Polycystic Ovarian Syndrome (PCOS)

PCOS is common condition affecting around 10% of women and people with ovaries, from puberty to menopause. It is caused by an imbalance of hormones called insulin and androgens. 

Around 50% of people with PCOS have other family members with the condition, and it is prevalent in Aboriginal and Torres Strait Islander, Asian and African communities. It is believed that around 70% of people with PCOS are not diagnosed worldwide. 

‘Polycystic ovaries’ means there are many small follicles that look like cysts (up to 8mm) on your ovaries. They are harmless. There is a difference between having polycystic ovaries and having 'polycystic ovarian syndrome’. To be diagnosed with PCOS, you need to have 2 or more ‘reproductive’ or ‘metabolic’ symptoms.  

Symptoms of PCOS include:

• Reproductive – irregular cycles with anovulation (an egg is not released from your ovary during your menstrual cycle), hirsutism (excess hair growth on body or face), alopecia (hair loss on the face or scalp), acne, and infertility 
• Metabolic – insulin resistance, metabolic syndrome, obesity, prediabetes, type 2 diabetes, high blood pressure, and high cholesterol 
• Psychological – anxiety, depression, and body image issues 

Irregular periods are not necessarily and indicator you have PCOS.  Find out more about menstruation (periods). 

How is PCOS diagnosed?

If you have symptoms, the first place to start is by seeing your GP, Women’s Health Clinic, or Sexual and Reproductive Health Clinic.  PCOS is diagnosed by a qualified health professional who is knowledgeable about PCOS. During an appointment, your Doctor or Nurse will assess you by asking questions about your symptoms and ordering blood tests.   

An ultrasound can show if you have polycystic appearing ovaries but is not always needed for a diagnosis. For many people, within 8 years of getting your period, it can be normal to have polycystic appearing ovaries but not have PCOS. 

How is PCOS managed?

PCOS is a chronic health condition that is treatable, not curable. 

You might be prescribed medications to manage PCOS, such as the Combined Oral Contraceptive Pill or Metformin. The combined oral contraceptive pill (COCP) has the hormones estrogen and progesterone.  It provides contraception, endometrial protection, and regulates periods. It can also reduce acne and alopecia.  Progesterone can also be used to regulate periods. Metformin is a medication that improves ovulation, reduces insulin resistance, and may reduce weight gain.  

If you are not ovulating and want to become pregnant, you may be prescribed medications and referred to a Fertility Specialist. Having a diagnosis of PCOS may not mean you are infertile, and you should use contraception if you do not want to become pregnant. 

Lifestyle goals to manage PCOS:

• Optimising hormonal outcomes  
• Regular exercise and balanced diet 
• Maintaining a healthy weight 
• Mental health and wellbeing 

How do I maintain a balanced diet? 

You can see a dietitian to make a diet plan that has low calories. It is important to remember that many diets that are very restrictive are difficult to maintain in the long-term. Dieticians can also help you if you spend a lot of time worrying about your weight and appearance, which can cause disordered eating habits. 

How much should I exercise?   

Exercise can be built into your daily life, include family time, and get you involved in your community. Walking, cycling, moving in your job, household chores, games, sports and planned exercise all contributes to your health and wellbeing. If you haven’t done any exercise for a while, start with 10 minutes and build up the time. If you want professional help, you can see an Exercise Physiologist. 

When you are under 18 years old some options are:

• Do moderate to intense exercise for 60 minutes, including strengthening exercises 3 times a week 
• 10 minutes bouts of exercise counting to 1000 steps 
• 30 minutes of exercise a day 

When you are 18 – 64 years old some options are; 

• 150 minutes of moderate exercise a week and 75 minutes of intensive exercise a week; plus 
• 2 days a week of muscle strengthening 

To lose weight; 

• 250 minutes of moderate exercise and 150 minutes of vigorous exercise a week; plus 
• 2 days a week of muscle strengthening  
• Minimise sedentary, screen time, and sitting activities
• Aim to lose 5-10% of body weight. 

Mental health and wellbeing 

The hormonal, physical and social impacts of PCOS can impact your mental health, and cause symptoms of anxiety and depression. You can have a mental health assessment and get a mental health care plan from your GP. This will help support you to have psychological intervention like cognitive behavioural therapy (CBT), or other counselling therapies of your choice. 

You might also explore medication as an option to help you, if you feel depressed, hopeless, have little interest or pleasure in life, are nervous, anxious, or have excessive worrying.