PCOS is a hormonal disorder that affects five to 10 per cent of women of reproductive age.

If you have PCOS you may have:

• periods that are irregular, infrequent or heavy
• difficulty in becoming pregnant
• immature ovarian eggs that do not ovulate, forming small follicles
• weight gain and an increase of fat in your upper body
• excessive facial or body hair
• acne on both the face and the body
• prediabetes or diabetes
• higher levels of blood fats.

While the causes of PCOS are not yet clear, recent studies show that both lifestyle and genetic factors can be involved.

What happens with PCOS?
Hormonal changes

In a normal menstrual cycle your hormones fluctuate, but with PCOS your body has an imbalance of hormones. This imbalance may prevent ovulation, which means the ovaries don?t release eggs.

The male-type hormones, called androgens, which include testosterone, are present in low levels in all women. Women with PCOS often have extra androgens in the blood, which can result in increased facial and body hair and acne. Your body usually also develops resistance to the hormone insulin, which regulates sugar levels. This can lead to an increased risk of diabetes.

What are the long-term risks associated with PCOS?
Long-term complications can appear in women of all ages. Women with PCOS have an increased
risk of:
? infertility
? type 2 diabetes
? impaired glucose tolerance
? high blood fats
? possibly heart disease
? thickening of the lining of the uterus.

Health tips

Enjoy a wide variety of nutritious foods, by eating plenty of vegetables, legumes, fruit and wholegrain cereals. Include lean meat, fish, poultry and/or alternatives. Try to include fish 3?5 times a week (this
can include canned fish, such as salmon, sardines and tuna).

Take time out just for you.
Make pelvic floor exercises a life-long habit ? even if you have no symptoms. Be active on most, or all, days of the week: you don?t have to do a 30 minute walk, 3x10 minutes is just as good!

3 serves of dairy each day for good bone health.
Fortunately, with early diagnosis and proper management, the long-term health risks can be prevented or delayed, or once PCOS is present, the health risks can be treated effectively.

Management of PCOS

There is no single treatment for PCOS, but its symptoms can be managed in the following ways:

Education
It is important that all women with this condition understand some key causes and vital treatments, which are emerging from the latest research.

Weight management
Weight management is really important. Healthy eating and regular physical activity are vital. For more information and advice, talk to a health practitioner or dietician.

Also, visit the Jean Hailes
website at www.jeanhailes.org.au and read our information sheet, Healthy Eating.

Management of insulin resistance
Most people who are overweight and have PCOS also have insulin resistance, although even thinner women with PCOS can be insulin resistant. Healthy eating and physical activity offer the best approach. Medications including metformin can also reduce insulin resistance and can be very effective at treating infertility. However, these medications need to be initiated under specialist endocrinology or gynaecology supervision.

Management of irregular periods
Regular periods help prevent excessive thickening of the lining of the uterus. Long gaps between periods can also lead to abnormal cells building up inside the womb and it is recommended that at least four cycles per year are needed to prevent this. Medications including a low-dose contraceptive pill, progesterone and metformin can be given so that menstrual bleeding occurs regularly.

Management of infertility
Firstly, it is important to consult your doctor to exclude other reasons for infertility. If infertility is a concern and you are overweight, then weight management and activity is the first line of treatment. After this, medications may be used to start the release of eggs, including metformin and clomiphene. While a surgical procedure can cause temporary ovulation, it is not often performed, as medications
are as effective, with fewer complications. Management of increased facial hair growth and acne Contraceptives and anti-androgen drugs can be used for the treatment of acne and excess facial hair. Cosmetic advice on waxing and laser hair removal is best taken initially from dermatologists or endocrinologists rather than beauticians.

Finally
A diagnosis of PCOS is not the end of the world. With support and accurate health advice, it can be managed well and you can live a comfortable and fulfilling life.

Where can I get more information?
www.jeanhailes.org.au
www.posaa.asn.au ? Polycystic Ovarian Syndrome Association of Australia 02 8250 0222
www.dav.org.au ? Diabetes Victoria 1300 136 588
This resource was developed with the support of the
Australian Department of Health and Ageing
Updated December 2005