Polycystic ovaries

Polycystic ovaries contain a large number of harmless follicles, these fluid filled sacs usually contain under-developed eggs. Polycystic ovary syndrome (PCOS) is a common condition that affects how a woman’s ovaries work. It causes that the occurrence of multiple sacs but they are often unable to release an egg, which means that ovulation doesn't take place. Signs and symptoms can include no period, difficulty of getting pregnant, weight gain or excessive hair growth.

Having polycystic ovaries means that you have a condition called polycystic ovary syndrome, which is often shortened to PCOS. It is a common hormonal disorder or condition for women, non-binary, or transgender people with ovaries, especially those of reproductive age. 

The main symptom of PCOS is the polycystic ovaries themselves. When a person has the condition, their ovaries will become enlarged, containing many fluid-filled sacs (follicles) that surround the eggs. Despite the name, you may or may not develop actual cysts when you have polycystic ovaries. The two conditions may also not be at all related.

The follicles involved in cases of PCOS are harmless. Measuring around 8 mm in size, they are simply underdeveloped sacs in which eggs would normally develop. If a person has the condition, the sacs are often unable to release an egg. This means ovulation does not take place and normally means that the person will not experience a period that month. This is perhaps the most noticeable symptom of PCOS, as it often causes a person’s period to become irregular.

Other symptoms of polycystic ovary syndrome include:

  • Acne or oily skin
  • Excessive hair growth (also called “hirsutism”, which is usually prominent on the face, chest, back, or buttocks)
  • Difficulties getting pregnant
  • Hair loss or thinning hair
  • Weight gain

PCOS is also often associated with an increased risk of developing certain health issues in later life. These include high cholesterol and type 2 diabetes.

The exact cause of polycystic ovaries is unknown. However, several factors may play a part in PCOS developing in the body:

  • Heredity (it has often been found that PCOS runs in families)
  • Excess androgen (having already high levels of “male” hormones, androgens, in your body may result in you developing acne and excess hair)
  • Excess insulin (if your body becomes resistant to insulin, your blood sugar levels may rise and make your body produce more. Excess insulin can increase androgen production, which then causes difficulty with ovulation)
  • Low-grade inflammation (research has shown that patients with PCOS have a type of low-grade inflammation that stimulates polycystic ovaries to produce androgens)
  • Being overweight or obese (this can increase the amount of insulin in your body)

There is no current cure for polycystic ovaries, but the symptoms can be treated. By speaking to your doctor or healthcare provider, you may be able to work together to come up with a solution that ensures your comfort. It may also allow you to get pregnant if you have previously been unable.

Some of the most common remedies to help you manage PCOS are:

  • Losing weight and keeping to a healthy, balanced diet
  • Medicines which may treat excess hair growth, or irregular periods and fertility problems
  • Laparoscopic ovarian drilling (LOD), which uses heat or a laser to destroy tissues in the ovaries that are producing androgens, such as testosterone

LOD procedures will normally only be recommended if fertility medicines are not effective.