Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS)

The most common gynaecological complaint I see in my clinic is Polycystic Ovaries/Polycystic Ovarian Syndrome (PCOS).

Some women only have cysts (PCO), while others have no cysts but have the syndrome (PCOS). Some have both. For the sake of this article, I am going to call this complaint PCOS, so people don’t get confused.

The one thing they both have in common is insulin resistance.

If you or someone in your family suffers from irregular cycles, gets hormonal acne and has extra hair, there is a good chance they have PCOS. It’s best to get the problem looked at and treated early, before it affects their fertility.

The great news is PCOS is completely treatable and reversible, with the right treatment. It’s a syndrome, not a disease, so by doing your research and seeing the right specialist, PCOS can become a thing of the past.

What Is Polycystic Ovarian Syndrome (PCOS)?

Polycystic Ovarian Syndrome (PCOS) is a reproductive disorder characterised by multiple cystic growths on the ovaries.

PCOS develops when the ovaries are stimulated to produce excessive amounts of male hormones (androgens), particularly testosterone.

This can occur due to the release of excessive luteinising hormone (LH) by the pituitary gland, or through high levels of insulin in the blood (hyperinsulinaemia) in women whose ovaries are sensitive to this stimulus.

It can also be caused by oestrogen dominance too.

PCOS is characterised by a complex set of symptoms, with research to date suggesting insulin resistance to be a leading cause.

The majority of patients with PCOS (some investigators say all) have insulin resistance, and there is likely to be a family history of insulin resistance too – genetics does play a fairly strong role in PCOS.

Insulin resistance is a common finding among both normal weight and overweight PCOS patients.

Many years ago, it was thought you had to be overweight to have PCOS, but now we know that many normal and underweight women have it too. Their elevated insulin levels contribute to or cause the abnormalities seen in the hypothalamic-pituitary-ovarian axis that lead to PCOS. Specifically, hyperinsulinaemia causes a number of endocrinological changes associated with PCOS too. Anyone with polycystic ovaries has more than 50% increased chance of developing diabetes down the track.

PCOS is the most common cause of oligomenorrhoea (light or infrequent periods) and amenorrhoea (an absence of periods), although 20-25% of normally menstruating women have PCOS. These women may have reduced fertility and an increased risk of miscarriage.

Risk Factors For Polycystic Ovarian Syndrome

Major causative factors and risk factors that can contribute to the incidence of PCOS include:

  • Insulin resistance
  • Obesity
  • Family history of PCOS
  • Family history of diabetes
  • Family history of insulin resistance
  • Family history of cardiovascular disease
  • Stress
  • Nutritional deficiencies
  • High glycaemic load diet
  • Sedentary lifestyle

Symptoms & Signs of PCOS

Common signs and symptoms of PCOS include:

  • Irregular menstrual cycles i.e., oligomenorrhoea or amenorrhoea
  • Infertility, generally resulting from chronic anovulation (lack of ovulation)
  • Elevated serum (blood) levels of androgens (male hormones), specifically testosterone, androstenedione, and dehydroepiandrosterone sulphate (DHEAS)
  • Central obesity (apple-shaped), centred around the lower half of the torso
  • Androgenic alopecia (male-pattern baldness)
  • Acne, oily skin, seborrhoea
  • Hirsutism (excess hair growth)
  • Acanthosis nigricans
  • Prolonged periods of PMS-like symptoms
  • Sleep apnoea
  • Multiple cysts on the ovaries
  • Enlarged ovaries, generally 2-3 times larger than normal, resulting from multiple cysts
  • Chronic pelvic pain
  • BGL dysregulation — e.g., hypoglycaemic episodes, diabetes, etc
  • Hypothyroidism

The Importance of Diet and Lifestyle

Dietary and lifestyle changes are an absolute must in the management of PCOS. The World Health Organisation recommends that dietary and lifestyle changes are the number one treatment for PCOS, along with other therapies.

