Beyond the myths: A gynaecologist explains PCOS

With Dr Rosie Littleproud

Hello everyone,

I hope you had a good week and eagerly expecting Easter. Today I want to bring to you very crucial information: a gynaecologist view on PCOS. Dr Rosie sees thousands of PCOS cases in her day to day job.

I had the pleasure to ask Dr Rosie some of our burning questions on what she is worried the most when she sees patients with PCOS, what’s her take on the cause of PCOS and best way to manage it. We discuss diet, supplements and the biggest myths about PCOS. My favourite advice from her:

Be kind to yourself!

Quick intro Dr Rosie

Hi, I am Dr Rosie Littleproud - I am an ST4 Obstetrics and Gynaecology Trainee. This means that I am four years into my specialist training in Obstetrics and Gynaecology. I qualified as a doctor in 2017, and have done a variety of jobs, in both the UK and Australia, before I started my training in Obstetrics and Gynaecology in 2021.

What does your speciality care about most when it comes to PCOS?

The most important aspects of PCOS relating to OBGYN, are:

• Endometrial hyperplasia - this is a pre-cancerous condition which arises when the endometrial lining (womb lining) does not shed. Therefore we recommend either using a hormonal contraceptive which thins the lining of the womb, or a progesterone medication

  (such as ‘Provera’) every 1 to 3 months to induce a bleed, and shed the uterine lining.

• Infertility - if patients are not having regular periods, then it can be a sign that they are not ovulating regularly. Without ovulation an egg is not released, and therefore one cannot become pregnant naturally.

• Gestational diabetes - patients with PCOS are more predisposed to developing diabetes in pregnancy. This can cause various complications within the pregnancy, and can be an indication for early delivery.

• Pregnancy induced hypertension and pre-eclampsia - increased risk in those with PCOS

• Miscarriage - increased risk in those with PCOS.

• Ovarian torsion - ovaries which are over 5cm in size are at risk of torsion. Patients with PCOS may or may not have ovaries which are over 5cm in size.

However, alongside OBGYN specific risks, PCOS is associated with cardiovascular disease, depression, anxiety, type 2 diabetes, high blood pressure, acne, and non alcoholic fatty liver disease.

What are your first thoughts when you see someone coming to you with diagnosed PCOS?