glucose.
If you have PCOS, there are a range of treatments available. You may need to work with a range of healthcare professionals such as an endocrinologist, fertility specialist, dietitian and exercise physiologist to manage the condition.
Managing your lifestyle is a very important part of controlling PCOS and reducing the risk of health problems that can arise.
If you are overweight or obese, aiming at achieving a healthy weight can help to improve PCOS symptoms, improve blood glucose control and help with other health conditions such as high blood pressure (hypertension). Weight loss can be challenging, but even losing a small amount, for example 5% of your body weight, can help.
A healthy, well-balanced diet can help to manage PCOS symptoms. A low-fat diet with plenty of fruits, vegetables and whole grains is recommended. If you need help planning your meals, a dietitian can provide guidance.
Regular physical activity can help to manage PCOS. However, particularly if you have type 2 diabetes as well as PCOS, it's important to talk to your doctor about what activities are suitable and any precautions you may need to take in order to be active safely.
Physical activity can help to manage symptoms associated with polycystic ovary syndrome.
Smoking can make the health problems that occur with PCOS significantly worse. If you smoke, your doctor can advise you on treatments and approaches that can make quitting smoking easier.
The lifestyle measures described above can help make your menstrual cycle more regular. Medications can also be prescribed. Your doctor will advise you on what medications are most suitable for your situation.
These include:
The lifestyle measures described above can help improve fertility. Medications that help to stimulate follicle development and ovulation include clomiphene citrate, metformin and gonadotropins.
In vitro fertilization (IVF) may help to achieve pregnancy if other fertility treatments are not successful.
Laparoscopic surgery can be used to either remove an ovary or treat it. It can help to remove tissue that is producing androgens (male hormones) and improve the hormone imbalances in PCOS.
In laparoscopic ovarian drilling (LOD) a laparoscope is inserted into the pelvis and used to destroy tissue in the ovaries. This is done either with heat or a laser. The effect of these procedures is not permanent.
The lifestyle measures described above can help reduce insulin resistance and improve your blood pressure and blood glucose levels. This can reduce the risk of serious health problems such as type 2 diabetes and heart disease.
Metformin may also be prescribed to help reduce insulin resistance.
Dealing with some of the symptoms caused by PCOS can be challenging. Women with PCOS can be at greater risk of a range of mental health problems, including depression, anxiety and eating disorders. Seeking support or advice from your doctor or a mental health practitioner can help.
There are a range of options available to reduce body hair. Cosmetic hair-removal treatments, particularly laser hair removal, are recommended.
Eflornithine hydrochloride is available in a cream. It disrupts an enzyme in hair follicles that is necessary for the hair to grow. It can help to prevent or delay facial hair regrowth and may improve the effect of cosmetic hair-removal treatments.
If these treatments are ineffective, or not an option, some medications may help.
These include:
Your doctor can advise on what therapies may be suitable for you.
Non-medication options can also be used to control hair growth, such as plucking, waxing and laser hair removal.
The combined oral contraceptive pill can help to improve acne. Topical and oral medications can also be prescribed to treat acne specifically.
Your doctor can advise you on suitable therapies.
The pressure the blood places on the walls of the arteries, largely mirroring the contraction of the heart, and consisting of two readings. The higher reading is systolic blood pressure, when the heart contracts, and the lower is diastolic blood pressure, when the heart is relaxed.
A health professional who specializes in diet and nutrition.
A doctor specializing in the endocrine (hormone) system of the body.
A health professional specializing in exercise to prevent and manage chronic diseases and injuries.
A simple sugar found in many foods (such as fruit) that functions as a major energy source for the body.
Because of the hormone imbalances that occur in PCOS, it can increase your risk of a range of serious health problems, including type 2 diabetes, high blood pressure (hypertension), heart attack and stroke.
When you have PCOS, you may need to see your doctor more regularly to check for these conditions.
Women with PCOS can have an increased risk of endometrial cancer.
The pressure the blood places on the walls of the arteries, largely mirroring the contraction of the heart, and consisting of two readings. The higher reading is systolic blood pressure, when the heart contracts, and the lower is diastolic blood pressure, when the heart is relaxed.
Relating to the internal lining of the uterus.
A chemical substance secreted in one part of an organism and transported to another part of that organism, where it has a specific effect.
PCOS is a long-term condition that may need to be managed for the rest of your life. With healthy lifestyle measures and appropriate treatment, most women with PCOS can achieve pregnancy and limit the symptoms and health problems the condition can cause.
In some women, PCOS may resolve without treatment around the age of 30-40 years.
PCOS cannot always be prevented, but lifestyle measures such as eating a healthy diet, exercising regularly and keeping your weight within a healthy range can reduce your risk of developing the condition, as well as helping to prevent or reduce many of its associated health problems.