There is a lot of confusion over PCOS and I see many women who have received this diagnosis and are then in a complete spin. They have no idea what this means for them and for their fertility or what they can do to manage the condition. For many women a diagnosis of PCOS comes after stopping the pill or when they see their doctor after not being able to conceive. This diagnosis is both devastating and isolating.
Polycystic Ovary Syndrome can be divided in to two distinct groups – Polycystic Ovaries (PCO) and Polycystic Ovary Syndrome (PCOS). Women diagnosed with PCO will have many cysts on their ovaries. However they will not have the severity of cysts or the hormonal imbalance and symptoms seen in women with PCOS. Therefore women with PCO are less likely to have problems conceiving than women diagnosed with PCOS.
PCOS is a chronic condition where the ovaries develop many tiny cysts caused by the egg follicles that have not been able to develop, as they should. The condition is also accompanied by a hormonal imbalance, which in turn makes it more difficult for the eggs to mature adequately and be released at the time of ovulation. PCOS is unfortunately the cause of fertility problems in many women and is believed to effect around 1:10 women in both the UK and US and everything is pointing to this being on the increase.
PCOS is in some women, complicated further by the development of insulin resistance. As many as 70% of women with PCOS have what is called insulin resistance. The cells in the body are resistant to the effect of normal insulin levels and to compensate, more insulin is produced to keep the blood sugar normal. This raised level of insulin is thought to be one of the reasons why PCOS develops.
Insulin resistance is one of the reasons why women gain weight and find difficulty in losing weight. Being over weight means that the delicate hormonal balance is effected and as a result ovulation is disrupted and in some circumstances completely ceases for a period of time. Other ways in which insulin resistance directly affects conception are not yet fully understood. There is some evidence to suggest that the insulin receptor cells in the womb lining may be impaired and cause lower pregnancy implantation rates as well as insulin levels having a direct correlation with pregnancy success during IVF. More research is required to fully appreciate the extent of this current evidence.
What are the symptoms?
Symptoms may begin during a woman’s teenage years and early twenties. Symptoms may vary in severity but can include:
• Weight gain
• Unwanted facial and body hair
• Thinning of hair or hair loss from scalp
• Depression and mood changes
• Irregular periods or no periods at all
• Irregular ovulation or no ovulation
• Reduced fertility
How can PCOS be treated?
Unfortunately, there is no current ‘cure’ for POCS and therefore treatment is often aimed at managing the symptoms and optimising your fertility. However the good news is, that there are lots you can do to help yourself by observing your fertility signs to determine when you ovulate and making small changes to your diet and adopting a more healthy lifestyle.
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