FAQ on Polycystic Ovary Syndrome (PCOS) with Mr Gidon Lieberman

Awareness of Polycystic Ovary Syndrome (PCOS) is still relatively low, but this condition is thought to affect at least 1 in 5 women in the UK. As with many conditions that affect fertility, a lot of women will not be diagnosed with PCOS until they find they are having difficulties trying to conceive, especially if their symptoms are mild.  In this scenario, education about the syndrome is key for early diagnosis and treatment.

What are polycystic ovaries?

Polycystic ovaries become enlarged and develop fluid-filled bubbles just below the surface, and contain eggs that have not fully developed. Most women with polycystic ovaries will not have any problems other than irregular periods. To be diagnosed with PCOS you must have polycystic ovaries, and also be experiencing one or more symptoms from the list below:

• Irregular periods
• Unwanted facial/body hair (hirsutism)
• Oily skin/acne
• Thinning hair/hair loss
• Weight gain
• Reduced fertility

What is PCOS?

Polycystic ovarian syndrome is a name given to a group of problems. In order to have PCOS you should have two of the following three – polycystic ovaries, an irregular menstrual cycle or an excess of male hormone.  The symptoms of PCOS can vary greatly between women and include all of the symptoms listed above.

What causes PCOS?

Polycystic ovary syndrome is associated with hormonal imbalances in the body, although the exact cause is unknown. It’s likely that there is a genetic link, as it tends to run in families (but not always). PCOS women will have higher than normal levels of Insulin, which helps to control the level of sugar in the blood.  PCOS women will be more likely to be resistant to Insulin, so the body produces high amounts of it to overcome this resistance. The high Insulin levels then lead to other hormone problems including high LH and Testosterone.  Typically considered a male hormone, all women produce a small amount of Testosterone in their ovaries, but the majority of it is usually converted to Oestrogen. For women with PCOS, the amount of Testosterone produced tends to be higher and this rise in Testosterone can affect menstruation and ovulation.

Who suffers from PCOS?

About 1 in every 4 young women will show polycystic ovaries on an ultrasound, but only some of these women will have other problems associated with PCOS. Symptoms usually begin in adolescence but can also appear later in life, usually in a woman’s early or mid-twenties. As PCOS can run in families, you should be aware of any history of the condition in your family in case you start to display any symptoms.

How do I know if I have PCOS?

If you are experiencing any of the symptoms of PCOS, the first step is to make an appointment with your doctor and discuss it to rule out any alternative causes. Your doctor will look at your symptoms, arrange for tests to check your levels of certain hormones and possibly arrange for an ultrasound to confirm the diagnosis.

What treatment is available?

If you have had a diagnosis of PCO or PCOS then the most important thing is not to worry. Although PCOS cannot be “cured’ most of the symptoms can be helped.

The first of the suggested treatment plans is usually lifestyle changes, especially if you are carrying excess weight. Excess fat in the body causes an increase in Insulin production, which can worsen the symptoms of PCOS.  Therefore, losing weight can lead to a significant improvement in the quality of life.  While maintaining a healthy weight may not completely treat your symptoms, it can certainly be beneficial to your overall health and PCOS treatment.

There are also medical interventions available to treat PCOS, depending on your specific symptoms and your views on how you would like to be treated. No two PCOS women are alike.

Additional treatments include alternative therapies such as acupuncture. Many patients who have irregular cycles with their PCOS have worked with acupuncture practitioners to regulate their cycles. It may not be a treatment for everyone, but is another option that can be explored for treatment.

How does PCOS affect fertility?

Many women with PCOS are struggling to conceive. The biggest issue with PCOS and sub-fertility is experiencing irregular ovulation or it being totally absent. There’s often a lot of confusion, as urinary ovulation sticks can how a false positive.  The good news is that with treatment, most women with PCOS will go on to have healthy pregnancies and there are many treatment options depending on your specific requirements.

Mr Gidon Lieberman is a Consultant Gynaecologist & Sub-Specialist in Reproductive Medicine & Surgery at Highgate Private Hospital.  Mr Lieberman is a fertility and gynaecology Consultant at the Whittington Health NHS Trust, London and Honorary Senior Lecturer at University College London. He specialises in the investigation and treatment of sub-fertility including intra-uterine insemination, PCOS and ICSI, menstrual disorders, pelvic pain, early pregnancy complications, menopause complications, gynaecological ultrasound, laparoscopic and hysteroscopic surgery.

A private consultation with Mr Lieberman at Highgate Private Hospital costs £250 if you are self-paying for your treatment. For insured patients, we also accept all major health insurers.

To book an appointment, contact us on 020 8003 4778 or email enquiries@highgatehospital.co.uk.