Polycystic ovary syndrome (PCOS) is the most common hormonal disorder among women of reproductive age. PCOS causes a woman’s body to produce excessive amounts of androgens or testosterone, hormones that are associated with male sex characteristics and reproduction.

PCOS disrupts the balance of both follicle-stimulating hormone (FSH), the hormone that causes the follicle and egg to develop and luteinizing hormone (LH), the hormone that causes the follicle to release the egg.

The result is that a small cyst is formed in the ovary, which disrupts the woman’s hormonal balance.

Risk Factors for PCOS

PCOS tends to run in families, but little is known about its cause or how it passes from one generation to the next.

Researchers believe that stress and environmental factors (including diet, exercise, and pollution) play a role in the development of PCOS. Other possible causes include excessive prenatal exposure to male hormones (androgen or testosterone) and excessive insulin production.

Symptoms of PCOS

  • Irregular menstrual periods (i.e. periods that last a long time, or occur infrequently)
  • Excessive facial or body hair (called “hirsutism”)
  • Acne
  • Male-pattern baldness
  • Obesity and/or unexplained weight gain
  • Infrequent or absent menstruation in adolescents
  • Pregnancy-related problems, including difficulty getting pregnant, having a miscarriage, and infertility

Complications of PCOS

If you have PCOS you are at a higher risk for these other conditions as well:

  • Type II Diabetes
  • High blood pressure (including pregnancy-induced high blood pressure)
  • Cholesterol and lipid abnormalities
  • Elevated levels of C-reactive protein (a cardiovascular disease marker)
  • Severe liver inflammation caused by fat accumulation (called non-alcoholic steatohepatitis)
  • Sleep apnea
  • Abnormal uterine bleeding
  • Cancer of the uterine lining (endometrial cancer) caused by continuous high levels of estrogen
  • Gestational diabetes
  • Depression and anxiety
  • Cardiovascular problems

Diagnosing PCOS

If your health care provider suspects that you have PCOS, she will perform a series of tests to confirm your diagnosis, including:

  • Physical examination
  • Pelvic exam
  • Blood tests (for cholesterol, glucose, and the level of androgens and testosterone)
  • Ultrasound (to assess the ovaries’ appearance)

Treatment for PCOS

No cure exists for PCOS, but treatments can help relieve symptoms, improve the quality of life, and reduce the risk of developing certain cancers.

Treatment generally focuses on management of the woman’s main concern(s), such as infertility, hirsutism, acne, and/or obesity.

The following are common treatments for PCOS:

  • Lifestyle changes: Maintaining a healthy weight can help minimize PCOS symptoms and control diabetes. In addition, eating a diet with a lot of high-fiber carbohydrates helps slow the digestive process and control blood sugar levels. Exercise helps lower blood sugar levels and can also help relieve symptoms. Women who smoke have higher androgen levels, so quitting smoking is another positive lifestyle change to make.
  • Hair removal: There are many ways to remove unwanted hair, including tweezing, shaving, depilatories, electrolysis (use of an electric current to destroy hair roots), laser therapy. Some medications can help with hirsutism but are usually more effective in men.
  • Oral contraceptivesBirth control that has a combination of estrogen and progestin are commonly used to regulate the menstrual cycles of women with PCOS; they work by decreasing the level of androgens in the body and preventing PCOS symptoms.
  • Progestin: Taking this hormone for 10 to 14 days every 1 to 3 months helps regulate a woman’s menstrual cycle. It reduces the risk of uterine cancer (also called endometrial cancer).
  • Anti-androgen drugs: Taking anti-androgen drugs reduces androgens’ effect; the drugs can be used in combination with oral contraception to improve acne and/or to slow hair growth.
  • Metformin: This drug, which is usually used to treat diabetes, improves the body’s response to insulin and can help regulate the menstrual cycle. It is not normally recommended for women with PCOS who have trouble becoming pregnant or have hirsutism. It can promote weight loss if the woman is already eating a healthy diet and exercising.
  • Laparoscopic ovarian drilling: Used in extreme cases of PCOS, this outpatient surgery uses electricity or lasers to burn holes in the follicles on the surface of the ovaries in order to induce ovulation.

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Updated August 2015

Polycystic ovary syndrome (PCOS)

 

Resources:

  1. The Center for Young Women’s Health: an award-winning health website for young women
  2. The Mayo Clinic: a leading medical center and research authority
  3. The National Institute for Health: national organization that supports medical discovery
  4. The Polycystic Ovarian Syndrome Association: non-profit organization dedicated to help women with PCOS