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How do I know if I have PCOS

As female reproductive systems are slowly becoming more understood and studied, we are now seeing a surge of women (in this article I will use the term women/woman to describe those with female reproductive systems) being diagnosed with health conditions such as Fibromyalgia, Endometriosis, and Polycystic Ovarian Syndrome (PCOS) to name a few. But if you’re like me, I struggle with grasping how we can diagnose these conditions as they all have different criteria and methods of diagnosis. Here, I go through what PCOS is and how we may be able to diagnose it. Please note, if you do suspect you may have any of the following conditions or symptoms, please consult your GP for support and advice.

What is PCOS?

PCOS is a complex hormonal condition affecting women up to 13% of women of reproductive age, in which 70% still remain undiagnosed. PCOS can affect female reproductive organs and hormone metabolism which can produce distinct symptoms from other women’s health conditions. As the name describes, women who have the condition may have multiple cysts on their ovaries. Cysts are sacs of fluid however, these cysts also contain an unfertilised egg, which we call follicles. These follicles cannot regularly release the eggs so they cannot become fertilised. Some women may have polycystic ovaries (PCO) but not have the syndrome. Below, I explain what I mean by that

The S in PCOS

The S in PCOS is the syndrome part of the condition. This entails the hormonal changes that occur with PCOS. Those with PCOS may have excess androgen secretion. Androgens are a group of sex hormones that assists in the regulation of reproductive development and health. Both men and women have androgens that control puberty, muscle development, bone density and sexual function. The excess secretion of androgens in PCOS may be due to the presence of low-grade inflammation. The chronic, low-grade inflammation may cause the polycystic ovaries to secrete more androgens than required. Excess androgens can affect ovulation, by inhibiting the release of eggs from the follicles on the ovaries. Therefore, some women may experience infertility. As testosterone is a type of androgen and can be seen in higher levels in those with PCOS (and typically males), it has been shown to cause hirsutism (excessive hair growth on the body and/or face), acne, baldness, and excessive hair loss.

Another part of the syndrome is insulin resistance which may or may not be present along with excess androgen secretion. Insulin is another hormone made by the pancreas, to help regulate our blood sugar levels. Insulin resistance means that our cells become resistant to insulin such that, the sugars in our blood cannot be absorbed by cells and be used as energy. The best way I can describe this is that insulin works as a key to open cells up, to allow for sugar (or glucose), to be let in and used up as energy. If our ‘key’ doesn’t work (our cells become insulin resistant), sugar is built up in our blood and raises our blood sugar levels. Furthermore, because our pancreas reacts to increased blood sugar levels by secreting insulin to combat the effect, more and more insulin is secreted. This build-up of insulin can also cause excessive androgen secretion.

What are the symptoms of PCOS?

Some symptoms you may be able to see with your own eyes, however, other symptoms are not so easy to tell unless you have blood tests or an ultrasound.

  • Acne

  • Balding/ scalp hair loss

  • Irregular menstrual cycles (maybe be more or less frequent)

  • Amenorrhoea (no periods)

  • Excessive facial or body hair

  • Sleep apnoea

  • Difficulty becoming pregnant

  • Anxiety and depression

  • High androgen levels and/or testosterone

  • Polycystic ovaries

How can PCOS be diagnosed?

The criteria for PCOS are to have two out of three of the following:

1. Excess facial or body hair, acne, hair loss, or a blood test indicating high levels of androgens and/or testosterone

2. Polycystic ovaries as seen on an ultrasound

3. Irregular or absent periods

Additionally, if you have a family history of PCOS, you may be 50% more likely to be diagnosed with it.

How can PCOS be managed?

If you have PCOS, there is a variety of ways to manage symptoms such as:

  • Ensuring you are moving regularly in a way that is enjoyable for you

  • Eating a well-balanced diet with low GI carbohydrates (more on this in another blog)

  • Seeing a mental health professional help manage any stress, anxiety and depression that may be a by-product of PCOS

  • Medical treatment such as medications or hormones

Who should I see if I have PCOS?

If you have been diagnosed with PCOS, it is best to have a team of medical professionals including:

  • Your GP

  • Endocrinologist

  • Gynaecologist

  • Women’s health dietitian (like me!)

  • Mental health professional

  • Exercise physiologist or physiotherapist

Hopefully, this blog has provided you with some direction as to what to do next if you're thinking you may have symptoms or, given you some insight into what PCOS is and how it works.

Stay tuned for an additional PCOS segment about the dietary management of PCOS in the not-to-distant future or contact me to find out more now!

  1. Better Health Channel- Polycystic Ovarian Syndrome (PCOS)

  2. Mayo Clinic- Polycystic Ovary Syndrome (PCOS)


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