Finding polycystic ovaries on ultrasound can be normal, if there are no weight issues, abnormal menstruation or infertility.

If such issues are present, then polycystic ovaries may indicate the presence of a metabolic condition called Polycystic Ovarian Syndrome (PCOS).

Polycystic Ovarian Syndrome (PCOS)

PCOS is a common hormonal condition in women of reproductive age. It is often associated with infrequent and light menstrual flow, subfertility and a high body mass index. Women with PCOS tend to have higher Male Hormone and Luteinizing Hormone levels with varying degree of Insulin Resistance. The exact cause of PCOS is not known but there appears to be a family link.

PCOS Diagnosis

Women who have at least 2 of the 3 characteristics are considered to have PCOS:

Hirsutism (increased hair growth) male pattern baldness or pimples from elevated male hormone levels.
Ovulatory problems showing up as reduced menstrual frequency and flow.
Polycystic Ovaries with multiple small cysts (<10mm) in the ovaries.

60% of women with PCOS fall into phenotypes,or patient types A and B. Patient type C are PCOS with no ovulatory problems. Patient type D are PCOS with no male hormone features.

PCOS Treatment

Irregular Menstrual Cycles: Often few and far apart with little menstrual flow. Sometimes heavy menstruation occurs after a prolonged period of absent menstruation.
Endometrial Hyperplasia and/or Cancer: There is a 5x chance of disordered womb lining with chronic irregular menstruation.
Anovulation and Infertility: A result of irregular menstruation and abnormal hormone levels.
Pregnancy Risks: PCOS predisposes to miscarriage as well as diabetes and hypertension in pregnancy.
Metabolic Disturbances: In older women with longstanding PCOS, there is a higher chance of developing hypertension, diabetes and raised cholesterol.

PCOS Treatment

Weight loss, healthy diet and exercise aiming for 10% reduction of weight loss can help regulate the menstrual cycle leading to ovulation and pregnancy.
Hormonal medication to achieve at least one menstruation every 3 months. Hormones like Diane-35, can lower the male hormone levels to reduce facial hair, pimples and male pattern baldness.
For subfertility, Letrozole or Clomid can be used to induce ovulation. For some women, IVF may be needed to help them get pregnant.
Laparoscopic Keyhole Surgery on the polycystic ovaries (Ovarian Drilling) will sometimes be needed when fertility medicines fail.

OUR CLINIC'S EXPERTISE

Over 20 Years’ Experience in Ovarian Cyst Management
Internationally-Trained Laparoscopic Gynaecological Surgeon
Strong Advocate of Laparoscopic Surgery for Ovarian Cyst
Specialised in Single Incision Laparoscopy
Fast Recovery, Minimal Pain, Almost Scarless

DR ANTHONY SIOW

Consultant Obstetrician & Gynaecologist
Medical Director, ASC Clinic for Women

MMed (O&G) (S’pore)
FRCOG (UK)
MRANZCOG (Aust-NZ)
FAMS (S’pore)
Australasian Gynae Endoscopy Society Member
American Assoc Gynae Laparoscopy Member

Dr Anthony Siow is a Consultant Obstetrician & Gynaecologist with over 20 years of experience in the diagnosis and treatment of ovarian cysts, including assessment based on symptoms and imaging findings. He has a long-standing interest in minimally invasive ovarian cyst surgery, was awarded the Ministry of Health Scholarship for Advanced Laparoscopy in Australia, and performs laparoscopic and single incision laparoscopic surgery for selected ovarian cyst cases. As Medical Director of ASC Clinic for Women, he recommends ovarian cyst surgery only when clinically indicated.

POLYCYSTIC OVARY

Polycystic Ovarian Syndrome (PCOS)

PCOS Diagnosis

PCOS Treatment

PCOS Treatment

DR ANTHONY SIOW