By consuming a reduced amount of low glycaemic index carbohydrates, keeping protein levels up to maintain muscle mass and eating ‘good’ fats (e.g. avocado, egg, coconut oil, uncooked olive oil, chia seeds, fish), insulin levels are reduced and fat stores can be accessed as fuel for energy production (thermogenesis).

The Wellness/Zone/Paleo style diets that I promote in my clinic help women with PCOS to maintain steady blood sugar and insulin levels, and will assist in weight loss – and maintain body mass for those underweight.

A diet composed of mainly low-GI foods combined with regular exercise will help to combat the effects of insulin resistance. This is why the Paleo style diets are the best diets to follow. Ideally, people with PCOS should get rid of grains altogether. Women with PCO and PCOS do not process sugars and refined carbs properly, which leads to making the PCOS and PCO worse.

Refined carbohydrates including sugar, sweets, fruit juices, white breads and pasta should be avoided. These foods have a high glycaemic index and are damaging in any amount for PCOS sufferers.

A diet high in vegetables (non-starchy), small amounts of low-GI fruits, essential fatty acids and lean protein sources provides essential phytonutrients, antioxidants, magnesium and helps to control inflammation and hormonal dysregulation.

Regular resistance training, or high interval exercise, is a must too (starting slowly and increasing as your fitness level improves).

Smoking and PCOS

Smoking cessation needs to be the highest priority for patients who smoke.

Allan Carr’s Easy Way To Quit Smoking is a fantastic book based on a program with a very high success rate. According to two studies (as published by the Journal of Addictive Behaviours), Allan Carr’s Easyway has an astonishing 53.3% success rate and has helped over 14 million people stop smoking.

You’ll find the best-selling, US version here or the version written especially for women here. If you’re in Australia, you might like to source the book from Book Depository (free shipping).

Acupuncture and Chinese medicine can also support smoking cessation – it’s entirely possible to quit smoking, easier and sooner than you think.

Other Treatments For PCOS

Acupuncture, Chinese medicine and nutritional supplements are another big part of treating PCOS – complementary medicine can help dramatically. In my clinic at Shen Therapies, we have our own specially designed formulas to treat PCOS.

What About Metformin and Other Medications?

Insulin-regulating medications (Metformin), hormone treatments (the pill, HRT) are used to regulate the menstrual cycle, control insulin resistance and to prevent further cysts developing. You can even get a procedure called “ovarian drilling”, which lasers the cysts and helps with the healing of the ovaries in severe cases.

Just remember: going on the pill does not fix this problem, it just masks it. This is why anyone with irregular cycles should see a women’s health specialist like myself, or a gynaecologist. Not just your GP, as they do not have specialised training such conditions.

Whatever you do, don’t leave your fertility in the hands of someone who wont help you to fix the root cause of the problem.

Articles posted on BellyBelly which are not written by Doctor Andrew Orr are the opinions of BellyBelly and not necessarily the opinion of Doctor Andrew Orr.

  • 3.1K


Doctor Andrew Orr is a Women's Health and Reproductive Specialist, with Masters degrees in both fields. His other qualifications include a BSc and BHSc, and he is a qualified nutritionist and doctor of Traditional Chinese Medicine. Doctor Orr's fertility work with couples has resulted in the births of over 12,500 babies.


    1. I just want to encourage you claudia as it is possible. I tried lots of treatments with no luch and ivf was next step. I wasn’t ready so we planned a big trip instead and then i fell pregnant naturally! I did change my diet and used a good naturopath and acupuncture so dont give up ☺

    2. Don’t lose hope, I struggled with pcos since adolescence. I never used any medicine, I just started working out frequently and lost almost 50 lbs. Once I lost weight I started menstruating regularly and I tracked it on an app for 3 months and on the 4th month I tried and got pregnant immediately. I thought we would never get pregnant and I worked hard and it finally happened. Now I have an 8 month old son and I couldn’t be happier! I wish you lots of luck and just advise you to take extra good care of your body:)

  1. I have pcos for the last 13 years would love to get more information about it as doctors don’t tell you enough about it. I am with my partner 5years and trying for a baby a year and no luck

  2. i had PCOS…it started when i had a miscarriage about 3yrs ago….and my Doctor told me if i did a surgery to remove the cysts i will b ok..and i did…but im still having irregular periods…so i was wondering if u have any advise that can help…please

  3. I was diagnosed with pcos almost two years ago. I’m interested in Shen therapies. I’m currently on metformin and have been since being diagnosed.

