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Polycystic ovary syndrome (PCOS)

PCOS causes irregular menstrual periods because monthly ovulation does not happen and levels of androgens (male hormones) are high. This happens in 5 to 10 out of 100 of women.

Jan 23, 2023

PCOS is a hormonal disorder. 5 to 10 out of 100 people have PCOS.

Signs of PCOS are:

Irregular or absent periods
Difficulty getting pregnant
Weight gain
Extra hair growth on the face, chest, or abdomen
Acne
Male pattern hair thinning
Enlarged ovaries with small cysts below the surface

Some people with PCOS do not have all the above signs. They may be thin with normal hair growth but still have irregular periods. They may have regular periods but also have extra hair growth and weight problems.

People make both male and female hormones. The amount of these hormones in men and women are different. With PCOS many small follicles form on the ovary. These follicles do not grow and lead to ovulation like in a normal cycle. So, levels of certain ovulation hormones become imbalanced. Levels of androgens, testosterone, DHEA sulfate (DHEAS), and androstenedione may be high. Lab tests to check these levels are often done to diagnose PCOS.

Diagnosis

PCOS can be confirmed when at least 2 of the below are found:

Irregular or absent periods
Polycystic ovaries on ultrasound
Hyperandrogenism (high levels of androgen) and/or hirsutism (extra hair growth)

Treatment

Infertility

People with PCOS often have absent or irregular ovulation. So, fertility medicines to cause ovulation may be needed.
Common medicines are clomiphene (Clomid^®), femara(Letrozole^®), or hMG injections.
Metformin (Glucophage^®) is sometimes prescribed. It helps ovulation efficiency in some people with PCOS.

Menstrual problems

Birth control pills or progesterone regulate the menstrual cycle.

Excessive hair growth and acne

Medicines, such as certain birth control pills can lower androgen levels.
Plucking, shaving, and electrolysis may be used.
Acne treatment and visit with dermatologist may be needed.

Obesity

Dieting and exercise are the safest way to lose weight.
If insulin levels are high, medicines like Metformin may be prescribed.
A visit with a dietitian may be helpful.

Long-Term

PCOS cannot be cured. Treatments can help.

Irregular cycles and long times between periods, cause the uterus lining to thicken over time. This can lead to very heavy, alarming bleeds. It also puts you at higher risk of endometrial cancer. So, you must not go longer than 8 weeks without a period.

People with PCOS and obesity often have blood sugar abnormalities and insulin resistance. Some have or become diabetic or prediabetic. Studies show a higher risk of conditions related to obesity, such as: