Polycystic Ovary Syndrome (PCOS)

PCOS/PCOD

Polycystic ovary syndrome (PCOS) is a condition in which the ovaries produce an abnormal amount of androgens, male sex hormones that are usually present in women in small amounts. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form in the ovaries. However, some women with this disorder do not have cysts, while some women without the disorder do develop cysts.

Ovulation occurs when a mature egg is released from an ovary. This happens so it can be fertilized by a male sperm. If the egg is not fertilized, it is sent out of the body during your period.

In some cases, a woman doesn’t make enough of the hormones needed to ovulate. When ovulation doesn’t happen, the ovaries can develop many small cysts. These cysts make hormones called androgens. Women with PCOS often have high levels of androgens. This can cause more problems with a woman’s menstrual cycle. And it can cause many of the symptoms of PCOS.

Treatment for PCOS is often done with medication. This can’t cure PCOS, but it helps reduce symptoms and prevent some health problems.

What causes PCOS?

The exact cause of PCOS is not clear. Many women with PCOS have insulin resistance. This means the body can't use insulin well. Insulin levels build up in the body and may cause higher androgen levels. Obesity can also increase insulin levels and make PCOS symptoms worse.

PCOS may also run in families. It's common for sisters or a mother and daughter to have PCOS.

What are the risks for PCOS?

You may be more likely to have PCOS if your mother or sister has it. You may also be more likely to have it if you have insulin resistance or are obese.

What are the symptoms of PCOS?

The symptoms of PCOS may include:

• Missed periods, irregular periods, or very light periods
• Ovaries that are large or have many cysts
• Excess body hair, including the chest, stomach, and back (hirsutism)
• Weight gain, especially around the belly (abdomen)
• Acne or oily skin
• Male-pattern baldness or thinning hair
• Infertility
• Small pieces of excess skin on the neck or armpits (skin tags)
• Dark or thick skin patches on the back of the neck, in the armpits, and under the breasts

How is PCOS diagnosed?

Your health care provider will ask about your medical history and your symptoms. You will also have a physical exam. This will likely include a pelvic exam. This exam checks the health of your reproductive organs, both inside and outside your body.

Some of the symptoms of PCOS are like those caused by other health problems. Because of this, you may also have tests such as:

• Ultrasound. This test uses sound waves and a computer to create images of blood vessels, tissues, and organs. This test is used to look at the size of the ovaries and see if they have cysts. The test can also look at the thickness of the lining of the uterus (endometrium).
• Blood tests. These look for high levels of androgens and other hormones. Your health care provider may also check your blood glucose levels. And you may have your cholesterol and triglyceride levels checked.

How is PCOS treated?

Treatment for PCOS depends on a number of factors. These may include your age, how severe your symptoms are, and your overall health. The type of treatment may also depend on whether you want to become pregnant in the future.

If you do plan to become pregnant, your treatment may include:

• A change in diet and activity. A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate.
• Medications to cause ovulation. Medications can help the ovaries to release eggs normally. These medications also have certain risks. They can increase the chance for a multiple birth (twins or more). And they can cause ovarian hyperstimulation. This is when the ovaries release too many hormones. It can cause symptoms such as abdominal bloating and pelvic pain.

If you do not plan to become pregnant, your treatment may include:

• Birth control pills. These help to control menstrual cycles, lower androgen levels, and reduce acne.
• Diabetes medication. This is often used to lower insulin resistance in PCOS. It may also help reduce androgen levels, slow hair growth, and help you ovulate more regularly.
• A change in diet and activity. A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate.
• Medications to treat other symptoms. Some medications can help reduce hair growth or acne.