  4. Such a helpful artical. I was diagnosed with PCOS a couple of years after giving birth to my son Ethan. The sonologist told me that it’s okay even if I don’t get an operation. But it feels really heavy inside especially when menstrual blood doesn’t all come out. I didn’t know anything about PCOS till I came across this article. I surely will have a talk with my OB Gyne about this so we can get it fixed.

  5. A soo believe that good diet made me concieve at 38 yrs wasn’t trying yoghart natural n nuts especially with exercise made me conceive have pcos never fell before ,my lifes complete funny also ended up with gestational diabetes 🎀xx zhealthy baby

  6. My name is Tiffany.I’m a 25 year old healthy individual other than pcos,which I have suffered from for many years.I was diagnosed when I was 16…at the time I had health insurance and soon after I lost it.My o.b.g.y.n put me on Metformin and told me to loose some weight, exercise and eat healthy.I did loose weight, at the time I believe I was 147lbs and now weigh 123lbs.I don’t exercise like I should but I do eat healthy.I also am married and we have been together since I was 17 and married for 7 years….because of the pcos I haven’t been able to conceive at all, we have been trying for bout 5 years and 0 positive pregnancy test.So my question is,is there anything over the counter medication that me and my husband can try

    1. Hey Tiffany,

      I also have PCOS and have been trying to conceive. My GYN has suggested I take prenatal vitamins and pregnitude. Pregnitude is over the corner but must be ordered by the pharmacist. It comes in powder form that you put in a glass of water twice a day. I’m on my 1st month of it. Hopefully this helps you & anyone else.

    2. Hi I was put on clomide twice a day for the first 5 days of my period and it’s gets you to ovulate normally. Hope this helps. But the doctor actual put me in this.

      1. I was on that and still did not ovulate so please remember not everyone is the same. I have been trying to concieve for 9 years and i finally got my wish. I am currently 24 weeks pregnant with a little boy. So just keep on trying and dont stress about it.

  7. Hi Dr Andrew Corr
    Thanks for sharing this link about polycystic ovarian syndrome.
    Actually I am one of those womens suffering with this problem and everytime I went to ob gyne doctors the only medication I received is to take contraceptive pills which is diane 35 just to balance my hormones and my period became normal.may I know if this pills can cure this cyst that grown in my ovary?and sometimes I noticed pained on my right ovary and sometimes pained also on my pelvic…and I planned also to get pregnant after 1yer…so can I asked some advice from you for the best medication regarding my ovarian problem?im scared I wont get pregnant anymore.
    Thank you and God bless

  8. I have pcos from my cycle start I am with my partner 2years and trying for a baby a year and no luck.Using so much madicine but not at controle pcos.Dr sugest surgery but we are not goiong under surgery when dr give Ingection starting EGG release i take that 5 months no i stoped .Pl give me the best tretment here (hyderabad in INDIA)

  9. I’ve had Pcos for 10 years or more but it was diagnosed 10 years ago. I got on metformin I lost some weight but I still felt very Ill, then changed my life style in eating habits and I’ve had 4 kids since then in 10 years. I noticed that as soon as I would change my eating habits to the recommend way on here I would increase my fertility and decrease the estrogen hormone my insulin bettered and I’m Diabetic free!

  10. Hi,
    I am 34 and I have 4 children. I am not boasting but I never had issues falling pregnant. Since the birth of my last child who is 2yrs old I breast feed her for 19mths (Jan this year) I have had serve pelvic pain, iiregular periods, increased acne on face, chest and back and facial hair. I also have have Hashimotos disease. I have ultrasounds, bloods tests and have came back normal. I have a family history of POCS and endometriosis. My dr has no idea why all this is happening?????

  11. this article has nothing about diagnosis.
    is there a test? is it a blood test? is it a invasive test?
    those details would have helped.

