Polycystic Ovaries ( PCO )

You may have been trying to get pregnant without success, and noticed that your periods are often delayed, you are putting on weight, or you have persistent acne. This may be due to a condition called polycystic ovary syndrome ( PCO ). Or your gynaecologist may have told you that you have PCO. Do you really have PCO?. The diagnosis is made on the finding of multiple small cysts on the outer portion of both ovaries on ultrasound scan (>8 cysts) and a hormone profile which shows an imbalance in two hormones (LH:FSH of >2:1). There may also be a raised male hormone, testosterone.

Nobody knows why this condition comes about but it is extremely common. It can occur from a young age or later years, it may be temporary or longstanding. If temporary, weight gain is usually not an issue and the irregular periods spontaneously resolve. If longstanding, the condition may be mild or become more severe with increasing weight gain, excessive hair growth, periods even just once or twice a year. There is also a tendency for these women to develop diabetes in later life.

Treatment will depend on the severity of the symptoms and whether pregnancy is desired. If wanting to get pregnant, the options include fertility tabs, injections, or surgery which involves drilling and clearing the cysts from the ovaries.There is a feedback mechanism to the part of the brain which controls the hormones and it appears that this procedure causes the a 'shake-up' resulting in a re-regulation of the hormones. The procedure is done through key-holes as a day procedure.  Medical treatment to lower the male hormone, and a drug known as metformin appears to help. Losing weight also appears to have a great effect in treating this condition. Unfortunately, it is difficult to lose weight with this condition!

 The miscarriage rate is much higher if pregnancy is achieved with PCO. Nobody knows the reason but is thought to be related to the high hormone levels. The risks are even higher if conception with metformin is achieved.

                                                 Ultrasound scan showing cysts in ovary