For those of us with atypical symptoms of PCOS, it's nice to read a doctor's explanation of PCOS causes that does not involve insulin resistance with accompanying obesity...
Question: I have recently had blood tests and found out that my oestrogen levels are very low and my testosterone levels are too high. My GP has said it could be polycystic ovary syndrome and is referring me to see a gynaecologist, which will take three or four months! My periods have changed dramatically over the past year, from being heavy and regular to light and irregular, and I find I am passing a lot of very dark coloured blood. I feel so poorly when I'm having my period that I often have the day off work. Do you think it is PCOS? Do you think I should wait months to see the gynaecologist or go privately? My partner and I want to start a family in the very near future.
Answer: Only you can decide whether or not to pay privately to see a gynaecologist sooner. Your doctor may be sympathetic and try to get your NHS appointment speeded up, but this is not always possible. Your symptoms would certainly fit polycystic ovary syndrome (PCOS) which is a common problem affecting as many as 20 per cent of women - only around 7 per cent of women seem to develop symptoms, however.
PCOS seems to be due to a hormone imbalance. PCOS sufferers have raised levels of free testosterone in the blood. All women produce testosterone, and they also produce a binding protein called SHBG (sex hormone binding globulin) that binds with most of the testosterone so that only a small amount is free in the blood stream and therefore biologically active. Women with PCOS make normal amounts of testosterone but reduced amounts of SHBG, so free testosterone levels are raised. This blocks the normal growth and development of egg follicles. As a result, the ovaries become covered with multiple small cysts containing under-developed eggs.
Some women with mild polycystic ovaries have no obvious symptoms, and are unaware of their condition. Others may notice that their periods become light, irregular or stop after a year or two of being normal. Some women also develop oily skin, acne, excess unwanted hair (hirsutism) and around 50 per cent become overweight, with fat mainly deposited around their waist.
Because women with PCOS who have irregular periods tend not to ovulate regularly, they may have difficulty conceiving naturally. However, treatment of PCOS and assisted fertility techniques are usually successful in helping to achieve pregnancy.
Self-Help for PCOS
• If you smoke, try to stop. Smoking reduces ovarian function and triggers a menopause at least two years earlier than normal. Smoking also increases your risk of coronary heart disease
• Lose any excess weight - even modest weight losses of around 6kg (1 stone) can correct hormone abnormalities, reduce unwanted hair and improve your chances of conceiving
• Follow a low-fat, high fibre diet
• Eat more rice, yellow-green vegetables and fish - especially oily fish
• Take evening primrose oil supplements
• After treatment of PCOS, it may take at least 6 months for excess hair to disappear. In the meantime, tweezing, bleaching, shaving, electrolysis or laser hair removal will give a good cosmetic result.
"Help for PCOS," iVillage, UK 
