Poly-cystic ovary syndrome – PCOS

Polycystic ovary syndrome (PCOS) is a condition of women that is becoming more commonly diagnosed.

Before we had such good ultrasound scanning machines, polycystic ovary syndrome was only diagnosed in when an operation had been performed and the ovaries had been seen to be full of cysts. Of course most people never have operations, and so the condition was less well understood.

Now with high quality and readily available ultrasound scans, the ovaries can be seen quite easily by an expert radiologist, gynaecologist or radiographer.

What is polycystic ovary syndrome (PCOS)?

Simply, polycystic ovary syndrome is diagnosed when the ovaries are full of cysts. Of course, this is not the main problem with polycystic ovary syndrome, but it is the obvious sign that a woman has the condition.

Normal ovaries produce eggs – usually one a month. Several eggs each month will start to develop, but only one will develop to maturity and release. This ache will be in a “follicle” which is basically a normal cyst. In other words, the egg is surrounded by fluid within the ovary. When it is released into the fallopian tube and then uterus (womb), it achieves this by the follicle bursting, releasing the egg and some fluid. This occurs midway through the monthly cycle and many women feel pain when this occurs – a condition called Mittelschmerz or “mid-month pain”.

Because the follicle is fluid filled and looks like a cyst, it is quite normal to see a few little cysts in the ovaries early in the month, and one or two mid-month.

If lots of large cysts are found in both ovaries, this would be abnormal and would be consistent with polycystic ovary syndrome (PCOS).

As stated above, the problem is and having lots of cysts in the ovaries, it is why a healthy person should develop these cysts. Further studies have shown that women who get polycystic syndrome have hormonal abnormalities that caused the cysts to form. In other words it is not the cysts that are the problem, but it is the cysts that show that the hormones are not balanced correctly.

The signs of polycystic ovary syndrome (PCOS).

Before ultrasound scans were so easily available, it was thought that polycystic ovary syndrome was a lot less common than it actually is.

It used to be thought that women who got very fat got polycystic ovary syndrome, due to their oestrogen (female hormone) being converted in the fat tissue into testosterone (male hormone). This increased amount of the male hormone testosterone caused the imbalance forming the cysts in the ovaries but also having other effects such as excess body hair, often in the male distribution.

Many women were told that the treatment was simply to lose weight.

However now that more women get pelvic ultrasound examinations, polycystic ovary syndrome is commonly found in very slim women who do not fit the classic pattern above.

There is still an underlying hormone abnormality, but recent research is starting to suggest that the balance between diet and nutrition, and the hormone balance of the female sex hormones, can get disturbed and cause polycystic ovary syndrome. It appears that certainly in some people, high carbohydrate diets cause very high insulin levels, leading after some time to the body getting used to excess insulin and then not responding to it – a condition called insulin resistance.

This then seems to have many effects on the body, one of which appears to be polycystic ovary syndrome.


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