talkhealth meets... Dr Unnati Desai


The NHS says that PCOS – or Polycystic Ovary Syndrome (PCOS) – affects one in 10 women in the UK however, lots of women aren't aware of the symptoms to look out for and are unsure of how to approach treatment. 

PCOS is when small sacs of fluid develop along the outer edge of the ovary, these cysts contain immature eggs called follicles. These follicles do not regulary release eggs, meaning women with PCOS do not menstruate regularly. 

Want to find out more? Nuffield Health’s GP National Lead, Dr Unnati Desai, explains everything you need to know about PCOS in her webinar. But, before you go and watch that – get to know her more in this quick Q&A! 

*Watch Dr Unnati's webinar here - what PCOS is?*

 

You first trained as a GP, what made you want to do this? 

I made the decision to train as a General Practitioner when I came back into medicine after completing a law degree. General Practice provides doctors with the opportunity for continuity of care with their patients, so we can start to fully understand their concerns and needs across many different presentations, as well as be involved in the progression of their care. To be privy to someone’s life and to be able to support them in times of need is a privilege.

Why are you so interested in women’s health? 

During my medical training, I was surprised at how many female patients would avoid discussing certain aspects of their intimate health, even with female doctors.

Whilst I was training in sexual health, I developed the skills needed to create an environment where my patients felt able to have conversations with me that were often difficult or embarrassing for them. As a result, the importance of putting patients at ease is the cornerstone of all my consultations.

It is important to me that women are empowered to be better able to understand their bodies through the various stages of life and manage their concerns at every step. There are many possible management options to numerous women’s health concerns that are available these days, but which many women are unaware of. Raising the profile of these management options = better quality of life.

Does everyone with ovarian cysts have PCOS?

It is estimated that one in three women in the UK will be noted to have cysts on their ovaries on an ultrasound scan. Of these women, approximately one in three will have the syndrome, meaning that they will have multiple cysts on their ovaries along with other features characteristic of polycystic ovarian syndrome (PCOS). Women with PCOS are at risk of long-term health concerns, so it is important to differentiate between the two.

The chronic condition continues to be under-recognised, why do you think this is? 

If a woman presents with severe symptoms of PCOS, or the most obvious one of infrequent or no menstrual cycle, then the diagnosis is not difficult. However, many women do not have severe symptoms, and therefore may not present to their GP. In certain ethnic backgrounds, discussing women’s health concerns is often left until fertility becomes the main concern.

The only time that PCOS may become more challenging to diagnose is when the patient has been on contraception from a young age. We won’t be able to diagnose PCOS until they have come off the contraception for at least six months and start to display symptoms.

Many people often don’t realise they have PCOS until they are trying to get pregnant as they may not have had many/any noticeable symptoms to present to a GP until they are struggling to conceive.

How can this be helped?

GPs need to be aware of the diagnostic criteria used to aid the diagnosis of PCOS, and once a clinical suspicion has been considered based on the medical history, the investigations required are non-invasive and include an ultrasound scan to visualise the multiple cysts and blood profile to identify the hormonal imbalance and high androgen levels.

What are the main symptoms of PCOS?

There are four main issues relating to PCOS, which clinically need to be managed. They are:

  • Menstrual irregularities – in PCOS menstrual bleeding is often infrequent or does not occur at all. It is important to manage this appropriately in order to prevent the thickening of the uterine (womb) lining, which is a risk factor for endometrial cancer later in life.
  • Fertility issues – if we miss a menstrual cycle, it is because we have not ovulated in that month. Patients with PCOS will often find it difficult to become pregnant as a result of the decreased ovulation, but at the same time, if they are not ready for a family, they still need appropriate contraception. I describe this to my patients as subfertility, not infertility.
  • Evidence of high androgen levels – this is a hall mark of PCOS and includes hirsutism (excess hair in the male distribution), male pattern baldness and acne, all of which can impact mental health.
  • Insulin resistance – this results in an increased risk of developing diabetes and metabolic syndrome. The latter includes abnormal lipid profile, increased central obesity (fat around the waist which is an indication of fat around the organs), and increased risk of stroke.

Information contained in this Articles page has been written by talkhealth based on available medical evidence. The content however should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands or treatments.

Information written by the talkhealth team

Last revised: 2 January 2023
Next review: 2 January 2026