Polycystic ovary syndrome (PCO)

PCO stands for Polycystic Ovaries. This means that there are lots of small follicles in the ovaries and that instead of being located at regular intervals the follicles resemble a string of pearls at the outer edge of the ovaries. Women with PCO may not necessarily have any symptoms worth mentioning, and many women live their entire lives without noticing it. The typical picture of PCO is that the follicles starts to grow but then stop growing early in the menstrual cycle, and ovulation does not occur. However, some women with PCO may have normal ovulation occasionally; therefore, there is a chance that they may conceive naturally.

PCO can develop into PCOS

PCOS stands for polycystic ovary syndrome and means that in addition to having the characteristic polycystic ovaries, there are also signs of:

Raised levels of the male sex hormone and/or
A tendency to have increased hair growth (hirsutism), i.e. facial hair and/or increased hair growth on the body, while the hair on the head can become thinner and there is a tendency to develop blemishes (acne).
Infrequent or absent ovulation, i.e. irregular and often long cycles >35 days

The extent of her skin and hair problems depends on the woman’s sensitivity to the male sex hormones.

What causes PCO(S)?

Genetic factors, i.e. there is a hereditary component, where some women will be more prone to develop PCOS than others.

PCO and overweight

Women with PCO have an increased tendency to gain weight, and this extra weight tends to be around the stomach—also known as an apple shape.

Half of all women with PCOS are overweight – and being overweight can make their symptoms worse.

When a woman has PCOS and is also overweight her sensitivity to insulin is reduced (insulin resistance). Insulin is produced in the pancreas, and if sensitivity is reduced, the pancreas will compensate by producing a larger amount of insulin. This “overproduction” of insulin will affect one of the sex hormones in a complicated interaction that leads to, among other things, irregular periods, absent ovulation and increased production of the male sex hormone.

Therefore, it is important that the woman improves her insulin resistance by maintaining a normal weight (BMI < 25) and exercising. This may increase insulin resistance, which is the optimal way of achieving a better hormone balance and also preventing or reducing the risk of developing type 2 diabetes and cardiovascular disease.

At VivaNeo, we can offer you a consultation with our dietitian, who can expand on the above and provide motivation to change one's lifestyle with a healthier diet and more exercise (a minimum of 30 minutes/day.

Medical treatment of impaired insulin resistance

If, as a result of her PCOS, a woman has developed insulin resistance (regardless of whether the woman is thin, of normal weight or overweight, a drug used to treat type 2 diabetes (metformin) can be used. This medicine increases sensitivity to insulin. However, not every woman benefits from taking metformin.

The mini pill can be used to regulate the menstrual cycle.

We recommend that you talk to your doctor or us about these treatments options.