In Australia, a considerable proportion of women suffer from a hormonal condition called polycystic ovarian syndrome, or PCOS. Between 12% and 21% of Australian women who are of reproductive age are thought to have PCOS, yet up to 70% go untreated. For early detection and successful treatment, it is essential to comprehend PCOS’s definition, symptoms, and diagnosis process.
What Is PCOS?
PCOS stands for Polycystic Ovary Syndrome. The term “polycystic” refers to the presence of many small cyst-like follicles on the ovaries, which can be seen during an ultrasound scan. However, having polycystic ovaries alone does not confirm the diagnosis of PCOS. To be diagnosed with PCOS, a woman typically needs to have at least two of the following three features:
- Polycystic ovaries visible on ultrasound: typically described as each ovary containing 12 or more follicles.
- Signs of elevated male hormones (androgens): This can be clinical signs such as excess facial or body hair, acne, or male-pattern baldness, or biochemical evidence from blood tests showing raised testosterone levels.
- Irregular or absent ovulation: Manifested as infrequent, irregular, or absent menstrual periods (cycles shorter than 21 days or longer than 35 days).
This definition is based on the internationally recognised Rotterdam criteria, widely used in Australia and globally.
What Are the Common Symptoms of PCOS?
PCOS symptoms can vary widely among women. Some may have mild symptoms, while others experience more severe effects. Common signs and symptoms include:
- Irregular or missed periods
- Excessive hair growth on the face and body (hirsutism)
- Acne and oily skin
- Thinning hair or male-pattern baldness
- Weight gain or difficulty losing weight
- Fertility difficulties due to irregular ovulation
- Mood disorders such as anxiety and depression
- Increased risk of type 2 diabetes and gestational diabetes
- Higher chance of cardiovascular risk factors like high cholesterol
- Skin tags and darkened patches of skin (acanthosis nigricans)
It’s important to note that not all symptoms are present in every woman with PCOS, and some symptoms can overlap with other conditions.
Why Is PCOS Important in Australia?
PCOS is a significant health issue in Australia, affecting up to one in five women in some populations, including higher rates among Indigenous Australian women. It contributes to considerable physical and emotional distress and is associated with long-term health risks such as diabetes, heart disease, and endometrial cancer.
Early diagnosis and management can improve symptoms, fertility outcomes, and reduce future health complications. However, many Australian women remain undiagnosed due to the variability of symptoms and lack of awareness.
How Is PCOS Diagnosed?
In Australia, diagnosis usually involves:
- A thorough review of symptoms and medical history
- Physical examination for symptoms such as acne or excessive hair growth
- Hormone levels are measured by blood testing to rule out other explanations.
- ultrasound examination of the ovaries
- Evaluation of metabolic risk variables, including cholesterol and blood sugar
The diagnosis requires at least two of the three Rotterdam criteria to be met.
Managing PCOS
While there is no cure for PCOS, symptoms can be managed effectively through lifestyle changes, medications, and specialist support. Australian guidelines recommend:
- Healthy diet and regular exercise
- Weight management, even modest weight loss can improve symptoms
- Medications to regulate periods, reduce androgen effects, and support fertility
- Psychological support for mental health issues
In Australia, PCOS means a complex hormonal condition that affects a large number of women, often presenting with irregular periods, excess hair growth, acne, and fertility challenges. Understanding what PCOS is and recognising its symptoms can empower women to seek timely medical advice and access appropriate care.