PCOS is a common condition that affects how a woman’s ovaries work. Because some of the symptoms of PCOS – for example, irregular or heavy periods – are also associated with other conditions, it’s important to exclude these and clarify what type of PCOS you have so that we can help you plan your short- and long-term treatment.
Irregular periods are common outside of PCOS and patients often visit a GP or gynaecologist for help. Ensuring you also have good metabolic and endocrine health is important though, because improving your health in these areas can often greatly improve your periods – and help with regular ovulation. If the periods are irregular because of your transition into menopause, we can also help with this. More rarely irregular periods are due to pituitary or hypothalamic dysfunction, and this requires specific testing which we can do if necessary.
We often work with female ultrasound experts and gynaecologists if we need to know more about the health of your ovaries to help classify and diagnose PCOS.
Heavy periods are common and again, most women start by visiting their GP or gynaecologist. However, there are many aspects of your assessment and care that we can help with as endocrinologists. We can make sure you do not have thyroid disease and if so treat it; we can ensure your iron stores are satisfactory, and treat and maintain them if not. We can also help with treatments to make the heavy periods less troublesome. If you have fibroids and want to consider having them treated, it is usually better to see a gynaecologist while they are still small to consider your options.
Before and after ovulation, and into the early part of menstruation, some women have disabling symptoms that affect their mental health. At one end of the spectrum is severe PMS, but some patients also have intrusive thoughts of self-harm or harm to others, and this is known as pre-menstrual dysphoria disorder. We have experience in helping you understand if this might apply to you – and if so, in helping you find the right diagnosis. Sometimes treatment involves specific psychological medicine, but it should always be with a doctor who understands the context of hormonal changes across the cycle.