Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS) is a hormonal condition that occurs in 12-18% of women between late adolescence and menopause. It’s one of the most common hormonal related problems in women during their reproductive years. PCOS is a leading cause of infertility and can also be a risk factor for other health problems.

Women with PCOS usually have a few of the following symptoms:

  • Irregular or absent periods
  • Excessive facial and body hair growth or hair loss from the head
  • Difficulty becoming pregnant
  • Acne
  • Weight gain (especially around mid section) and difficulty losing weight
  • Infertility

PCOS occurs in 12-18% of women between
late adolescence and menopause

What is the relationship between PCOS and type 2 diabetes?

Between 65-80% of women with PCOS have insulin resistance which occurs when the insulin made by the body is not working as well as it should. Insulin is an important hormone for regulating blood glucose levels. When insulin resistance occurs, the pancreas needs to make more and more insulin to effectively control blood glucose levels.

Insulin resistance is a risk factor for type 2 diabetes, gestational diabetes (diabetes during pregnancy) and pre-diabetes. High insulin levels also reduce fat breakdown and stimulate fat storage, blood lipid problems such as low HDL-C (good cholesterol) and/or high triglycerides, and the overproduction of androgens (so-called ‘male hormones’). This can contribute to obesity and an increased risk of heart disease and stroke as well as the other symptoms previously listed.

As women with PCOS are likely to have insulin resistance, they have a greater risk of developing type 2 diabetes, gestational diabetes (diabetes during pregnancy) and pre-diabetes.

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How is PCOS treated?

PCOS is usually diagnosed after consideration of medical history, symptoms, hormonal testing and sometimes ultrasound. Treatment can vary depending on these findings however diagnosis of PCOS often requires lifestyle changes. These generally include following a low fat, high fibre, low glycemic index, healthy eating plan, giving up smoking and doing regular physical activity which can help with weight management and improve insulin sensitivity. A weight loss of as little as 5% can improve insulin levels, acne, ovulation, fertility, reduce excessive hair growth and improve mental health. These lifestyle changes can also assist with managing other risk factors including high blood lipids, blood pressure and hormone levels. In many women the male hormone levels reduce therefore reducing future risks.

Sometimes medication called metformin, which has been shown to improve insulin resistance, may also be prescribed for women with PCOS. However, like any medication, metformin may cause side effects and if prescribed, should be used in conjunction with recommended lifestyle changes. Other treatments may include the oral contraceptive pill to regulate menstrual cycle and anti-androgen drugs (eg: cyproterone) to reduce male hormone effects like acne or excessive hair growth. Treatments to combat these may also increase insulin resistance.

For more information

To find out more about PCOS, talk to your doctor or phone the Polycystic Ovarian Syndrome Association of Australia on 02 8850 9429 (www.posaa.asn.au) or call DiabetesNSW on 1300136 588 and talk to a Credentialled Diabetes Educator.