PCOS is a common hormonal imbalance affecting approximately 1 in 10 women of reproductive age. It is becoming increasingly more common amongst young women and can result in health issues such as infertility, obesity and diabetes (insulin resistance). The exact cause of PCOS is unknown, but it is thought to be a combination of hormonal imbalance, insulin resistance and genetics.

There are 3 main symptoms for diagnosing women with PCOS, which include:

1. Irregular or absent periods
2. High testosterone levels which include symptoms such as acne or male-pattern hair growth (hirsutism)
3. The appearance of polycystic ovaries on ultrasound scan

Only 2 of the above 3 symptoms are needed to diagnose PCOS, however many more symptoms can exist. These include fatigue, insomnia, anxiety, low mood, hair thinning/loss, difficulty losing weight and headaches.

There is no cure for PCOS, but a number of treatment options exist. It is therefore important to speak to a healthcare professional if experiencing any of the above symptoms, so that a holistic management plan can be commenced to help improve symptoms and manage PCOS.

Treatment options

Lifestyle Treatment

• Lifestyle modifications remains the cornerstone of managing PCOS. Ensuring a balanced diet with a high protein intake, increased fibre intake and low intake of refined sugars or processed foods, can help improve PCOS symptoms. Regular physical activity of moderate intensity at least 30 minutes five days a week, is also beneficial and overall weight loss can help regularize menstrual cycles and reduce insulin resistance.

• Psychological support via a mental health professional can also improve psychological symptoms and stress associated with PCOS.
• Ensuring adequate sleep is also essential to reduce stress which can otherwise exacerbate symptoms of PCOS

Medical Treatment

• If not planning on getting pregnant, the use of hormonal contraception such as the combined oral contraceptive pill can help regulate menstrual cycles, reduce testosterone levels and also prevent unplanned pregnancies.
• If planning on getting pregnant, the diabetic medication metformin has been found to improve insulin resistance and regularize menstrual cycles, improving fertility rates.
• Other medication to improve fertility includes clomiphene citrate or letrozole.
• To reduce excessive hair growth, medication such as spironolactone can improve acne and hirsutism.

Surgical Treatment

• To improve fertility rates, surgical treatments such as laparoscopic (key-hole surgery) ovarian drilling and in-vitro fertilization (IVF) can be done.

Newer Treatment options

• There is emerging evidence for newer nutritional supplementation to improve symptoms of PCOS, such as inositol and berberine supplements. However, more research studies need to be conducted to understand the effectiveness and safety profile of the supplements to improve PCOS management.

While PCOS is a complex condition, various treatment options are available to manage its symptoms effectively. Lifestyle modifications, medications, and advanced treatments can significantly improve the quality of life for women with PCOS. It is essential for women to work closely with their healthcare providers to develop a personalized treatment plan that addresses their specific needs and goals. By staying informed about the latest treatment options and making proactive lifestyle changes, women with PCOS can lead healthier, more fulfilling lives.