What is PCOS?

PCOS is a complex hormonal disorder with wide-ranging systemic effects on many organs. As a gynaecology doctor I see and treat the impact PCOS has on a woman’s reproductive system such as irregular periods, changes to ovulation and infertility. 

PCOS affects every woman differently. Some women experience obvious symptoms, while others may have mild signs and remain unaware they have the condition until they start trying for a baby. 

Common Symptoms of PCOS 

As a multi-organ disorder, symptoms can vary in severity and may include: 

• Irregular or absent periods 

• Excess facial or body hair

• Scalp hair thinning or hair loss 

• Acne or oily skin 

• Weight gain 

• Depression and anxiety 

Because symptoms can overlap with other conditions, we use the current guidelines to help accurately diagnosis and manage your health, focusing on your current life stage.

PCOS and Fertility 

People with PCOS may first see a gynaecologist when they are concerned about fertility or are actively trying for a pregnancy. PCOS is a leading cause of female infertility. This is due to hormonal imbalances, particularly elevated androgens, which can prevent regular ovulation. 

In a typical menstrual cycle, several small follicles begin developing in the ovaries. 

Usually, one follicle becomes dominant, matures fully, and releases an egg at ovulation. 

In women with PCOS, however, many follicles may begin developing, but no single follicle becomes dominant. This means ovulation may not occur regularly, or at all. 

Irregular ovulation makes it difficult to time conception and for some people they can go months of anovulation (no ovulation) which can become stressful and frustrating for those waiting on a positive pregnancy test. 

However, there is encouraging news. Up to 60% of women with PCOS can conceive naturally with appropriate treatment and support without requiring fertility clinic intervention. 

Early diagnosis and proactive management make a significant difference.  For those with a diagnosis of PCOS who are considering starting a family, or who have been unable to fall pregnant we can support you through the right step for you, including medical management, ovulation induction right through to IVF.

Managing and Treating PCOS 

There is currently no cure for PCOS, but symptoms can be managed effectively. Best practice is to use a multidisciplinary focus on addressing the symptom you are most concerned about right now, whether it is reproductive, metabolic, cardiovascular, skin, sleep or psychological. 

Here are some of the options that I would discuss with my patients in a typical consultation for PCOS. 

1. Lifestyle Changes 

Lifestyle modification is often the first and most powerful step. 

I acknowledge for some this is a difficult conversation and there are often physical, emotional, and logistical barriers to exercising or adopting a healthier lifestyle. 

The patients I consult often report extreme fatigue, feelings of self-doubt or are frustrated because they may have made healthy lifestyle changes already and are still experiencing symptoms.

However, don’t be disheartened because with modest changes in lifestyle and exercise you can:

• Reduce insulin resistance by up to 50% 

• Help restore ovulation 

• Improve fertility 

I like to spend time with you to work out how we can help you here at BWC. I work closely with our allied health team such as our physiotherapist, dietitian, or psychologist, who can form your support crew.

2. Metformin 

For some patients I will discuss the use of Metformin. Metformin is a medication commonly used to treat type 2 diabetes. It is often prescribed in PCOS to improve insulin sensitivity. 

In women with PCOS who over-produce insulin and testosterone, metformin helps the body respond more effectively to insulin. This can assist in regulating hormone levels and, in some cases, help restore ovulation. 

3. Hormonal Contraception 

For those not currently trying to conceive, hormonal birth control such as the oral contraceptive pill may help regulate menstrual cycles and lower androgen levels. 

By reducing certain hormones, hormonal contraception can improve symptoms such as acne, excess body hair and irregular bleeding. 

Taking Back Control 

A diagnosis of PCOS can feel overwhelming but with the right plan, many women restore ovulation, improve their symptoms (and go on to conceive naturally). Early intervention, individualised care and ongoing support are key. 

At Ballarat Women’s Clinic, we take a balanced approach, addressing hormonal health, metabolic wellbeing and fertility planning together to create tailored management plans that address both physical and emotional wellbeing. 

Our goal is beyond symptom control, we work to help you feel informed, supported and in control of your health. 

If you are experiencing irregular cycles, persistent acne, unwanted hair growth or concerns about fertility, we encourage you to book an appointment with one of Ballarat Women’s Clinic’s gynaecologists for assessment. 

PCOS is common. It is manageable, and with the right individualised plans, most people can achieve excellent long-term health and fertility outcomes. 

Written by Senior Registrar Gynaecologist, Dr Erin Stewart

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