Symptoms
- Infrequent or absent periods
- Excess facial, chest and abdominal hair (hirsutism)
- Acne, oily skin and hair thinning
- Weight gain and difficulty losing weight
- Difficulty conceiving
Diagnosis
At least two of the following are required: irregular ovulation, clinical or biochemical excess androgens, and polycystic ovaries on ultrasound. Thyroid disease, high prolactin and adrenal disorders must be excluded. In adults, a high AMH can support the diagnosis.
More than an ovarian condition
PCOS is linked to insulin resistance, type 2 diabetes, high cholesterol, sleep apnoea and a higher long-term cardiovascular risk. Very infrequent periods can thicken the uterine lining. Blood sugar, cholesterol and blood pressure should be checked regularly.
Prof. Dr. İkbal Kaygusuz is a co-author of numerous international publications on cardiovascular risk markers in PCOS (pentraxin 3, hepcidin, ADMA), the effect of treatment on these markers and the links between PCOS and other systems.
Treatment
- Lifestyle: even 5-10% weight loss in women with excess weight can improve cycles and ovulation.
- Cycle control and hair growth: the combined pill is often used by women not seeking pregnancy.
- Insulin resistance: metformin may be added in suitable patients.
- Trying to conceive: letrozole is the first-line ovulation treatment; if unsuccessful, gonadotropins, insemination or IVF are planned.
PCOS and IVF
The ovaries may respond strongly to medication, increasing the risk of ovarian hyperstimulation syndrome (OHSS). An antagonist protocol, lower doses, agonist trigger and freezing all embryos when needed markedly reduce this risk.
PCOS and pregnancy
Gestational diabetes and gestational hypertension are more common in women with PCOS. Optimising weight and blood sugar before pregnancy and careful monitoring during pregnancy are recommended.
Frequently Asked Questions
Can women with PCOS get pregnant?
Does PCOS go away?
Sources
- Teede HJ, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertil Steril, 2023.
- Is pentraxin 3 a new cardiovascular risk marker in polycystic ovary syndrome? Gynecologic and Obstetric Investigation, 2014.
- Is hepcidin a new cardiovascular risk marker in polycystic ovary syndrome? Gynecologic and Obstetric Investigation, 2013.
- Effect of ethinyl estradiol-cyproterone acetate treatment on asymmetric dimethyl-arginine levels in women with polycystic ovary syndrome. Archives of Gynecology and Obstetrics, 2014.
The information on this website is for general information only and does not replace a medical consultation.
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