    1. I was diagnosed with pcos 20 yrs ago…suspicion was based on symptoms. Diagnosis was confirmed by ultrasound .. btw.. I am now 44 and 9 1/2 months pregnant with my first child..I didn’t try. ..just happened after weight loss surgery

  12. Pls Doctor, I was diagonised with PCOS and been on metformin for a while now with other vitamins, what else can I do to help me conceive

  13. Hi Dr,

    I was diagnosed with PCOS, but then i got pregnant, my Gyn asked me to take metformin for the first 3 months, but it didn’t suit me, it had multiple side effects on me so i stopped it during the second month. Should i keep taking it or its ok?

  14. Hi All, I am mid 30s, was diagnosed with pcos and thyroid condition at 19yrs. Told would not have children.
    Thankfully I have one little boy and another child on the way. I share this as a do not lose hope. If it is meant to be it will find a way. Good luck all.

  15. Hey…i am of 25…last year only i was diagnosed with pcos..the problem m facing is m not able to loose weight ,though m doing gyming n aerobics n dieting too..bt still dere is nothing happening with my weight..plz suggest me sumthing ..wat to do..

    1. I would cut out sugar and grains from your diet, and make sure you’re getting enough protein. Drink lots of water in place of juices, soft drinks, flavoured milks, sports drinks etc. Grains are in lots of processed foods – cereals, bread, biscuit, cake, pasta – get rid of those. Look up a paleo style of diet.

  16. You do not need to cut grains to have a low GI diet and one that assists PCOS. I’m sick of grains being labeled as a culprit for everything despite a plethora of evidence to the contrary! Our Dietary Guidelines are based on 55,000 research articles and meta analysis, and would be more than sufficient. Recommending Paleo to everyone (especially children!) is not evidence based, can leave room for poor balance of nutrients and an unhealthy obsession with labelling a healthy diet inappropriate. It will do nothing for the planet either, including grains in the diet is far more sustainable.

  17. I was diagnosed with PCOS at just 12 years old. I would go months without getting a period and my hair would grow abnormally fast. My weight has always been a struggle for me. I would gain weight than loose it. Being on birth control at 12 helped regulate my periods but I still dealt with all the other symptoms of PCOS.

    It was my dream for years to be a mother some day. I was in a very toxic relationship for 8 years in which ended in marriage and quickly divorce. I wanted so bad to be a mommy. Now looking back I’m thankfully that i didn’t conceive when I was in that relationship with that person.

    Three years ago I met the love of my life. I was still struggling with the abnormal periods and hair growth. Two years ago after running all these tests a OBGYN doctor came in the room and told me those dreaded words that no woman wants to hear “you will not be able to conceive.” As someone that always wanted to be a mother some day those words were devastating to me. I just didn’t want to believe what I was just told.

    Now fast forward to 2 years later in May 2015. I was at a graduating party when out of no where I got the biggest dizziness spell. I shrugged it off just thinking I had low blood sugar or something. Then when I noticed I had light brown spotting I decided it couldn’t hurt to take a pregnancy test. The test showed a faint positive result. I figured it was an evap line until I had taken 7 more pregnancy tests and they all came back faint positive. The next day I went in to my doctors for a blood test. A day later it was confirmed. I was 4 weeks pregnant with my miracle baby.

    My finance’ and I knew I wasn’t going to have an easy pregnancy. During my first trimester I was diagnosed with a “threaten miscarriage”. Having PCOS gives you a 40% chance of miscarrying. I was terrified that this miracle that we were being given was going to be taken away just like that.

    After three months of waiting and hoping we went in for our anatomy scan where we found out we were expecting a healthy baby boy. Now I’m 35 weeks awaiting the birth of my miracle child. I never thought that i would be able to conceive a child. Now I’m about to be a mommy. It still seems like a dream to me.

