Polycystic Ovary Syndrome (PCOS) Overview

Polycystic ovary syndrome (PCOS) is a grouping of symptoms linked to infrequent ovulation. A complex hormonal disturbance, PCOS affects up to 30 percent of all premenopausal women.  

Signs and symptoms
If you have PCOS, you may have normal reproductive organs (uterus and fallopian tubes). However, you may have one or more of the following signs and symptoms:

  • Menstrual disturbances
  • Obesity
  • Irregular or absent periods
  • No bleeding to excessive spotting
  • Cycle lengths more than thirty-five days
  • PMS and pelvic pain
  • Infertility and miscarriage
  • Hair and skin problems (acne, seborrhea, balding, and more)

While any and all of these symptoms may be part of polycystic ovary syndrome, the triad of PCOS is usually related to irregular periods, skin problems and obesity. Also, some women are lean and athletic and still have PCOS.

With polycystic ovary syndrome, the hair and skin problems are often more common than either menstrual cycle irregularity or obesity. These skin disorders are related to an increase in the level of male hormones (hyperandrogenism).

The good news is that the fewer symptoms you have for polycystic ovary syndrome, the greater your response should be to medication and treatment.

Diagnosing PCOS
To make an accurate PCOS diagnosis, your doctor will do a physical examination and take your personal medical history. In addition, the doctor will check for symptoms and physical findings and do lab tests of LH/FSH levels, DHEAs and testosterone levels.

Your doctor will check for insulin resistance with a glucose tolerance test with insulin levels. Most women with polycystic ovary syndrome have at least slight lab abnormalities. Many women may have several abnormalities, while you may only have one or two.

Ultrasound and PCOS
Ultrasound of the abdomen is a necessary diagnostic tool in almost all women who may have PCOS. The ultrasound can determine ovarian and endometrial function. A finding of more than 10 cystic structures less than 10 mm in either ovary meets the general criteria for PCOS.

PCOS treatment
Treatment for PCOS includes a comprehensive program to help you manage PCOS symptoms and increase the chances of getting pregnant. Depending on your symptoms, treatment may include:

Weight loss - By losing weight, your hormone balance improves and you may get your period again. Some fertility specialists recommend a low-carb/high protein diet to help with weight loss and to reduce the amount of circulating insulin. Exercise, when doctor approved, is also highly beneficial.

Progestins - This medication imitates the action of the hormone progesterone and is used to regulate the menstrual cycle and reduce the blood levels of LH.

Oral contraceptives - If you have PCOS and do not want to become pregnant, oral contraceptives may be prescribed as a foundation of treatment.  

Corticosteroids - Steroids can suppress adrenal androgen production and may be useful in PCOS treatment that has an adrenal component. Still many women do not like the side effects of steroids and often stop using them.  

Anti-androgens - Skin problems with polycystic ovary syndrome may improve with anti-androgens. This group of medications can be used only when not attempting a pregnancy or without some form of adequate birth control.  

Diuretics - A water pill called spironolactone may be prescribed if you have excessive hair growth or acne. This diuretic helps to reverse these problems associated with PCOS.

Metformin - Metformin (glucophage), a treatment for type 2 diabetes, affects the action of insulin in the body and is helpful in reducing PCOS symptoms. 

Other treatments for PCOS may include the use of GnRH analogs and ovarian drilling to induce ovulation in some women who have not responded to medications.

Find answers for PCOS
Polycystic ovary syndrome is vastly unrecognized by doctors and women alike. So, talk openly with your doctor about your PCOS symptoms. Using a multifaceted treatment program, your doctor will help you get in control of the symptoms and reduce the risk of further problems.

Ask a doctor in your area about PCOS

Sources
  • Integramedfertlity.com: Learn About Polycystic Ovarian Syndrome (PCOS) From a Leading Specialist. 
  • CARS: Center for Applied Reproductive Science: Polycystic Ovary Syndrome 
  • MedicineNet.com: Polycystic Ovarian Syndrome. 
  • Bruce, D, Thatcher, S. & Berg, B. Making a Baby.
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