Polycystic Ovary Syndrome (PCOS)

What Is PCOS?

Polycystic ovary syndrome, or PCOS, is a hormonal condition that women can get during their childbearing years. It can affect your ability to have a child (your doctor will call it your fertility). It can also:

• Stop your periods or make them hard to predict
• Cause acne and unwanted body and facial hair
• Raise your risk of other health problems, including diabetes and high blood pressure

You can get treatments for the symptoms. And you could be able to get pregnant, although you may need to take medicines to improve your fertility.

Some women with PCOS have cysts on their ovaries. That’s why it’s called “polycystic.” But the name is misleading because many women with PCOS don’t have cysts.

What Do Hormones Have to Do With PCOS?

When you have PCOS, your reproductive hormones are out of balance. This can lead to problems with your ovaries, such as not having your period on time or not getting it.

Your body makes hormones to make different things happen. Some affect your menstrual cycle and are tied to your ability to have a baby. The hormones that play a role in PCOS include:

• Androgens. They’re often called male hormones, but women have them, too. Women with PCOS tend to have higher levels.
• Insulin. This hormone manages your blood sugar. If you have PCOS, your body might not react to insulin the way it should.
• Progesterone. With PCOS, your body may not have enough of this hormone. You might miss your periods for a long time or have trouble predicting when they’ll come.

What Are the Symptoms of PCOS?

The most common PCOS symptoms are missed, irregular, infrequent, or prolonged periods. Excess androgens can cause hair loss, hair in places you don’t want it (like on your face), and acne. Other symptoms include:

• Darkened skin or excess skin (skin tags) on the neck or in the armpits
• Mood changes
• Pelvic pain
• Weight gain around your middle

What Are the Causes of PCOS?

Doctors don’t know all of the reasons why some women get PCOS.

You might be more likely to have PCOS if your sister or mother also has it. It could also be related to problems that make your body produce too much insulin, which can affect your ovaries and their ability to ovulate (or release eggs).

What Complications Can PCOS Be Linked With?

If you have PCOS and your androgen levels are too high, you have higher odds for a number of complications. These can differ from woman to woman and include:

Trouble getting pregnant. Cysts in the ovaries can interfere with ovulation. That’s when one of your ovaries releases an egg each month. If a healthy egg isn’t available to be fertilized by a sperm, you can’t get pregnant. You may still be able to get pregnant if you have PCOS. But you might have to take medicine and work with a fertility specialist to make it happen.

Insulin issues and diabetes. Insulin resistance may cause your body to make too many androgens. If you have insulin resistance, the cells in your muscles, organs, and other tissues don’t absorb blood sugar very well. As a result, you can have too much sugar moving through your bloodstream. This is called diabetes, and it can cause problems with your cardiovascular and nervous systems.

Metabolic syndrome. This group of symptoms raises the risk of cardiovascular disease . The symptoms include high triglyceride and low HDL (“good”) cholesterol levels, high blood pressure, and high blood sugar levels.

Other common complications of PCOS include:

• Depression
• Anxiety
• Bleeding from the uterus and higher risk of uterine cancer
• Sleep problems
• Inflammation of the liver

How Is PCOS Diagnosed?

No single test can diagnose PCOS. Your doctor will start by asking about your symptoms and medical history and by doing a physical exam, and possibly a pelvic exam.

They might give you blood tests to measure your hormone levels, blood sugar, and cholesterol. An ultrasound can check your ovaries for cysts, look for tumors, and measure the lining of your uterus.

How Is PCOS Treated?

Treatment will depend on your symptoms, your age, and whether you want to become pregnant. If you’re overweight, losing a little -- even 5% to 10% of your weight -- can make you feel better. It also might help the way your medications work and improve your fertility.

Your doctor may tell you to take the diabetes drug metformin (Glucophage) to lower insulin resistance, regulate ovulation, and help with weight loss.

If you aren’t planning to get pregnant, your doctor might prescribe hormonal birth control, like the skin patch or the pill. These medications can help lower your risk of endometrial cancer, get your periods on track, clear up acne, and lessen extra body hair. If you do want to get pregnant, fertility medications can help your ovaries release eggs.

Ask your doctor about medications to treat body hair and acne.

You should also see your doctor if you’re having:

• Irregular periods
• Mood changes
• Unexplained weight gain
• Changes in your hair or skin

These symptoms might not be caused by PCOS but could signal other serious health issues.

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