Dr. Sidiq Aldabbagh, MD - OBGYN

What is PCOS?

 

Polycystic ovary syndrome (PCOS) is a common condition and affects approximately 7 in 100 women.

 

What are the symptoms of PCOS?

 

• Irregular, infrequent periods or no periods at all.

• Infertility (due to irregular or no ovulation)

• Excessive hair growth (hirsutism) on the face, chest or back

• Weight gain

• Hair loss from the head

• Oily skin or acne

 

How do we diagnose PCOS?

 

Any two out the following three features would be diagnostic.

Ovaries have many (more than 12) tiny cysts:  These cysts are small blister-like-lumps (about 5-8 mm) that form on the surface of the ovaries. Women produce an egg every month and these eggs, if not released, may be retained as small cysts. This is usually seen on an ultrasound scan. The polycystic appearance of ovaries is seen on an ultrasound scan in 22% of women but only a few of these women will have the “syndrome”.

 

• Hormonal imbalance (Hyperandrogenism):  Ovaries produce the “female” hormones, such as oestrogen and progesterone and also very small amount of the “male” hormone, testosterone. When the level of testosterone in the blood goes over a certain level, it can cause some of the common symptoms of PCOS like acne and unwanted hair growth.

Failure to ovulate every month (anovulation) leading to infrequent or absent periods:  Oligomenorrhea means less than six periods in a year and amenorrhoea means no periods at all.

 

Does PCOS affect fertility?

 

Although around 60% of women with PCOS achieve spontaneous pregnancy without any medical help, some women can struggle with ovulation and may need help. Usually, this is quite simple in the form of medication and scans.

 

What is the treatment for polycystic ovary syndrome?

 

Stay slim through a combination of regular exercise and diet. Metformin a drug used to treat very early diabetes can also help with carbohydrate metabolism and losing weight.
Treatment of PCOS depends on symptoms and whether you are trying for a family or not. The easiest way of controlling PCOS is to go on the combined pill which prevents recruitment of new egg-follicles and stops the problem from getting worse.

Obviously, the contraceptive pill is not an option if you are trying for a family. If you have been trying for longer than six to twelve months you may need ovulation induction tablets such as Clomiphene citrate and serial scans.

Treatment of unwanted hair can be either cosmetic or through medication.

 

Lifestyle management: to reduce the risk of cardiovascular disease and diabetes in later life.

 

Can diet and nutrition help PCOS

 

Decrease or Eliminate:

 

It is important to remember that due to insulin resistance, PCOS women are not able to deal with simple carbs. Hence it is important to avoid the following:

 

• Sugars: White refined sugar, artificial sweeteners etc
• Natural sweet sugars: Honey, dates, agave, too much fruit
• Carbohydrates (High Glycemic Index): White bread, white rice, white pasta

 

Eat Plenty of:

 

‘Low GI’ Diet: Foods containing low Glycemic Index such as brown bread, rice and pasta, sweet potatoes, traditional porridge or muesli

‘Good’ fats: Nuts, seeds, cold pressed oils, oily fish, avocado and coconut

Green leafy vegetables: Spinach, broccoli, kale, asparagus, rocket, broccoli, Brussel Sprouts

Proteins: are OK with PCOS

 

Summary

 

Polycystic ovaries on ultrasound scan are found in 22% of women.
A polycystic ovarian syndrome is seen only in 7% of women.
Best way to control PCOS is to stay slim through a combination of low GI diet and exercise.

If you are not trying for a family being on the combined pill will control the condition well.
60% of women achieve spontaneous pregnancy.
Sometimes drugs such as metformin or clomiphene citrate may be necessary to induce ovulation.