Polycystic Ovary Syndrome

Frequently Asked Questions

  • Polycystic ovary syndrome or PCOS is a collection of symptoms, characterised by high levels of male hormones (androgens), ovaries with many follicles or cysts (polycystic) and irregular or absent ovulation (oligo-ovulation or an-ovulation), causing irregular menstruation and endocrine impacts.

  • - high levels of androgens (hyperandrogensim)

    - irregular menstrual cycle length

    - irregular or absent ovulation

    - painful ovulation

    - many ovarian follicles or ‘cysts’

    - heavy period post extended cycle length

    - bloating

    - excessive hair growth

    - excessive hair loss or pattern baldness

    - acne

    - insulin resistance

    - difficulties with weight maintenance

    - infertility

    - mental health impacts: depression or anxiety

  • PCOS is diagnosed most commonly via the Rotterdam criteria. To be diagnosed with PCOS two of these criteria are met;

    1. hyperandrogegism ( clinical features - acne, excess hair growth or hair loss and biochemical - high levels of male hormones on blood tests)

    2. menstrual cycle irregularities - cycle lengths longer than 35 days or more, anovulation, oligo-ovulation, or ovulatory dysfunction

    3. polycystic ovaries - multiple follicles in ovary present on ultrasound

    4. elevated anti-mullerian hormone (AMH) levels - present on ultrasound (not used for teenagers)

  • - exercise and movement

    - anti-inflammatory diet and lifestyle

    - laser hair removal

    - minimising stress

    - weight maintenance, as needed

    - hypoglycaemic medications - e.g. metformin, gliceride, sitagliptin

    - metabolism medications and supplements - e.g. inositol, liraglutide, semaglutide

    - assisted reproductive technology, as needed

References

Bulsara, J., Patel, P., Soni, A. & Acharya, S. (2021). A review: Brief insight into polycystic ovarian syndrome. Endocrine and Metabolic Science, 3, 1-7. https://doi.org/10.1016/j.endmts.2021.100085

Lobo, R.A. (2022). Polycystic ovary syndrome. In D.M. Gershenson, G.M. Lentz, F.A., Valea & R.A. Lobo (Eds.), Comprehensive Gynecology (8th ed., pp. 824-837). Elsevier. https://doi.org/10.1016/B978-0-323-65399-2.00048-6

Teede, H., Thien, T., Laven, J., Dokras, A., MOran, L., Piltonen, T., Costello, M., Boivin, J., Redman, L., Boyle, J., Norman, R., Mousa, A. & Joham, A.(2023). International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2023. https://www.monash.edu/__data/assets/pdf_file/0003/3379521/Evidence-Based-Guidelines-2023.pdf

Teede, H., Thien, T., Laven, J., Dokras, A., MOran, L., Piltonen, T., Costello, M., Boivin, J., Redman, L., Boyle, J., Norman, R., Mousa, A. & Joham, A.(2023). International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2023 - summary. https://www.monash.edu/__data/assets/pdf_file/0003/3371133/PCOS-Guideline-Summary-2023.pdf