PCOS - Polycystic Ovary Syndrome
Diagnosis & Management by Telehealth
Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting women in Australia and worldwide. It's thought that up to 13% of all women are affected and 70% of these remain undiagnosed.
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It can lead to various symptoms, including irregular periods, acne, weight gain, and fertility issues. Having PCOS doesn't mean that you are infertile.
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While there's no cure for PCOS, evidence-based management strategies can help you effectively manage symptoms, improve your quality of life, and reduce long-term health risks.
Understanding PCOS
PCOS is a complex condition with multiple contributing factors, including hormonal imbalances, insulin resistance, and genetics.​​​​​
Common symptoms include:
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Irregular menstrual cycles
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Excess hair growth (hirsutism)
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Acne and oily skin
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Weight gain and difficulty losing weight
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Hair thinning or loss
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Fertility problems (which are treatable once a diagnosis of PCOS is made)
Ultimately women with PCOS are at risk of other conditions such as:
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Cardiovascular disease,
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Type 2 Diabetes
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Depression
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Cancer of the uterus.
By making a diagnosis, and getting good advice, you can help reduce the risk of poor health outcomes.
Evidence-Based Management Strategies for PCOS
Healthy Diet
A balanced diet rich in whole foods, fruits, vegetables, and lean protein can help manage weight, improve insulin sensitivity, and reduce symptoms. Consider working with a registered dietitian to develop a personalised plan. Avoid fast food and processed foods.
Regular Exercise
Engaging in regular physical activity, such as brisk walking, swimming, or cycling, can help with weight management, improve insulin sensitivity, and boost mood.
Stress Management
Stress can exacerbate PCOS symptoms. Practice relaxation techniques like yoga, meditation, or deep breathing exercises/mindfulness to manage stress levels.
Hormonal Contraceptives
Oral contraceptive pills can help regulate menstrual cycles, reduce acne, and manage excess hair growth, as well as prevent pregnancy for those that need it. There are many different types. Our doctors will help you choose the right one.
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Metformin
This medication can improve insulin sensitivity, which in turn may help with weight management, menstrual regularity, and fertility.
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Anti-Androgens
These medications can reduce excess hair growth and acne caused by high androgen levels. Some oral contraceptive pills contain anti androgens such as cyproterone.
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Fertility options
If you are trying to get pregnant, having regular unprotected sex, but its just not happening, we can help with a subfertility workup.
Healthcare Professionals
Consult with one of our GP’s who have a special interest in PCOS, for diagnosis and personalised treatment recommendations.
Endocrinologists and gynaecologists are specialists who you may have been referred to, though a GP with extra training in women's health is more likely to take a holistic approach. PCOS is a syndrome, not a disease.
Other health care professionals can help too, such as a dietician and an exercise physiologist.
Support Groups
Connect with other women with PCOS through online or in-person support groups. Sharing experiences and information can be empowering and helpful.
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The AskPCOS App has an active discussion forum to connect with others who know what you're experiencing first hand...
Mental Health Support
PCOS can impact your emotional well-being. Seek support from a mental health professional if you're experiencing anxiety, depression, or body image issues.
Your usual GP may be able to refer you on a Mental Health Care Plan which allows you to access Medicare subsidised counselling.
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Do I need to have an IUD insertion with sedation or can I be awake?The choice is yours. If you have intravenous sedation, you will have a brief, light anaesthetic and have no recollection of the procedure. You will need someone to drive you home, as you can’t drive on the day of a sedation anaesthetic. Commonly, those who have an IUD insertion (or removal) with sedation are women who: Are nervous or tense about being examined or having cervical screening tests Are only recently or never sexually active Have had surgery to their cervix, such as a LLETZ procedure Have ONLY had elective Caesarean section deliveries (without labouring) Are approaching menopause Want an IUD removed, but the threads cannot be seen in the cervix If you DO opt for sedation, then you should: NOT eat any food during the 6 hours prior to your appointment Drink only water between 6 and 2 hours before your appointment Have nothing pass your lips in the 2 hours immediately before your appointment (this means no food or dring and includes smoking, lollies and chewing gum) An awake IUD insertion procedure takes about 5-10 minutes and there may be some discomfort. We advise that you take some simple pain relief (the same as what you would normally take for period pain) about 30 mins before the procedure. Awake IUD insertion can also be performed using local anaestheticand/ or a Penthrox inhaler (green whistle). The doctor who performs your insertion procedure will discuss what kind of anaesthesia might be necessary.
