On the Coast – Families Issue 95 I August/September 2018 | Page 26

Polycystic
Ovaries
and PCOS
is not a fertility
death sentence
by Diana Arundell
M
any women that have been
diagnosed with polycystic
ovaries and/or polycystic ovarian
syndrome are often automatically
told that they may not be able to
have children, or may have major
difficulties conceiving.
To be told this blanket statement is
damaging to a woman’s (and possibly her
partner’s) mind, and is certainly more
destructive than healing. Although it
may be the case for a small percentage
of women left untreated, it is far from
the truth for many women diagnosed
with this condition. Polycystic ovaries
(PCO) and polycystic ovarian syndrome
(PCOS) is certainly not a fertility death
sentence because it is not a permanent
condition, and with an accurate diagnosis
and correct treatment, the body can
be supported back into healthy fertile
balance. The sooner it’s diagnosed
and treated, the better because if left
untreated for a long time it can affect
fertility and significantly increase the
chance of developing diabetes. Some
women have cysts on their ovaries but
not the syndrome, some women have the
syndrome without the cysts and other
women have it all.
World wide 1 in 5 women are
diagnosed with polycystic ovaries
and in Australia 12-21% of women
are diagnosed with polycystic ovaries.
Clinically this appears to be increasing
at an alarming rate over the last couple
of years. If it is not addressed, it can lead
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KIDZ O N T H E C OA ST
to many health complications and as
with many other chronic diseases, it can
actually affect the health and fertility
of future offspring. Risk factors that
can contribute to the development of
PCO/S include: family history of PCO/S
or diabetes, obesity, insulin resistance,
stress, nutritional deficiencies, a high
sugar/refined carbohydrate diet and
a sedentary lifestyle. Other than the
family history, these things are treatable
and by resolving them properly (not
just masking with medication), this can
positively impact the genetic expression
of the woman and of future generations.
Polycystic ovaries or polycystic
ovarian syndrome (it is referred to
the syndrome when other signs and
symptoms are present, not just cysts
on the ovaries), results in the failure to
ovulate regularly, and it’s important to
acknowledge that this condition can
not solely be diagnosed via ultrasound.
Polycystic ovaries as seen on an
ultrasound on their own can’t explain
why ovulation did not occur or predict
if ovulation will occur in future cycles.
There may be a temporary issue causing
irregular periods, even polycystic ovaries
but it may not be part of the syndrome.
There are other cysts not related to
polycystic ovarian syndrome such as
dermoid cysts, haemorrhagic cysts, large
functional or chocolate cysts.
Polycystic ovarian syndrome (PCOS)
is associated with a number of signs
and symptoms including the following:
irregular or absent period, hirsutism
(hair growth on face, neck, chest), acne
usually on side of face, chin/neck and
top/back of shoulders or chest, male
pattern baldness/hair loss, obesity - but
almost 50% of cases are lean or normal
body weight. Cysts on the ovaries can
show up in an ultrasound as enlarged
ovaries containing a large number of
follicles or a pearl necklace look around
the outside of the ovary. In the case of
PCO/S there is usually more than 12 fluid
filled, underdeveloped follicles in one or
both ovaries. It is however important
to acknowledge that teenage girls may
naturally have a higher number of
follicles.
For a most accurate diagnosis and
treatment plan to follow, many other
factors need to be considered and tested
for. Thorough investigations can help
focus the treatment to address the
underlying issues contributing to PCO/S
as well as providing symptomatic relief
if required. PCO/S can occur when the
ovaries are stimulated to produce too
much testosterone (or male hormones –
androgens). This can happen when there
is persistent high levels of insulin in the
blood, or due to an excessive release of
luteinising hormone (LH), or if there
is oestrogen dominance. Although it
appears PCO/S is a female reproductive
issue, more recent research is pointing to
the insulin resistance being the leading
cause. Insulin resistance can interfere
with hormonal communication between
the hypothalamus-pituitary-ovarian
axis and this can lead to irregularities in