What causes PCO

PCOS - Polycystic Ovarian Syndrome

15% of all fertile women suffer from>

When PCOS (polycystic ovarian syndrome) is present, the ovaries produce a disproportionate number of follicles. Usually the follicles are evenly distributed in the ovaries. In PCOS, the follicles are mostly located on the outer edge, while there is dense tissue in the middle. The ovary itself is enlarged compared to the normal case. Sometimes this is the only finding and no further symptoms occur. In most cases, however, the condition is associated with a variety of symptoms, including:

  • increased androgen level (male sex hormone) and / or
  • missing or less frequent ovulation.
  • (It must be possible to rule out any other diagnosis.)

Increased male sex hormone levels can lead to the following symptoms:

  • Tendency towards excessive hair (hirsutism) - fine / fluffy facial hair (beard) and excessive body hair with thinner head hair at the same time.
  • Increased tendency to acne
  • depressions
  • irregular bleeding or lack of menstruation

The degree to which these symptoms cause problems depends on a woman's androgen sensitivity. The problems caused by these symptoms are often the reason women see a doctor.

A lack or low frequency of ovulation is not directly visible, but can lead to the following symptoms:

  • Menstrual cycle disorders in which a long time passes between cycles or menstruation is completely absent.
  • Difficulty getting pregnant as ovulation does not occur.

For women who do not want to have children, the long periods between menstrual cycles can be practical or even comfortable. However, this condition indicates an imbalance in the body and should therefore be treated to ensure regular menstruation with normal intervals between cycles.

What causes PCOS?

PCOS is considered hereditary. 70% of all women are insulin resistant and, if left untreated, will develop diabetes.


Unfortunately, women with PCOS have an increased tendency to gain weight. Because of the increased androgen levels, all of the extra fat will accumulate around the waist. This also applies to women with PCOS who are not overweight.

Why is obesity particularly problematic for women with PCOS? Adipose tissue secretes chemical substances that lead to reduced insulin sensitivity (insulin resistance). To compensate for the lower sensitivity, the pancreas produces more insulin.

This leads to:

  • Increase in the level of androgens in the blood
  • Worsening of skin and hair problems
  • Egg development in the ovaries stops
  • Lack of ovulation
  • Menstrual irregularities
  • infertility

Why is lack of physical activity particularly problematic for women with PCOS?

A lack of physical activity in itself can lead to insulin resistance, both in overweight and non-overweight people. This is because muscles excrete an important chemical substance (IL-6 or interleukin-6) when they work. This substance ensures, maintains or increases insulin sensitivity. Physical activity thus leads to the excretion of IL-6, which in turn increases insulin sensitivity: more physical activity = higher insulin sensitivity.

When people under-use their muscles, which is not uncommon in today's society, it weakens their insulin sensitivity.

Look out for long-term health effects

Reduced insulin sensitivity and the subsequent increase in insulin production lead to an increased risk of type 2 diabetes - even in people who are not overweight.

Reduced insulin sensitivity also disrupts fat metabolism in the blood and increases the risk of heart and vascular diseases. This risk increases further if the person is overweight.

It is therefore extremely important to consciously increase insulin sensitivity through exercise and maintaining a normal weight. This is the best prevention.

In cases where the menstrual cycle is abnormal or when there is no menstruation at all, a lack of rejection of the mucous membrane from the uterus can increase the risk of developing endometrial cancer.

Preventive treatment

If your weight is normal (body mass index ≤ 25), you should try to maintain it, i.e. not to become overweight. If you are overweight, the most effective treatment is to lose weight.

Exercise is beneficial for all people, regardless of their weight. Half an hour a day is highly recommended.

Medical treatment of reduced insulin sensitivity with meformin

If you have become insulin resistant as a result of PCOS, you may already be taking the drug metformin (also known as Orabet or Glucophage) for type 2 diabetes; this is true regardless of whether you are overweight or not. Metformin increases insulin sensitivity and can therefore correct an imbalance in many cases.

Unfortunately, the administration of metformin does not lead to an improvement in all people and it cannot be said in advance who will improve and who will not.

Meformin can also cause side effects such as nausea, diarrhea, and a metallic taste in the mouth.

Treatment of abnormal hair growth

Oral contraceptives (the “pill”) can sometimes reduce abnormal hair growth, but they are not always effective.

The antiandrogen spironolactone (Spiron) is an effective option in some cases.

Laser hair removal is probably the most effective form of treatment; however, it is expensive and the effect is not permanent.

Acne treatment

Oral contraceptives (the “pill”) sometimes improve this, but not in all cases.

Treatment if you want to have children

While PCOS does not prevent pregnancy from occurring, many PCOS patients need a little help getting pregnant. Since normal follicle development and normal ovulation are required for pregnancy, hormone treatments can be helpful here.

In PCOS, the growth of ÆGBLÆRERNE is normal at first, but then comes to an early standstill and ovulation is disturbed.

Many women with PCOS ovulate as normal on occasion. Thus, many of them can get pregnant without treatment. In fact, many women never find out they have PCOS, so they get pregnant and have a child naturally.

Where can I find out more about PCOS?

In some cases, PCOS is diagnosed early, sometimes in teenagers, when a doctor is seen to treat hair growth abnormalities or acne. In other cases, a diagnosis is not made until a woman seeks medical advice about infertility, and in some cases a diagnosis is never made.

No matter at what point in time PCOS is diagnosed, there are always many questions, some of which are difficult to answer.

Learn more about the causes of infertility in women