Polycystic Ovary Syndrome

Polycystic Ovary Syndrome

PCOS Team in Dedicated Women’s Health Suite

OB/GYNs experienced specifically in diagnosis and management of PCOS

Specialists in Fertility and Adolescent Gynaecology

Providing the right care, expertise & approach for key PCOS patients groups

Advanced and Accredited Diagnostic Capability

From colposcopy to transvaginal ultrasound, with the latest equipment

What is Polycystic Ovary Syndrome?

Polycystic ovary syndrome (or PCOS) is a common condition that causes an imbalance of reproductive hormones in women. The ovaries of people with PCOS produce high levels of the male sex hormone, testosterone, compared to women without PCOS. Testosterone is usually produced in small quantities in women, and is essential for healthy ovarian function.

In women with PCOS, however, elevated levels of testosterone interfere with the ovaries, ovulation, and a variety of other bodily systems. The hallmark symptom of PCOS is an irregular menstrual cycle. This is because raised testosterone levels can prevent ovulation (i.e., the release of an egg from an ovary), resulting in a delayed or missed period. A lack of ovulation can also lead to the development of ovarian cysts; small, fluid-filled sacs that grow inside the ovaries.

How Common is Polycystic Ovary Syndrome?

PCOS is the most common hormonal disorder in women of reproductive age, and may affect up to 20% of women aged 15 – 45 worldwide. What’s even more surprising is that the majority of women with PCOS aren’t aware that they have the condition. Estimates suggest that 50 – 75% of women with PCOS are currently undiagnosed, largely thanks to a lack of information about the symptoms of the condition.

It is, therefore, important for all women of reproductive age to familiarise themselves with the indicators of PCOS. If you have an irregular menstrual cycle, read on to learn about the other signs and symptoms. If you do suspect you might have PCOS, contact the Integra Women’s Health Team and we can investigate further.


What are the Symptoms of Polycystic Ovary Syndrome?

The symptoms of PCOS can vary significantly from person to person, but the three main signs of PCOS are:

  • An irregular menstrual cycle (including delayed, missed, or heavy periods)
  • High androgen levels
  • Ovarian cysts

PCOS is usually diagnosed based on the presence of at least two of these three symptoms. However, PCOS is a complex disorder that can affect multiple organs and bodily systems.

Other symptoms of PCOS include:

  • Acne
    High testosterone levels can cause the skin to produce more oil than usual, leading to breakouts. Acne may appear on the face, back, or chest of people with PCOS.
  • Weight gain
    Weight problems and PCOS go hand in hand, and as many as 4 out of 5 women with the disorder are obese.
  • Hirsutism (excess hair growth)
    Excessive hair growth is a very common symptom of PCOS, and may appear on the face, back, stomach, and chest.
  • Dark patches of skin
    PCOS can cause patches of skin in body creases to darken. This often affects areas around the neck, under the arms, and beneath the breasts.
  • Male pattern baldness
    High testosterone levels can trigger male pattern baldness in women with PCOS, which causes hair on the scalp to thin or fall out.

Here at the Integra Healthcare Women’s Health Suite in Grand Pavilion, Grand Cayman, we regularly diagnose and treat PCOS. If you are experiencing any of the symptoms listed above, make an appointment with a member of our PCOS team to discuss appropriate investigations and your treatment options.

Complications of Polycystic Ovary Syndrome

If left untreated, PCOS can lead to a variety of serious health complications. As PCOS primarily affects the reproductive hormones and system, infertility is a common side effect of the condition. However, PCOS also increases your risk of heart disease, stroke, type II diabetes, and cancer.

