Polycystic Ovarian Syndrome (PCOS)
Polycystic Ovarian Syndrome (PCOS) is a condition in which the ovaries produce an abnormal amount of androgens, a male sex hormone that is usually present in women in small amounts.
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 Polycystic Ovarian Syndrome (PCOS)?
Factors that might play a role include:
- Excess insulin: During the metabolism of sugar, your body’s primary energy source, insulin is produced in the pancreas. Your body can produce more insulin if your cells become resistant to insulin. Ovulation may be hindered by excess insulin, which increases androgen production.
- Low-grade inflammation: These substances are produced by white blood cells to fight infection. PCOS can lead to heart and blood vessel problems because of a type of low-grade inflammation that stimulates polycystic ovaries to produce androgens.
- Heredity: Research suggests that certain genes might be linked to PCOS.
- Excess androgen: The ovaries produce abnormally high levels of androgen, resulting in hirsutism and acne.
What are the symptoms of Polycystic Ovarian Syndrome (PCOS)?
Signs and symptoms of PCOS vary. A diagnosis is made when you experience at least two of these signs:
- Polycystic ovaries: The ovaries may be enlarged and contain follicles that surround the eggs. This might lead to irregular functioning of the ovaries.
- Excess androgen: A high concentration of male hormones may cause physical signs, such as excessive facial and body hair, severe acne, and male-pattern baldness.
- Irregular periods: PCOS is characterized by infrequent, irregular, or prolonged menstrual cycles. There may be fewer than nine menstrual cycles per year, periods that are longer than 35 days, and a heavy flow.
Complications of Polycystic Ovarian Syndrome (PCOS)
- Infertility
- Type 2 diabetes or prediabetes
- Sleep apnea
- Abnormal uterine bleeding
- Cancer of the uterine lining (endometrial cancer)
- Depression, anxiety, and eating disorders
- Gestational diabetes or pregnancy-induced high blood pressure
- Miscarriage or premature birth
- Metabolic syndrome
- Nonalcoholic steatohepatitis
Diagnosis of Polycystic Ovarian Syndrome (PCOS)
PCOS cannot be definitively diagnosed with a test. During the first appointment, your doctor will likely ask about your medical history, including your menstrual cycle and weight changes. Check for signs of excess hair growth, insulin resistance, and acne during a physical exam.
Your doctor might then recommend:
- A pelvic exam
- Blood tests
- An ultrasound
If you have a diagnosis of PCOS, your doctor might recommend additional tests for complications. Those tests can include:
- Screening for obstructive sleep apnea
- Screening for depression and anxiety
- Periodic checks of glucose tolerance, blood pressure, and cholesterol and triglyceride levels
Treatment and Medications for Polycystic Ovarian Syndrome (PCOS)
Your doctor may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Losing weight may also increase the effectiveness of medications your doctor recommends for PCOS. It also helps with infertility.
To regulate your menstrual cycle, your doctor may recommend:
- Combination birth control pills
- Progestin therapy
To help you ovulate, your doctor may recommend:
- Gonadotropin
- Metformin
- Letrozole (Femara)
- Clomiphene
To lessen excessive hair growth, your doctor might recommend:
- Spironolactone (Aldactone)
- Birth control pills
- Eflornithine (Vaniqa)