To make a diagnosis of PCOS there are a group of criteria called the Rotterdam criteria.

A patient needs any two of the following:

  • Evidence of ovulation problems
  • Evidence of male hormone excess
  • Ultrasound evidence of polycystic ovaries.
  • Ovulation and Menstrual Problems
  • Amenorrhoea/Oligomenorrhoea

The ovary is not reliably producing eggs, female hormone levels produced by the ovary are often low. The uterus therefore receives only a few messages to thicken its lining. As there’s no orderly ovulation there’s no drop by progesterone levels to trigger a period so bleeding doesn’t occur. PCOS patients have absent or sparse periods.

  • Heavy periods or irregular frequent bleeding

This is common in patients who are obese with PCOS. Sometimes the tiny and primitive follicles produce enough oestrogen to thicken the liner of the uterus but the compacting and balancing hormone, progesterone, is absent.

This can cause the liner of the uterus becoming thicker and thicker and eventually undergoing a sort of pre-cancerous change. this might be related to quite heavy bleeding or irregular, frequent and even constant bleeding. Patients with this type of bleeding need investigation of the liner of the uterus by hysteroscopy and biopsy to form sure that they’re not developing cancerous or pre-cancerous changes.

  • Obesity

Obesity is going to be present in many patients with PCOS (50%). However many patients whose ovaries function during a PCOS way are often quite thin. Obesity can become self-perpetuating with PCOS therein the abnormal hormone levels being produced by the ovary can predispose to obesity. As explained above, once the fat tissue is laid down it then starts to supply female hormone which increases the extent of disorganisation within the body’s environment which may cause further obesity. Good weight control and dieting is an efficient method of treating PCOS.

 

  • Acne and Abnormal Hair Growth (Hirsutism)

Increase the levels of male hormone are produced by the ovary and to a lesser extent by any excess body fat. These increased levels of male hormone ravel to receptors within the skin and should trigger an epidemic of acne.

Different patients will have different sensitivities to those changes in male hormone so measuring the amount of those male hormones in blood tests isn’t predictive of how severe the skin changes are going to be . Patients even have different abilities to convert the male hormone which is present in blood into more active sorts of male hormone which affect the skin and hair follicles of the skin.

Some patients will have their hair follicles activated by these increased male hormone levels and start to develop excessive hair growth which is named hirsutism. this might occur particularly on the upper lip, chest, stomach and legs and arms. it’s going to even be amid a more coarse hair growth instead of the traditional fine female hairs.

  • Infertility and PCOS

One of the common presentations of patients with PCOS is difficulty becoming pregnant. Reading the knowledge above it’s easy to know why. the foremost common problem related to PCOS is disordered ovarian function and poor ovulation. This predisposes to infertility. However it must be stressed that there are many patients who have a light sort of PCOS who can become pregnant. Not all patients with PCOS fail to ovulate.

  • PCOS and diabetes

Recent research has shown that there’s a link between PCOS and insulin resistance. Insulin is that the hormone produced by the pancreas within the body. it’s liable for helping sugar to be metabolised into energy within the body. Patients who have PCOS are therefore more likely to possess trouble handling a sugar load. When this happens, the condition is named diabetes. there’s now a case for testing some patients with PCOS for early stages of diabetes. Patients with PCOS are 3-7 times more likely to develop diabetes later in life.