Polycystic Ovary Syndrome (PCOS) is a serious, underlying hormonal imbalance that for years has been masked by symptoms which women suffer in silent embarrassment or unwittingly present to the wrong people - the beautician or dermatologist - to treat. Few GPs have the time or the experience to link this litany of seemingly irritating but trivial complaints to reach a diagnosis and those that do, have been trained to prescribe the contraceptive pill - which, it is now shown, will make the condition worse.

For many sufferers, the condition is only diagnosed when an ultrasound scan to investigate unexplained infertility shows a string of tiny, fluid-filled cysts laced across the ovaries, looking for all the world like a pearl necklace. The result of a major hormone imbalance and too much testosterone in the body, PCOS is an inherited condition and there is no known cure. The symptoms themselves may not appear life threatening - not being able to have a baby will not kill you - but the overall risks associated with having it are much higher than doctors previously thought.

A woman with PCOS is, according to researchers, seven times more likely to develop diabetes than a woman of the same age and lifestyle who does not have the syndrome. She is also now known to be 7.4 more times at risk of a heart attack and four times more likely to suffer from high blood pressure. The first two of these conditions are major killers in the Western world - which is why, finally, PCOS is getting the attention such a common condition deserves.

One of the reasons it is so difficult for doctors and health practitioners to recognise and diagnose this endocrine disorder is that it can vary wildly in its severity. In its worst form, it causes obesity and hirsutism but again, only 50% of sufferers will present with these telltale signs.

Dr Adam Carey, a reproductive endocrinologist and co-founder of the Centre for Nutritional Medicine in London (no longer in operation), is also the co-author of the first book dedicated to PCOS yet even he admits that when he worked in hospitals, he would put women presenting with the symptoms of PCOS on the pill. This, it is now known, not only fails to tackle the underlying condition but will actually make it worse. The symptoms will improve over the short-term, say 2-3 years, but when they return, they are likely to be even more severe.

The two key biochemical markers of PCOS are that sufferers make too much insulin and too much testosterone. Researchers are now certain the two are linked and a study just published in the US journal, Proceedings of the National Academy of Sciences, has suggested this link is a gene called follistain which has two telltale functions: It plays a role in the development of the ovaries and is needed to make insulin. 

Testosterone, which is believed to be made by these tiny ovarian cysts, is carried in the bloodstream by a substance called sex hormone binding globulin. Think of it as being like a car transporter without which there are runaway or “free” testosterone molecules, which then bind in the wrong places, including under the skin where they cause acne and excess facial hair. One of the symptoms of PCOS is a tendency to put on weight - and when your weight increases, the amount of sex hormone binding globulin, which is made by the liver, decreases. This explains why reducing your weight is so crucial in controlling and even reversing PCOS.

Insulin works to control sugar levels in the blood. Many women with PCOS are known to be resistant to their own insulin. It is, say Dr Carey, as if the cells have gone deaf and can no longer pick up messages from the pancreas, which makes insulin, about how much is needed. When this system breaks down, the body reacts by storing more of the calories from your food, especially carbohydrates, as fat. You put on weight, even though you are eating the same amount. Excess insulin also acts on the ovaries to make more testosterone - which is the very last thing you need. It is also the reason the contraceptive pill, which makes the body even more insulin resistant, is an ill-advised short-term solution.

You can manage the symptoms and even reverse PCOS by changing your diet to eat less carbohydrate and to eat smaller, more frequent meals. This avoids sudden rushes of blood sugar and so helps control insulin production and prevents weight gain. Protein has been shown to reduce the rate of glucose absorption and stabilise insulin production, so eat a little protein with each meal. Cut out all refined carbohydrates, which means all cakes and biscuits, and take exercise to maintain optimum weight. The good news, if there is any, about having slightly higher levels of testosterone is that it means the body responds well to exercise and will thank you for your improved physique.

The biochemistry of PCOS is fascinating - but even more gripping, says Dr Carey, is the realisation that here is a genetic condition where, although there is no cure, sufferers can control the outcome through diet and lifestyle: “It is a condition where women really can use their environment to interact with their genetic programming and create a positive outcome.”

For those seeking an alternative approach beyond nutrition, Traditional Chinese medicine reports fantastic results with hormonal disturbances, including PCOS, and practitioner Zita West, a former NHS midwife who specialises in holistic health for women, has helped many PCOS sufferers conceive through a combination of acupuncture and rebalancing herbal and vitamin supplements.

She knows that to many Westerners, the idea of auricular (ear) acupuncture sounds bonkers but she claims, and there is plenty of anecdotal evidence to support this, that it is a powerful tool to help with conception when the underlying problem is one of hormones gone haywire: “Rebalancing hormones is part of our Wellbeing Programme where we like to treat a woman on a weekly basis. Chinese medicine, for example, pays particular attention to the body’s energy channels and centres and I have noticed, with a lot of women suffering from PCOS, that the lower channels are very cold.”

According to West, this is easily remedied using a technique called Moxibustion where, instead of needles, the practitioner uses a herb which is a form of mugwort. This is shaped into small cones and placed at the appropriate acupuncture points before being warmed with a flame. It does not hurt but actually creates a very soothing warmth throughout the body as it stimulates a revitalised energy flow.

Dr Carey acknowledges that the importance of catching PCOS early enough for a woman to make the appropriate lifestyle changes is only just beginning to filter down from hospital consultants to GPs. It helps that the condition has now moved out of the corridors of gynaecology to be seen as a metabolic condition with a genetic basis in its own right. The idea that it is one of the first conditions to give sufferers the power to affect the expression of their own genes - a kind of natural genetic engineering - will make it, he says, a part of the biggest sea change in the practice of medicine in the first decade of the 21st century medicine.

*Polycystic Ovarian Syndrome by Dr Adam Carey and Colette Harris is published by Thorsons, £9.99. The Doctor’s Laboratory (TDL) in Wimpole Street, London (020-7460 4800), can test for this condition. The test costs £150. Remember though, the results will be passed back to your family doctor.

*A medically qualified herbalist can tailor a treatment plan that includes the hormone balancing (adaptogenic) herb, Agnus Castus. Contact the National Institute of Medical Herbalists on 01392-426022. For online information and to talk to other PCOS sufferers, visit www.pcosupport.org