    I just wanted to share my story with women that are struggling with PCOS syndrome. Don’t give up, their is hope and my son is proof that miracles happen☺️

  18. I have a friend with PCOS who is starting on a supplement regimen called Plexus. If you are on Facebook search for PCOS and PLEXUS and Plexus. There are a ton of people posting about how it has helped them conceive and reduce their other symptoms. There is even a Facebook group dedicated to it. Check it out ladies!

  19. I’ve been diagnosed with PCOS since i was 13 years of age and now I am 22. I’ve been prescribed Diane 35 since then and around 1 year ago I’ve been taking Metformin along with it. I’m thinking of stopping the use of Diane 35. I will be getting married soon. Would this help me have kids in the future?

  20. hi my wife is having irregular periods an lately she went up to 30 days from 21 we’ve been trying but all in vein plz help?

  21. I suffered with heavy painful irregular periods , excessive hair which shattered my confidence I spent hundreds on laser treatments which didn’t work, weight gain and acne as a teenager and was diagnosed with pcos and put in dianette contraceptive pill at 15 to help my symptoms, I then fell pregnant on this surprisingly at 17 which ended in miscarriage. I then came off the pill and didn’t fall pregnant for 10 years, I had stopped ovulating completely , for many years I tried to find out about my fertility and was constantly fobbed off because of my young age, but going through that at 17 was tough to deal with and the uncertancy off having a child in the future constantly played on my mind as the years went on and not falling pregnant,
    they finally acted when I was 24 after years of me being persistent, they put me on metformin, steroids for my immune system to stop me rejecting the pregnancy, vitamins, and progesterone suppositories I also lost a lot of weight but still no pregnancy , they then tested my ovulation and found I needed stimulating and gave me clomid which didn’t work and then letrozole which didn’t work either , they then checked my tubes and found they were blocked and my ovaries had lots of cysts (I think they could of prevented this from having to result in surgery if they had listened me to me years ago, you know your own body!) I had a laparoscopy which resulted in my left tube being removed my right tube being unblocked and my ovaries lasered, after recovery we tried again with all meds still no pregnancy. I was lucky to have ivf and finally had a healthy boy at age 28 . These issues consumed my life from age 15 to 28 and didn’t stop there. After having him my ovaries seemed to kickstart which Iv heard can happen in women with pcos after a pregnancy as they have in a way rebooted, to my surprise I had fallen pregnant naturally we were so happy as a second child would mean going through Ivf again and at a big cost second time round.
    Unfortunately it was ectopic and I was rushed into surgery, this was due to my remaining tube still being damaged from previous scarring, I now suffer with chronic ovulation pain every month which has me doubling over in pain and severe period pains. I don’t want to go on contraception to help this as I don’t want to pump hormones into a body that already has hormonal problems. Just want people to make sure they go until someone listens no matter how small the symptom you have or your current life situation as this really did consume my youth with worry. Being put on the pill is NO solution it just covers the issue up, pcos really did lead to more and more issues, I feel they failed me. I am however So grateful I have my boy and will cherish him every day.

  22. I was diagnosed with PCOS when I was 17. Was tols I would have a hard time conceiving. I was put on many different birth control pill to regulate my hormones and alleviate the symptoms. The best pill For me was Triquillar 28 – it regulated my periods and i was acte free, lost weight without trying, no pain during cycles and light periods. Although still had the facial and chest hair (electrolysis has gotten most of it away permanently!!) I was on Triquillar for 5+ years. At 28 I decided to stop taking it in hopes to get pregnant. I Expecting a difficult and long journey. I got pregnant right away. I never thought it would happen. Please don’t lose hope, don’t stop trying and don’t stop looking for a solution that works for you, since every PCOS is different.

  23. Just wondering can u have pcos after having kids. I have never heard of this before but I have most of these symptoms and I didnt have them until the last year or 2. I have been having my periods every 2 weeks for the last 2 or 3 months but I just thought that was because I have just come off the depo needle which I was on for 8 years and my body was just flushing everything out.

Leave a Reply

Please note: in order to prevent spam and inappropriate language, all comments are moderated before they appear. We appreciate your patience awaiting approval. BellyBelly receives many comments every day, and we are unable to approve them all as soon as they are posted.

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

loaded font roboto