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What do I need to bring with me?2 or 3 sanitary pads (light flow only) Some photo identification- a driver’s licence or passport Your Medicare card Warm, comfortable clothes and nothing that is too restrictive around the tummy A snack, or some food or drink for AFTER the procedure
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Are there any reasons why a woman can’t have an IUD inserted?If you have a history of breast cancer, we will need a letter from your oncologist and/or breast surgeon to say that you are clear to have a Mirena (hormonal) IUD. If you have a history of uterine fistula or complex surgery to your uterus, an IUD may not be suitable (a previous Caesarean Section is fine). Large fibroids, unusual layout such as bicornuate uterus or any other problem which can distort the inside of your uterus (womb) might make the use of an IUD difficult. We will discuss your options with the report from a formal pelvic ultrasound. If you know you have an unusual uterus, please make an appointment to discuss your options PRIOR to booking in for your procedure. (We dont want you to waste your time by accepting your booking and then us not being able to help you) A pregnancy must be excluded before using an IUD, and that is why we like you to come in for an IUD insertion within 7 days of the start of your menstrual period. In that way, we know that you are not likely to be pregnant. However, if you do not get regular periods, you can still have an IUD inserted but the timing needs to be discussed with one of our doctors or nurses.
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Do I need a pelvic ultrasound before my IUD insertion?If you are over 40 years old and you have heavy periods, we need you to have a formal pelvic ultrasound scan to make sure that there are no underlying problems. If needed, we can refer you for a bulk-billed pelvic ultrasound scan. Women in their forties who have heavy periods are likely to need to have a Pipelle endometrial biopsy, and there is an additional charge for this procedure (Medicare rebates apply). If you have had a termination of pregnancy (medical or surgical), and you haven’t yet had a period after the procedure and you wish to have an IUD inserted, you should have a pelvic ultrasound performed. Please send us the report prior to booking in for your IUD insertion. We can provide you with a request form which will be “bulk billed for Medicare card holders.
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What if I want my IUD removed or replaced?Removal of an IUD is usually quite straightforward, and can be done in the consulting rooms by a doctor who has experience at removing an IUD. If the IUD strings are not able to be found in the cervix, and you want to have your IUD removed, we need an ultrasound scan before we attempt to remove the IUD to ensure that the device is still in the uterus (womb). Please dont have unprotected sex for one week prior to the IUD removal or replacement, as sperm can hang around and its possible you could get pregnant once the IUD is removed, even from sperm which have been in the body for a few days.
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Why should I use a condom for the week before my IUD removal or replacement?Please do not have condomless sex one week prior to the replacement OR removal of an IUD (as sperm can hang around, and this can result in an unintended pregnancy).
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Do I need to have a GP consultation before having my IUD inserted?You do need to have a consultation prior to having your IUD inserted, which can be done with your own doctor, or one of our doctors or clinical nurse specialists. This pre-insertion consultation is important, as the timing of insertion, the type of device and anaesthetic options all need to be discussed.
You're NOT Alone!
PCOS is a manageable condition, and with the right strategies, you can take control of your health and well-being. Remember, you're not alone, and seeking support from one of our GPs is a great place to start. It's likely we will refer you for some basic blood tests and possibly a pelvic ultrasound scan, and you can undertake these investigations in your local area.
If you can commit to a healthy lifestyle, explore treatment options with one of our doctors, and prioritise your mental health, you can effectively manage PCOS.
Don't let it get you down!
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