Click on a statement or question below to learn more about PCOS

Everything you need to know about PCOS, PCO & Ovarian Cysts.
PCO or Poly Cystic Ovaries.
PCOS beliefs as it stands today.
What can be done?
What you are likely to hear from your doctors.
What you may not hear from your doctors.

Everything you need to know about PCOS, PCO & Ovarian Cysts.

What have you been diagnosed with and what to worry about:

What tests are done?

What is an ovarian cyst?
They are fluid filled sacs either inside or on the wall of the ovary.

Are ovarian cysts normal?
Yes and they are typically harmless. There are two types of normal ovarian cysts: follicular cysts and corpus luteum cysts. These cysts form part of the female’s normal menstrual cycle and are short-lived. Many women will have some type of ovarian cyst during their fertile life and they are typically recycled by the body naturally within three months.

Are there abnormal ovarian cysts?
Yes. Dermoid cysts contain many different types of body tissues within it and are typically surgically removed. Cystadenomas are a thick gooey mucous type cyst that grows out of the ovary and can get quite large. It too typically needs to be surgically removed. Both cysts are uncommon and are rarely the cause of more serious problems.

What is a follicle?
You naturally have follicles from which your eggs are grown and released every month.  When you ovulate, an egg bursts out of its follicle and travels down the fallopian tube in search of sperm and fertilization. A normal ovary will have 6 to 10 follicles producing eggs per month, with a dominant follicle that will ultimately release the primary egg. It’s like a little olympic games every month to see who can grow the best egg.

What is a follicular cyst?
A follicular cyst begins when the follicle doesn’t rupture or release its egg. Instead it grows larger and turns into a cyst. Any ovarian follicle that is larger than approximately 2cm can be regarded as an ovarian cyst. Typically only one follicular cyst will form at a time and is dissolved by the ovary in a few weeks.

What is the corpus luteum?
When you ovulate a follicle releases an egg through the wall of the ovary to pass into the fallopian tube. This starts a chain reaction to release large quantities of estrogen and progesterone to aid fertilization. Once the follicle emerges from inside the ovary and ruptures it is now called the “corpus luteum” (literally meaning yellow body). Imagine how a fruit emerges from a flower an your have the right idea.

What is a corpus luteum cyst?
Typically if pregnancy does not occur then the corpus lute will naturally dissolve over the next 3 months. Sometimes the opening of the follicle closes allowing fluid or blood to accumulate. They may grow up to 5 cm and not be the cause of any problems. Cysts over this size can rupture or twist the ovary and can cause internal bleeding and sharp pain. Typically the pain disappears after a few days.

How do I know if I have them?
Typically there are no symptoms or signs however if the cysts are large you may have pelvic pain in the form of a dull ache, or pain during sex or just before your period. It may person your bowels causing pain during bowel movements or pressure on your bladder causing more frequent urination.

So if ovarian cysts are normal, harmless and present no symptoms why are they a problem?

PCO or Poly Cystic Ovaries.

What is it?
This is when a woman has a high level, 14 or more, rather than the normal 6 – 10 partially mature follicles in her ovary at any one time, making them appear to be polycystic. The definition of a follicular cyst is any follicle over 20 mm in diameter. When compared to the normal size of any maturing follicle is between 18 – 36 mm it is easy to see how the definition of the cyst and reality of the normal formation of a follicle can confuse a problem with a normally functioning ovary. It is believed up to 30% of women will have polycystic ovaries at any one time without any symptoms or a reduced chance to fall pregnant.

So when does PCO become a problem.

PCOS or PolyCystic Ovarian Syndrome.
Now here is where things start to get a bit messy. To be diagnosed with PCOS you must be diagnosed with at least two of the following.
1. Poly Cystic Ovaries as mentioned above.
2. Irregular periods.
3. Increased male hormones called androgens in a blood test with symptoms of excess growth of male body hair or acne.
4. May be overweight. (This is not included in the diagnostic criteria but is a common association)

So why is this messy?
If a woman has irregular periods and increased testosterone but does not have polycystic ovaries, excluding a pituitary or thyroid gland dysfunction, she can be diagnosed as PCOS.

Huh? Whenever the word ‘syndrome’ is used in modern medicine, it means a group of symptoms that typically appear with each other but they don’t necessarily don’t understand why and don’t typically have a treatment for it.

PCOS beliefs as it stands today.

  1. PCOS is a metabolic disorder associated with an imbalance in hormone levels typically released by the ovaries.
  2. The syndrome is associated with an excess of insulin produced by the pancreas. Insulin is the hormone produced that allows our cells to use sugar in our body, if you are ‘insulin-resistant’ your cells will not absorb sugar in the bloodstream as effectively leading to high blood sugar levels and diabetes. It is believed that excess insulin may promote the release of male androgen hormones.
  3. Imbalances in a woman’s hormones can make her male androgens dominate her female estrogens creating male body hair and interrupting ovulation leading to irregular periods. This is caused because the egg has not been released from the follicle and the ensuing cascade of hormones that normally lead to fertility or menstruation is not present.
  4. Low grade inflammation from fighting off infections can stimulate polycystic ovaries to produce male androgens.
  5. PCOS does have a hereditary link to it, researchers are looking into genes that may be responsible however lifestyle factors that are typically passed down from the parents are more likely to culprit.

What can be done?


No1 Therapy.
Weight loss.
Losing 5 – 10 kg has been proven to resolve PCOS in many women who are overweight and return her menstrual cycle back to normal function. For women who don’t have 5 – 10 kg to lose try options further down. For women who need to lose much more than 10 kg you know where to start now.

Could be cure.

No2 Therapy
Chinese herbal Medicine
There has been a long clinical history in China and Taiwan for the use of Chinese Herbal Medicine and Acupuncture for the treatment of PCOS and related fertility problems. Advanced Fertility Solutions’ PCOS formula have been traditionally used for to treat disorders of fibroids, endometriosis and PCOS, and depending on your particular situation and how they are combined could lead to a restored normal menstrual cycle, restored hormone imbalance, removal of cysts in or around the ovaries, a reduction in male hair and weight loss. Provided cysts are under 5 cm in diameter a period of 3 months may be all the time needed to resolve this problem and set your fertility back to normal. Many scientific tests have been done around the world on these formulas however the rigorous models for scientific research are loosely followed in some circumstances leading to the conclusion that ‘it may be effective in some circumstances but more research should be done to confirm these results’.

Not cured but suggested it may help.

No3 Therapy.
Supplements made by the pharmaceutical companies.
Some vitamins have been scientifically tested to have an impact on the various imbalances that present in a woman’s body when she has PCOS. Trying to find actual evidence is difficult however.

What you are likely to hear from your doctors.

Medical Doctor – PCOS, we don’t have a treatment for it, but we do have medicines that can treat the symptoms.

  1. Contraceptive pill to make your cycles regular. (You are unlikely to get pregnant taking this).
  2. Clomid (Clomiphene) to force your body to ovulate. This can also make your cycles regular and is the first line of pharmaceutical therapy for this disorder.
  3. Metformin a diabetes drug for people who are insulin resistant. Typically used when clomid does not create ovulation as an adjunctive therapy.
  4. Letrozole (Femara) typically used to treat breast cancer it slows oestrogen production and produces more follicular stimulating hormone need for ovulation. Also used if climbed doesn’t work.
  5. Gonadotrophins, human growth hormones containing FSH and LH given as shots to cause ovulation.
  6. Ovarian drilling. A surgical procedure done via laparoscopy to open the maturing follicle and cause ovulation. This is a less used procedure.

What you may not hear from your doctors.

1. Contraceptive pill does not treat PCOS however it will regulate your menstruation. Your PCOS may naturally resolve over time (especially if diet and weight loss have been attended to) however, if not, your PCOS will likely be waiting for you when you come off it.

2. Clomid has been known to be quite successful, however the hormone therapy does tend to take a toll on a woman’s emotional state and after 4 cycles tends to want another therapy because she doesn’t think she can handle any more.


3. Metformin is proven to assist in ovulation but has not seen any increase in pregnancy rates.


4. Letrozole is as effective as clomid in causing ovulation but has not shown if it improves pregnancy rates. Safety trials are underway as tests on animals have shown it to create birth defects. No studies have been done on women to this end.


5. Gonadotrophins – Stage 2.


6. Drilling leaves scar tissue on the ovary so that spot will be unlikely to release another egg from it. Perhaps this explains is lack of popularity.