Polycystic ovary syndrome (PCOS) is a hormonal disorder common among persons assigned female at birth and of reproductive age. Persons with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.
The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.
The exact cause of PCOS is not clear. Many persons with PCOS have insulin resistance which means the body may not be using insulin effectively. Insulin levels build up in the body and may also contribute to higher androgen levels. Additionally, obesity and overweight, characteristics typically associated with PCOS can also increase insulin levels and make PCOS symptoms worse.
PCOS may also run in families. It has been noted that sisters or a mother and daughter can both have PCOS.
The risks associated with PCOS vary depending on its severity, but they can include long-term health issues such as infertility, gestational diabetes, metabolic syndrome, endometrial cancer, and even mental health concerns such as depression and anxiety. Persons with PCOS are more likely to develop certain serious health problems. These include type 2 diabetes, high blood pressure, problems with the heart and blood vessels, and uterine cancer. Persons with PCOS often have problems with their ability to get pregnant (fertility).
The symptoms of PCOS may include:
A healthcare provider will ask about the person's medical history and their symptoms. They may also have a physical exam, most likely including a pelvic exam. This exam checks the health of the reproductive organs.
Some of the symptoms of PCOS are like those caused by other health problems. Because of this, there 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 healthcare provider may also check your blood glucose levels. And you may have your cholesterol and triglyceride levels checked. have many cysts
Treatment for PCOS depends on a number of factors. These may include age, severity of symptoms and overall health. The type of treatment may also depend on whether the person with PCOS want to become pregnant in the future.
If this is the case the treatment may include:
Medications to cause ovulation. Medications can help the ovaries to release eggs normally. These medications also have certain risks. They can increase the chance of multiple births (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.
A change in diet and activity. A healthy diet and more physical activity can help with the loss of weight and may reduce symptoms. They can also help the body use insulin more efficiently, lower blood glucose levels, and may help with ovulation.
If the person does not plan to become pregnant, 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 with regular ovulating.
Medications to treat other symptoms. Some medications can help reduce hair growth or acne.
Some persons struggle with the physical symptoms of PCOS, such as weight gain, hair growth, and acne. Cosmetic treatments, such as electrolysis and laser hair removal, may help the person feel better about their appearance. Talking with a healthcare provider about the best ways to treat the symptoms is a critical recommendation.
See a healthcare provider if there are concerns about menstrual periods, if you are having difficulty with getting and or staying pregnant or if there are signs of excess androgen such as worsening hirsutism, acne, and male-pattern baldness.
References
S.M. Sirmans and K.A .Pate (2013) Epidemiology, diagnosis, and management of polycystic ovary syndrome“ Clinical Epidemiology. 2014:6 1–13
Here are places you can find further information on the condition:
PCOS Awareness Association
National Health Service: Polycystic ovary syndrome
Reproductive Facts – Topics: Polycystic Ovary Syndrome (PCOS)
Jean Hailes – PCOS
In 2018 . the following international guidelines for the evaluation and management of PCOS was released:
2018 PCOS Guidelines
We seek to provide relevant and up-to-date information to allow those with PCOS to make informed decisions as it pertains to the condition. Whilst we provide these links and references to external resources, we have no control over what they produce on these third-party sites and thus are not responsible for the content and cannot confirm the completeness of any of the information from any other site. Thus, we claim no liability for any damages or injuries of any kind arising from such content or information. Please remember to seek the expert opinion of a medical practitioner for medical advice.
