What is PCO and PCOS?

Polycystic ovaries (PCO) are commonly mistaken for polycystic ovary syndrome (PCOS). If you have PCO, you do not necessarily have PCOS.

It’s also important to note that the fluid filled structures in the ovaries associated with PCO are not technically cysts. Ovaries contain follicles, which are where the ova develop, and they are naturally filled with fluid. Normally only two to five follicles develop at the one time and they are scattered throughout the ovary.

PCO is diagnosed if the follicles behave abnormally. Abnormal behaviour is characterised by a greater number of follicles developing at the same time, usually more than twelve, and arranged into a circle. Polycystic ovaries are also larger and have a slightly different appearance.

Polycystic ovary syndrome is a combination of PCO and a series of symptoms, typically:

  • Excess body hair
  • Acne and other skin problems
  • Scalp hair loss
  • Irregular or missing periods
  • Heavy periods
  • Fertility problems
  • Insulin resistance
  • Weight issues

PCO does not cause pain in the pelvic area. If you experience pain, this is more likely due to a cyst, which usually disappears without treatment. Surgical treatment is a last resort if cysts persist. PCO does not need to be treated surgically.

Not all the information published online about PCO and PCOS is correct. For accurate information about what PCO and PCOS is, possible causes, diagnosis, tests, fertility, insulin resistance, and the benefits of diet and exercise, we recommend Professor John Eden’s book.

For information on how to purchase Professor John Eden’s book, Polycystic Ovary Syndrome. A Woman’s guide to identifying and Managing PCOS, (2005) purchase a copy from the POSAA online shop or contact WHRIA on 1300 772 206.

How do you treat PCOS?

Lifestyle factors, such as diet and exercise, have a significant impact on PCOS and this is the key to controlling symptoms. For example, insulin resistance and being overweight can affect PCOS and its symptoms.

The drug metformin is very useful to help manage sugar cravings. If you have irregularities in your menstrual cycle associated with PCOS, it can also help to correct these. Symptoms such as excess body hair can be treated with anti-androgens (male hormone blockers) such as spironolactone, which can be used alone or combined with a contraceptive pill.

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Fact or fiction? 17 PCOS myths… busted

  1. Myth: Few women have polycystic ovaries.
    About one in four women of reproductive age have PCO.
  2. Myth: Polycystic ovaries are full of cysts.
    Fact: The term PCO refers to a pattern of twelve or more small follicles arranged around the periphery of the ovary in a pearl – necklace like pattern. They are not technically cysts, and do not need to be removed surgically.
  3. Myth: Women with polycystic ovaries have cysts that need to be removed surgically.
    Fact: The so-called ‘cysts’ are actually small follicles, each containing an egg. There is no need for surgery to remove the follicles from an ovary: they are a normal part of an ovulating ovary.
  4. Myth: All women with PCO have PCOS.
    Fact: PCOS is diagnosed only when two of the following three symptoms are present and other causes are excluded:
    • Irregular periods (usually fewer than six periods per year)
    • Blood tests or symptoms suggesting male hormone excess
    • Polycystic ovaries
  5. Myth: Women do not have any male hormones, women only make female hormones.
    Producing adequate amounts of testosterone is an essential part of being female. Women must be able to make testosterone, a male hormone, as without it they could not produce oestrogen.
  6. Myth: Polycystic ovaries are painful.
    Fact: Polycystic ovaries do not cause pain. Pain in the ovary could be from ovulation or from a cyst, which should usually clear up in time.
  7. Myth: Scalp hair loss is usually due to PCOS.
    Fact: Scalp hair loss may be due to an iron or zinc deficiency, and this possibility needs to be eliminated before PCOS is treated. It may also be a sign of an underactive thyroid, malnutrition, sickness or stress.
  8. Myth: Some women with hirsutism (excess body hair) think that they are turning into a man.
    Fact: You can’t be female without making female hormone, and you need to produce testosterone to produce oestrogen.
  9. Myth: There are no really effective treatments for severe acne.
    Fact: Hormonal therapies, such as Cyproterone acetate, are effective irrespective of whether or not there is an identifiable hormonal problem such as PCO. Isotretinoin is also useful.
  10. Myth: The contraceptive Pill causes excess body and facial hair.
    Fact: The Pill is a good treatment for hirsutism as it suppresses the ovaries, lowering testosterone levels.
  11. Myth: Amongst those with PCOS, only women with a higher than average weight will suffer from menstrual irregularities.
    Fact: Thin women can also suffer PCOS-caused menstrual irregularities; however the number of these women is much smaller – only 5 to 10%.
  12. Myth: All women with menstrual irregularities have PCOS.
    Fact: Many conditions can cause menstrual irregularities, so if you are suffering from this condition you should have blood tests to exclude other causes before treating PCOS.
  13. Myth: All women who suffer from excess hair and irregular periods have PCOS.
    Fact: Adult-type 21-hydroxylase deficiency also presents with these symptoms, so it can be wrongly diagnosed as PCOS
  14. Myth: The contraceptive pill causes infertility.
    Fact: The Pill is a safe way to prevent pregnancy and its effects are reversible for women during their reproductive years.
  15. Myth: The Glycaemic Index (GI) is the only factor influencng the way food affects blood glucose and insulin levels.
    Fact: Some foods will lower the GI of the entire meal. These foods include acids in foods, (e.g. fruit acids and vinegar), fat, fibre and high protein foods.
  16. Myth: High GI foods are those that rate close to 100.
    Fact: The GI of glucose is 100. A GI of 70 or more is said to be high. A low GI result is said to be 55 or less (40 or less is better).
  17. Myth: Women with PCOS have less bone strength.
    Fact: Women with PCOS have normal bone strength.

Support for PCOS

Polycystic Overy Syndrome Association of Australia (POSAA)

POSAA is an Australia-wide support group for women with Polycystic Ovary Syndrome (PCOS), as well as their families. Its main objectives are to:

  • Facilitate a support network for women and their families
  • Increase public awareness about PCOS so women can take action and feel empowered
  • Lobby for more research into PCOS and finding more effective treatment
  • Increase awareness of the symptoms, diagnosis and treatment of PCOS among health professionals

POSAA is a registered charity and relies on donations, which are tax deductable if over $2. Please visit the POSAA Website to make a donation and help improve the quality of life of women with PCOS, or to find out more.

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