Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome, or PCOS, is the most common hormonal condition that affects women in their reproductive years and a primary cause of infertility. 

The condition occurs when a woman’s ovaries produce higher than normal amounts of male sex hormones, known as androgens. The result is a hormonal imbalance that can lead to irregular periods and problems with ovulation, the part of the menstrual cycle when an egg is released by one of the ovaries.

Common signs and symptoms of PCOS include:

• Irregular menstrual periods 
• Obesity or weight gain, especially in the abdomen
• Abnormal hair growth on the face and body, including the chin, chest, stomach and back (hirsutism)
• Acne
• Multiple follicles, more than 12, in each or one of the ovaries (that were used to be called “cysts”, hence the word “polycystic”) 
• Dark patches of velvety skin on the neck, groin, underarms and under the breasts (acanthosis nigricans)
• Thinning hair on the scalp
• Infertility due to anovulation (the inability to release a mature egg every month)

Symptoms often begin appearing during the teenage years.

You may be a greater risk of PCOS if you have:

• A mother, sister, aunt or daughter with the condition 
• Insulin resistance, which can lead to higher insulin and androgen levels 
• Obesity, which can increase insulin levels 

Women with PCOS may be at increased risk of developing other serious health issues, including:

• Type 2 diabetes
• High blood pressure
• Cardiovascular disease
• Metabolic syndrome
• Endometrial (uterine) cancer
• Sleep apnea
• Depression

Diagnosis typically includes:

• A thorough discussion of your medical history and symptoms 
• A physical exam, including a pelvic exam, to look for signs of PCOS
• Blood tests to check androgen and other hormone levels, as well as blood glucose and cholesterol levels 
• An ultrasound to examine your ovaries and the lining of the uterus (endometrium), which may thicken in PCOS patients

Treatment options vary based on each patient’s condition, symptoms, and whether pregnancy is desired in the future.

For women who plan to become pregnant, PCOS treatment strategies include:

• Weight loss through a healthy diet and regular exercise, to reduce symptoms, make menstrual cycles more regular, and lower the risk of related health issues
• Medication (like metformin) to treat or prevent the development of diabetes, which improves ovulation
• Medication to improve ovulation with or without intrauterine insemination (IUI)
• In vitro fertilization (IVF), when medications don’t improve ovulation

For women who do not plan to become pregnant, treatment strategies include:

• Weight loss through a healthy diet and regular exercise, to reduce symptoms, make menstrual cycles more regular, and lower the risk of related health issues  
• Birth control pills (or other forms of hormonal birth control) to correct hormonal imbalances for more regular menstrual cycles, reduce androgen levels, and reduce the risk of endometrial cancer
• Oral medications and topical creams for the treatment of acne and hirsutism 
• Medication (like metformin) to treat or prevent the development of diabetes.