What is PCOS?
Polycystic ovary syndromeis a condition that causes the production of irregular hormone levels, affecting the ovaries and causing missed periods. It's extremely common – affecting one in five women in the UK. It can also be treated. Polycystic ovaries have more follicles than non-polycystic ovaries. TheNHS调用这些毛囊的underdeveloped sacs', and says that they're 'often unable to release an egg'. When this happens, ovulation can't take place.
What causes PCOS?
PCOS causes are unknown – but there are a few factors thought to have an effect:
- Genetics: It sometimes runs in families – so if your mum, sister or another female family member suffers from the condition, you might be at greater risk.
- Hormones: Lots of women diagnosed are found to have a hormonal imbalance. They have raised levels of testosterone (the 'male' hormone), prolactin (the hormone that causes the breasts to produce milk) or luteinising hormone (which usually stimulates ovulation but can cause problems). It's not known exactly why these changes to hormone levels take place.
- Insulin resistance: High levels of insulin cause the ovaries to produce too much testosterone. This, in turn, can cause weight gain, which again triggers the body to produce more insulin.
PCOS symptoms can come and go, but you'll usually first experience them in yourlate teens or early twenties。The symptoms of PCOS can become apparent later on, though, and many women don't realise they have it until they have troubletrying to conceive。
Not all women will experience all the possible symptoms, and each symptom canvary from mild to severe。
Take a look at this PCOS symptoms checklist for the ones you might experience:
- Disruption to your menstrual cycle – resulting in absent or irregular periods.
- Infertility (because ovulation isn’t occurring).
- A tendency towards excess hair growth, particularly on the tummy, face and nipples. This is caused by extra testosterone, which may also make the hair on your head a bit thinner.
- Loss or thinning of the hair on your head.
- Spots and oily skin.
- Weight gain, which can make things worse in itself – raising insulin levels and stimulating testosterone production.
- Pelvic pain.
- Dark patches of skin in your groin, neck and armpits (acanthosis nigricans).
- Mood swings.
These symptoms (particularly depression) may be caused by other issues – so if you're struggling with any of them, do see your GP.
I was diagnosed about eight years ago. I had the classic symptoms – overweight, spots etc but my cycle was fairly regular. I had strong insulin resistance and really struggled to lose any weight.
How is PCOS diagnosed?
多囊卵巢综合征的诊断,two of the three following factors need to be present:
- Polycystic ovaries (you can have these without having the full syndrome – and, confusingly, you may have the syndrome even if your ovaries aren’t polycystic).
- Anovulation (no egg released).
- Raised testosterone levels.
通常是在a vaginal ultrasound scan查看卵巢，看看它们是否多囊结合血液检查以检查睾丸激素水平。
If you're diagnosed, your GP will discuss the lifestyle changes you can make to keep the condition under control. They'll also start you on medication if you need it. And you could be referred to anendocrinologist or gynaecologist, depending on your treatment needs.
我有一个朋友（严重），现在有两个漂亮的女儿 - 都通过自然概念。她正在使用怀孕之间的植入物，这对她来说真的很好。
PCOS treatment options
Although there isno cure for PCOS,symptoms can be treated，使大多数试图怀孕的妇女能够。
The treatment recommended may include:
- Drugs such as Clomifene to stimulate ovulation.
- Medication like Metformin, which lowers insulin. It’s a drug usually given for type 2 diabetes but can be used ‘off label’.
- 促性腺营养蛋白注射以刺激卵巢（但是，这里存在过度刺激的风险 - 可能导致多次妊娠）。
- Laparoscopic ovarian drilling – which isn’t nearly as horrific as it sounds! Under general anaesthetic, a tiny microscope is inserted into the lower abdomen to look at the ovaries. The tissue producing the male hormones is then lasered off.
I ended up having an operation (ovarian drilling), which significantly improved the symptoms. I was then given fertility treatment (Clomid) for about a year and just after I finished treatment got a big fat positive.
How can I improve my chances of getting pregnant with polycystic ovary syndrome?
There's lots you can do to help reduce the effects of polycystic ovary syndrome and boost your fertility.
If you'reoverweight，尝试失去其中的一些，以帮助打破胰岛素水平升高的周期。反过来，它们增加了体内产生的睾丸激素量。NHS说even a 5% weight losscan make a big difference to the syndrome’s effect on your fertility. It could also reduce your risk of developing long-term problems associated with polycystic ovary syndrome – including diabetes, high blood pressure, heart disease and endometrial cancer.
Having a reasonably good diet was the one thing that I think might have helped. I advocate an organic homemade diet, although I'm still a chocolate and wine fiend. There's no need to give up everything!
Is there a recommended PCOS diet?
Having abalanced dietand taking regular exercise are the easiest ways you can help limit the effects of the syndrome. Try toavoid sugary foods, alcohol and caffeine, as these can all affect insulin resistance.
You should also aim to:
- 少吃肉– reduce your intake of meat and when you do eat it, try to eat good-quality, organic meat. Too much meat can worsen any imbalance in your oestrogen levels.
- Eat more plant-based protein– try to up your intake of beans, nuts, legumes and other non-meat sources of protein.
- Include Omega 3 fats in your diet– they've been shown to lower testosterone levels in women.
- 吃一点全脂乳制品– although you should avoid consuming too much dairy, a small amount of full-fat, good-quality dairy can actually be beneficial.
- Take supplements– a lack of certain vitamins and minerals can negatively affect your ability to conceive. Your doctor can advise you on which supplements you may need to take.
Arecent study(February 2019) also found that 'increasing dietary fibre and magnesium intakes may assist in reducing IR and hyperandrogenemia in women with polycystic ovary syndrome.' But what does this mean? Put simply, you shouldopt for carbs high in fibre that digest more slowly。这包括水果和蔬菜，全麦和豆类。
As well as diet, consider your stress levels. Dealing with mine made all the difference for me.
How will PCOS affect me in pregnancy?
Being diagnosed prior to getting pregnant will give you time to make as many changes to your lifestyle as possible. Your GP will also be able to suggest options for keeping symptoms under control during pregnancy and beyond.
Associated health conditions
Unfortunately, polycystic ovary syndrome can increase your risk of developing other health conditions later on in life. For example, if you have it you have an increased risk of developing:
- Type 2 diabetes，这种情况会导致血糖水平过高。
- Depression and mood swings，因为症状会影响您的信心，自尊和一般的幸福感。
- High blood pressure and high cholesterol, which can lead to heart disease and stroke.
- Sleep apnoea, a condition that causes interrupted breathing during sleep.
That's not to say that you'll definitely develop these conditions – but it's good to be aware that there's a link. If you find yourself struggling with any of them, don't hesitate to go and see your GP. There's plenty of support available to you.
And if you just want a listening ear, remember that the Mumsnet forums are always open.
These two charities are built solely around polycystic ovary syndrome; spreading awareness as well as providing resources and support networks.