Polycystic Ovarian Syndrome

What is polycystic ovarian syndrome?

PCOS is an endocrine (hormonal) problem. It is diagnosed by clinical or hormonal changes associated with irregular ovulation, increased androgen activity and insulin resistance, as well as an ultrasound assessment. PCOS can make it harder to fall pregnant naturally. Polycystic Ovary Syndrome (PCOS) is well supported with Chinese Medicine and acupuncture, but it is not resolved quickly.

What are polycystic ovaries?

The term ‘polycystic ovaries’ describes the appearance of the ovaries on an ultrasound scan – they contain many small follicles (12 or more) and the ovaries are often larger than average.

As many as 20% of women of childbearing age have ovaries that appear polycystic on ultrasound, but many will have no symptoms and do not have polycystic ovarian syndrome (PCOS). If you have polycystic ovaries but have regular cycles and are ovulating, your fertility will not be impaired. If you have any concerns please speak to your fertility specialist.

How do I know if I have PCOS?

The most common symptoms of PCOS include irregular periods (or no periods at all), increased facial and body hair growth, acne, weight gain and difficulty falling pregnant. The causes of PCOS include genetic predisposition, but the condition may not always be clinically evident.

Imbalances in hormonal production affect ovulation, which may occur irregularly or not at all. There may also be a mild increase in testosterone levels, causing darker and thicker hair growth and acne. Hormonal imbalances also cause problems with sugar metabolism, leading to insulin resistance and a higher risk of diabetes if you do fall pregnant.

How does PCOS affect my fertility?

  • Your menstrual cycle may be irregular and ovulation erratic,
  • Women who are obese have a reduced implantation rate, even with normal ovulation,
  • Increased risk of anaesthetic and pregnancy complications, mainly associated with weight, and
  • Women who are significantly overweight have an increased risk of miscarriage (this is not directly caused by PCOS).

All these issues mean the chance of getting pregnant naturally may be lower if you have PCOS and you should seek medical advice.

How do you test for PCOS?

An ultrasound scan may indicate the presence of many small follicles. Blood tests are required to make the diagnosis and may reveal altered hormonal patterns including slightly increased testosterone levels or normal levels with increased activity.

How do you treat PCOS?

There are a number of options available, which your fertility specialist will discuss with you, including:

  • Reducing your body mass index (BMI) if required. For women who are overweight, this is the most important form of medical treatment, and can return ovulatory cycles to normal as well as reduce long-term metabolic risks. Combining healthy eating with moderate exercise is of proven benefit.
  • Insulin sensitising agents.
  • Ovulation inducing drugs such as Clomiphene.
  • Injections of follicle stimulating hormone (FSH).
  • Assisted reproduction technologies, including IVF
  • Acupuncture as a supportive therapy