Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is the most common hormonal disorder among women of reproductive age. Infertility is one of the most common PCOS symptoms. Because the symptoms of PCOS are seemingly unrelated to one another, the condition is often overlooked and undiagnosed.
Polycystic ovary syndrome causes irregular menstrual cycles, excessive body or facial hair and polycystic ovaries as its main symptoms. Polycystic means "many cysts," and PCOS often causes clusters of small, pearl-sized cysts in the ovaries. The cysts are fluid-filled and contain immature eggs. Women with PCOS produce slightly higher amounts of male hormones known as androgens, which contribute to some of the symptoms of the condition.
The cause of PCOS is not known. Some women with PCOS are less sensitive to insulin than other women, a condition known as insulin resistance. Insulin resistance can cause the ovaries to produce too many male hormones. The resulting hormonal imbalance can cause the symptoms of PCOS. The condition appears to run in families, and sisters of those with it are twice as likely to have it. Currently, PCOS has no cure, but a variety of PCOS treatments can help alleviate the symptoms of this disease, including infertility.
PCOS is a syndrome disease defined by a collection of signs and symptoms. The symptoms of PCOS that one patient experiences can be very different from the symptoms of another patient. If you have two or more of the following symptoms, you need to have a thorough checkup to determine if you need PCOS treatment:
- Irregular or missing menstrual periods
- Excess or unwanted body or facial hair growth
- Thinning hair on the scalp
- Weight problems, often including weight gain around the waist
- Skin problems, including skin tags, darkening skin and acne
Complications of PCOS
The common PCOS symptoms are difficult enough for most women, but some will experience further complications, including:
- Diabetes, elevated insulin levels or insulin resistance
- Heart and blood vessel problems
- Uterine cancer
- Sleep apnea
Each of these problems can be life threatening, which is why treatment for PCOS is so important.
Polycystic ovary syndrome treatment starts with a proper diagnosis. Treatments are then chosen based on a woman's symptoms, age and future pregnancy plans. Treatment for PCOS may include:
- Birth control pills to regulate menstruation
- Insulin-sensitizing medications
- Ovulation induction to treat infertility
- Androgen-blocking medications
- Topical anti-hair-growth medications
- Other excess hair treatments
- Treatments for hair loss
- Acne treatments
- Removal of other skin problems
Lifestyle and Prevention
One of the best treatments for PCOS is a healthy lifestyle. A healthy diet, low in refined carbohydrates, is important, as this can help regulate blood sugar levels. Exercise can also help the body regulate insulin and keep excess weight off. Losing weight is challenging with PCOS, but doing so can help reduce the male hormone levels in the body, and some women will begin to ovulate naturally. With a proper diagnosis, lifestyle changes, and PCOS treatment, women can get relief from this condition and the overwhelming health problems it can cause.
Cristina Meriggiola, MD, PhD
University of Bologna
Musa Zamah, MD, PhD
University of California, San Francisco