Polycystic ovaries vs PCOS: What’s the difference?

Have you heard of polycystic ovarian syndrome (PCOS) or polycystic ovaries? Have you ever wondered if these are the same thing? Or what the difference is? Today we are going to talk about polycystic ovaries and PCOS, what they are and what the difference is.

What are polycystic ovaries?

Usually, each month in preparation for ovulation our ovaries will “choose” a follicle (a ball of cells filled with fluid and an egg inside). This follicle will develop over the first half of your cycle and then release the egg during ovulation.

Having polycystic ovaries means that your ovaries grow lots of follicles at a time, instead of just one. They are usually harmless but can sometimes interfere with ovulation as they are not developing in the normal way.

What is PCOS?

Polycystic ovarian syndrome (PCOS) is common among women. We think that about 1 in 10 women have PCOS in the UK. It is a condition that involves various hormones and affects how the ovaries work.

There are three main features associated with PCOS. Having two or more of these might mean that you have PCOS.

• Irregular periods
• High levels of androgens
  • Androgens are the “male” hormones in the body but women also have them too – just lower amounts than men
  • The main androgen is testosterone and increased levels can cause increased body hair, acne or facial hair
• Polycystic ovaries
  • This means that each month, instead of growing one dominant follicle (group of cells with the egg inside), lots grow instead. Then you end up with lots of follicles on your ovary.
    • NOTE: Having polycystic ovaries ALONE does not mean you have polycystic ovarian syndrome

What is the difference?

Polycystic ovaries are isolated to the ovaries. PCOS is a metabolic condition (it involves lots of different hormones in the body) and can lead to other health complications.

You can have polycystic ovaries as part of PCOS but polycystic ovaries alone does not equal PCOS.

Does the difference between polycystic ovaries and PCOS matter?

Yes.

PCOS is a medical condition that can affect your health in multiple ways (although it can also cause you no problems at all – everyone is different!). Polycystic ovaries alone do not cause issues with your overall health. If the disruption in ovarian function causes hormonal dysregulation or affects your periods/gives you other symptoms then it might actually be PCOS. But polycystic ovaries alone won’t necessarily affect your overall health at all.

What are the symptoms of PCOS?

The symptoms of PCOS vary from person to person. More than half of the women with PCOS don’t have any symptoms at all.

The most common time to start noticing PCOS symptoms is in your early 20s or late teens.

The common symptoms of PCOS are:

• Irregular periods or not getting periods at all
• Trouble with fertility or not being able to get pregnant
• Excess hair
  • This is called hirsutism and is usually on the face, back, or chest
• Weight gain
• Hair loss or thin hair on your head
• Acne or oily skin

Because of the hormonal disruptions involved in PCOS, it can be associated with other health conditions such as type 2 diabetes. PCOS can increase the risk of other hormonal (metabolic) disorders in later life so it is important to speak to a doctor if you think you might have PCOS.

Treatments for PCOS

PCOS is not something that can be “cured”. But that doesn’t mean you have to just put up with the symptoms.

Treatments for PCOS has two goals:

1. To treat the symptoms that are bothering you
2. To prevent you developing other health conditions later in life

Lifestyle changes

A healthy and balanced diet can improve the symptoms of PCOS.

Losing weight can also help but only if you feel that you are overweight and you can lose weight in a healthy and sustainable way. Crash diets or putting a lot of pressure on your body is not the way to do this.

Medical treatments

Hormonal contraception (birth control) can help with symptoms like hair growth or hair loss. It also helps some people to lose weight (but it can also have the opposite effect for other people). Hormonal contraception can also help with skin symptoms like acne or oily skin but it is important to remember that this is only really masking the issues and symptoms.

Do I have to have regular periods?

If you are not on hormonal birth control then it is recommended that you have at least 3 periods per year. Progesterone (hormone) tablets can be taken every 3-4 months to induce a period if you don’t want to be taking hormones all the time.

The reason for this is that if you aren’t having periods (in the context of PCOS) then your risk of endometrial cancer (cancer of the lining of the uterus/womb) in later life is increased. This is because the lining (endometrium) is not getting the coordinated signals it normally gets during your menstrual cycle. This means that it builds up in an abnormal way and this can increase the risk of abnormal cells developing.

NOTE: This does not apply if you are not having periods because you are on hormonal birth control. If you are taking the pill continuously or have an intrauterine device (IUD) or implant that stops your periods then this is not dangerous. The hormones in these contraceptives prevent the endometrium from building up at all.

ANOTHER NOTE: If you are having sex with someone with a penis and you don’t want a baby, progesterone every few months will not prevent you getting pregnant.

Other treatments

Metformin is a medicine that is usually used to treat type 2 diabetes. It can also be useful in PCOS. It can lower blood sugar levels and improve your body’s response to insulin. This can also have long-term benefits and reduce the risk of health complications later in life.

Metformin can also improve the chance of ovulating so if you are taking metformin but don’t want to get pregnant then make sure to use contraception if you’re having sex that might lead to pregnancy.

I want to have a baby. What does my PCOS mean for this?

PCOS can make it more difficult to get pregnant for some women. In order to get pregnant you have to ovulate, so if you are not ovulating every month, then it makes it harder to get pregnant.

This being said, not every person with PCOS will struggle to get pregnant. Some women with PCOS have no trouble getting pregnant. Everyone is different.

Some women might need treatment to help but, with treatment, most women with PCOS are able to get pregnant. There are medicines that can help with ovulation or sometimes treatments life IVF might be required. If you are wanting to have a baby and struggling to get pregnant then talk to your doctor about your options.

My mum and sister have PCOS, do I have PCOS?

Possibly.

PCOS does tend to run in families but just because your mum or sister has PCOS doesn’t mean that you definitely will as well.

I was told that only overweight people have PCOS, is this true?

No.

People of any shape or size can develop PCOS.

It is more common in people who have more body fat though. This is because the fat in our bodies also produces small amounts of hormones so the more fat we have the more of these hormones our bodies produce. This can contribute to hormonal conditions such as PCOS.

PCOS can also make it very difficult to lose weight or make you gain weight more easily. This also contributes to why PCOS is more common in people with bigger bodies.

What do I do if I think I have PCOS?

This depends on what your goal is.

If you have symptoms that are bothering you a lot, you should talk to your doctor. The symptoms might improve with balancing your diet, or they might not (everyone is different, remember?). If you need medication to help with your symptoms then that is okay and your doctor will be able to help.

If you are trying to have a baby and not getting pregnant then your doctor is a good person to talk to first. Remember there are lots of options and having PCOS doesn’t mean you can’t have babies.

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