1. What is the Polycystic Ovary Syndrome or PCOS?
  2. Which are the symptoms?
  3. Which are the complications?
  4. Diagnosis and Treatment
  5. Is a healthy lifestyle important?

What is the Polycystic Ovary Syndrome or PCOS?

Polycystic Ovary Syndrome (PCOS) affects women’s health in terms of metabolism and reproductive system. It is characterised by a thickening of the ovaries due to the appearance of multiple ovarian cysts and to hormonal and metabolic alterations (hyperandrogenemia, insulin resistance with consequent hyperinsulinemia).

PCOS, which affects 5-10% of women, starts in puberty and is the most common endocrine alteration in women of childbearing potential.

PCOS is the expression of a complex functional alteration of the reproductive system given by the increase in androgens (male hormones), which causes the typical symptoms of this pathology.

Which are the symptoms?

Typical symptoms include irregular menstruation or amenorrhea, minor hirsutism with growth of hair in atypical areas such as chin, upper lip, back, thus with signs of virilisation.

Other symptoms can include weight gain together with fatigue, lack of energy, sleep problems, mood swings; in some women it can affect fertility and pregnant women affected by PCOS have a higher risk of complications during pregnancy like gestational diabetes, pre-term labour and pre-eclampsia.

Which are the complications?

Polycystic Ovary Syndrome can cause serious complications. The presence of high levels of oestrogens amplifies the risk of endometrial hyperplasia and endometrial cancer. The presence of high levels of androgens instead increases the risk of metabolic syndrome and hirsutism. In the long term, the excess of these hormones can cause a greater risk of cardiovascular disorders like hypertension and hyperlipidaemia. PCOS is closely correlated to obesity, which causes insulin resistance that contributes to the increase in the ovaries’ production of androgens.

Diagnosis and Treatment

PCOS diagnosis is obtained by the gynaecologist through specific exams such as serum hormone dosage exams, pelvic scans, glycaemic control, insulinemia control, and hormone dosage including total testosterone, FSH, prolactin and TSH. When testosterone levels are slightly increased and FSH levels slightly decreased, this suggests a PCOS diagnosis. The two elements that are necessary in order to come up with an accurate diagnosis are an ovulatory dysfunction as clinical and/or bio-chemical evidence of hyperandrogenism and the presence of more than 10 follicles/cysts per ovary observed through pelvic scan. PCOS treatment includes the administration of progesterone or oral contraceptives to correct hormonal abnormalities, relieve symptoms and improve fertility in particular for those women who desire to become pregnant. Hormonal contraceptives are the primary therapy as they reduce circulating androgens making menstrual cycles more regular.

Is a healthy lifestyle important?

PCOS is not a synonym of sterility and in this case, ovulation is induced through the use of contraceptives. Exercise and weight loss are also very important as they reduce insulin resistance: the reduction of insulin and oestrogens levels causes the recovery of ovulation or at least favours the effect of contraceptives used to induce ovulation.

For this reason, a healthy lifestyle is very important to prevent such pathology.