  • Infertility
    PCOS is a leading cause of infertility in women, as the disorder often prevents ovulation from taking place. Lack of ovulation is the cause of infertility in around 25% of infertile couples, and PCOS accounts for up to 95% of cases where ovulation is the issue.
  • Metabolic syndrome
    Up to 80% of women with PCOS are overweight or obese. Both obesity and PCOS can lead to metabolic issues such as high blood pressure, high blood sugar levels, and high cholesterol. Collectively, these conditions are known as metabolic syndrome.
  • Cardiovascular diseases
    Metabolic syndrome can increase your risk of cardiovascular diseases, such as heart disease and stroke.
  • Diabetes
    Insulin resistance affects 65 – 70% of women with PCOS (though the percentages vary depending on the weight of the patient). Insulin resistance and metabolic syndrome both significantly increase your risk of developing type II diabetes.
  • Sleep apnea
    Sleep apnea is a condition in which a person regularly stops breathing as they sleep, which interrupts rest. This is common among women who are overweight, and especially if they also have PCOS.
  • Endometrial cancer
    The hormone imbalance caused by PCOS can increase a woman’s risk of endometrial cancer (a cancer of the uterine lining). This is especially true for women who are also overweight, or have type II diabetes.


What can you expect from our PCOS-experienced OBGYNs?

The Initial Consultation
Your first appointment will involve a discussion of your symptoms and menstrual cycle. You may also be asked about your family medical history, as PCOS may be hereditary.

Pelvic Examination
During your initial appointment, your doctor may also ask to perform a pelvic exam. This is a visual and manual examination of your reproductive organs where the doctor will check for abnormal growths in the vagina, ovaries, and uterus. We are very fortunate to have Dr Madhavi Manoharan on our team, who is formally accredited in Colposcopy by The British Society for Colposcopy and Cervical Pathology.

Blood Tests
Blood tests may be performed to check your hormone levels, as high androgen levels is a key indicator of PCOS. A blood test may also be used to assess your blood glucose and cholesterol levels.

Ultrasound Examination
An ultrasound examination may be carried out to more closely inspect your ovaries and uterine lining. This type of ultrasound is called a transvaginal ultrasound, and involves the insertion of a wand-like device (called a transducer) into the vagina of the patient. Our PCOS team is formally trained and accredited to perform this procedure.


Diagnosis of Polycystic Ovary Syndrome

Diagnosis of Polycystic Ovary Syndrome

If you suspect that you may have PCOS, it is important to discuss your symptoms with a doctor so you can gain access to the treatment you need. Our PCOS team is highly experienced in the diagnosis and treatment of the condition, and will use their expertise to assess:

  • Irregularities in your menstrual cycle
  • The appearance of your ovaries
  • Your hormone levels

There is no single test for PCOS. Instead, your Integra OB/GYNs, located within our dedicated Women’s Health Suite in Grand Pavilion, Grand Cayman, will lead you through a series of diagnostic steps, such as:

  • Your initial consultation
  • Pelvic examination
  • Blood tests
  • Ultrasound examination
Treatment of Polycystic Ovary Syndrome

Treatment of Polycystic Ovary Syndrome

PCOS cannot currently be cured, but there are a variety of available treatment methods that can effectively reduce and manage the symptoms. Our approach is to focus on the treatment of problematic symptoms such as infertility, excess hair growth, obesity, and acne.

We are also the only practice in Cayman Islands to offer a combined treatment services from our PCOS-focused OBGYNs and our dermatology team. Using their collective expertise, our highly-trained doctors can treat all aspects of PCOS, from reproductive issues to hair and skin problems.

Contact us to set up an appointment, where we will discuss all treatment options and determine which approach is the best fit for your needs.

Dr Madhavi Manoharan

Dr Madhavi Manoharan

Consultant Obstetrician, Gynaecologist & Fetal Medicine

Dr Manoharan has 23 years’ experience in obstetrics and gynaecology, including more than a decade at tertiary level, 7 years as consultant at the prestigious Royal Free London NHS Foundation Trust and a number of years as Assistant Professor at the world-renowned Weil Cornell Medicine, located in their Qatar campus, part of Cornell University.


  • Gynaecological Services
  • Obstetric Services
  • High-Risk Obstetric Service
  • Fetal Medicine

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