Unfortunately, many GPs are relatively unfamiliar with Polycystic Ovary Syndrome, which can also be known as Polycystic Ovarian Syndrome, (PCOS) and appropriate diagnosis and management of the condition. In many cases, you, as a patient, will know more about the condition that your doctor.
Diagnosing the syndrome is a little like putting a medical jigsaw puzzle together, only that it often takes quite a while to put the pieces together. Many times doctors will treat symptoms separately and unrelated without diagnosing the underlying problem of PCOS.
Women often consult their doctors about one symptom at a time and treatment is usually prescribed for that symptom alone. (For example, some women will go to their GP saying they have a weight problem, but won’t mention anything about irregular periods or their facial hair problem.) It’s not until a history is developed that both doctor and patient see that together, all the symptoms point to PCOS. After diagnosis, a proper treatment plan can begin to treat all aspects of the syndrome rather than each symptom.
Sadly, there is not a single, quick test to identify PCOS. Diagnosis depends upon the knowledge and skills of your doctor to piece together the symptoms from your patient history and physical appearance. A number of tests can then be arranged to confirm other symptoms of the syndrome such as hormonal imbalances.
You need two out of three things to be diagnosed with PCOS:
- Irregular or less frequent menstrual cycles from an early age
- Polycystic ovaries, on ultrasound
- Excessive body & facial hair or high blood androgen levels.
Doctors can order an trans-vaginal ultrasound to assess whether your ovaries are enlarged or have cysts. Or they can order blood tests to detect high levels of androgen and features of insulin resistance including abnormal cholesterol or glucose. They can also order a blood test to detect high levels of LH (lutenizing hormone) or an elevation in the ratio of LH to FSH (follicle stimulating hormone).
The doctor should also rule out out other possible causes of irregular menstruation and excessive hair growth; such as thyroid disorders or rarely Cushing's syndrome, congenital adrenal hyperplasia, or other disorders of the pituitary or adrenal glands.
If you are diagnosed with PCOS, and you have sisters, they have a 50% chance of also having PCOS. Make sure they have the tests too to see if they suffer the syndrome.
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Huge boost for women suffering from PCOSIn August 2011, ‘The Evidence-based guideline for the assessment and management of polycystic ovary syndrome' was released. The Guideline provides thirty-eight recommendations addressing four key areas including the challenges of assessment and diagnosis. Importantly, the Guideline addresses the long-term complications of PCOS including increased risk of diabetes, cardiovascular disease, obesity, depression and anxiety. As a result of the new Guideline Australian women suffering from PCOS will benefit from more effective diagnosis and treatment.
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