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Polycystic Ovaries

Polycystic Ovary Syndrome (PCOS) is a very common condition affecting at least 14% of all women of reproductive age.

Symptoms of polycystic ovaries

To diagnose polycystic ovaries 2 out of 3 of the above criteria are required. Clinically one or more of the following symptoms may also be present:

  • Irregular ovulation or no ovulation
  • Infertility; difficulty in becoming pregnant
  • Recurrent miscarriages
  • Unwanted facial and/or body hair (hirsutism)
  • Oily skin, acne
  • Being overweight, rapid weight gain especially around the waist and abdomen (central obesity); or difficulty in losing weight

Causes of polycystic ovaries

  • In PCOS there is an imbalance between the pituitary gonadotropin luteinizing hormone (LH) and the follicle-stimulating hormone (FSH), resulting in a lack of ovulation and an increased testosterone production.
  • Nobody knows exactly what causes this imbalance but it is felt that it is probably a combination of genetic and environmental factors.
  • Many women with PCOS have a weight problem and there appears to be a relationship between PCOS and the body’s ability to make insulin.

Insulin is a hormone that regulates the change of sugar, starches and other food into energy for the body’s use or for storage. Many women with PCOS have insulin resistance, in which the body cannot use insulin efficiently. Since some women with PCOS make too much insulin, this leads to high circulating blood levels of insulin, called hyperinsulinemia.

It is believed that hyperinsulinemia is related to increased androgen levels and it is possible that the ovaries react by making too many male hormones (androgens). This can lead to acne, excessive hair growth, weight gain (obesity), and ovulation problems as well as type 2 diabetes. In turn, obesity can increase insulin levels, causing PCOS to get worse.

Investigation

  • Transvaginal Ultrasound (specific reporting on numbers of follicles is essential)
  • FSH/LH ratio (on day 3-5 of menses) or after progesterone challenge (avoid mid-cycle day 18-20 in women with cycles less than 35 days)
  • Male hormone (androgen) profile
  • Blood sugar testing (oral glucose tolerance ) if BMI >27
  • Thyroid function tests
  • Lipid profile (cholesterol, LDL and triglycerides)

Treatment

Lifestyle change and change in diet are absolutely paramount. Prescription medication is also an option that can be explored. We recommend contacting us for treatment options as each persons case may require different varieties of treatment.

Summary

  • In polycystic ovarian syndrome presenting symptoms are highly variable
  • Not all women with polycystic ovarian syndrome are infertile
  • Treatment of polycystic ovarian syndrome is highly individualised
  • Lifestyle changes and exercise are mandatory as part of the management of the condition

Conclusion

Polycystic ovaries is a very common problem in women of reproductive age that has both short-term effects upon reproductive function and longer term effects upon the risk of diabetes and cardiovascular disease.The treatment of polycystic ovaries is highly individualised and very much dependent on the presenting symptoms and needs of the woman in terms of fertility, cycle control, weight issues, and hyperandrogenic symptoms.

Contact us

As London’s specialist gynecology clinic we recommend you contacting our team regarding polycystic ovaries by calling 020 7806 4098 or by emailing london.wellwomanclinic@hje.org.uk.

Wellwoman Clinic

The Wellwoman Clinic is a specialist centre offering assessment and treatment of gynaecological conditions. We treat women of all ages, prioritising patient needs and comfort throughout their treatment.

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Patient information

Our Hospital is renowned for providing exemplary levels of care across more than 90 services. From orthopaedics, to urology, our private GP practice and Urgent Care Clinic, our services are led by some of London’s leading Consultants. For more information, and to find a service suitable for your care, find out more about the services that we offer.

Make an enquiry

If you have any questions relating to treatment options or pricing information, get in touch with us by filling out one of our contact boxes or giving us a call on 020 7806 4098.

Our Appointments Team have a dedicated and caring approach to finding you the earliest appointment possible with the best specialist.

If you are self-paying you don’t need a referral from your GP for a consultation. You can simply refer yourself* and book an appointment.

If you have health insurance (e.g. Bupa, Axa Health, Aviva), you will need to contact your insurer to get authorisation before any treatment, and in most cases you will also require a referral letter from your GP.

If you are not registered with a GP, we have an in-house private GP practice you can use. Alternatively, we can suggest the most appropriate course of action for you to take, given your location and individual circumstances.

*Please note – for investigations such as X-rays and MRIs, a referral will be required. However, we may be able to arrange this for you through our on-site private GP.

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