Polycystic Ovarian Syndrome (PCOS)
What is polycystic ovary syndrome? — Polycystic ovary syndrome is a condition that can cause women to have irregular periods, get acne (oily skin and pimples), grow extra facial hair, or lose hair from their head. The condition can also make it hard to get pregnant. People sometimes call polycystic ovary syndrome "PCOS." It is very common – about 5 percent of all women have PCOS. Most women with PCOS are overweight or obese.
What causes PCOS? — In women with PCOS, the ovaries don't work very well. About once a month, the ovaries are supposed to make a structure called a follicle. As the follicle grows, it makes hormones. Then, it releases an egg. This is called "ovulation."
But in women with PCOS, the ovary makes many small follicles instead of one big one. Hormone levels can get out of balance. And ovulation doesn't happen every month the way it is supposed to. Doctors aren't sure why this happens to some women.
What are the symptoms of PCOS? — Women with the condition might:
●Have fewer than 8 periods a year
●Grow thick, dark hair in places where only men tend to grow hair, such as on the upper lip, chin, sideburn area, chest, and belly
●Gain weight and become obese
●Have acne (oily skin and pimples on their face)
●Lose hair from their head like men do
●Have trouble getting pregnant without medical help
Should I see a doctor even if my symptoms are mild? — Yes. Women with PCOS are more likely to have other health problems, too. These include:
●Diabetes (high blood sugar)
●High cholesterol levels
●Sleep apnea, a sleep disorder that causes people to briefly stop breathing while they sleep
The risk of heart disease might also be higher in women with PCOS, but more research is needed for doctors to be sure.
Are there tests I should have? — Your doctor or nurse will decide which tests you should have based on your age, symptoms, and individual situation. Possible tests include:
●Blood tests to measure levels of hormones, blood sugar, and cholesterol
●A pregnancy test if you have missed any periods
●Pelvic ultrasound – This test uses sound waves to make a picture of your uterus and ovaries. Doctors sometimes use this test to help figure out if you have polycystic ovaries.
How is PCOS treated? — The most common treatment is to take birth control pills. The pills don't cure PCOS. But they can improve many of its symptoms, like irregular periods, acne, and facial hair. Birth control pills also protect women from cancer of the uterus.
Other treatments for symptoms of PCOS are:
●Anti-androgens – These medicines block hormones that cause some PCOS symptoms. Spironolactone (brand name: Aldactone) is the anti-androgen that many doctors use.
●Progestin – This hormone can make your periods regular, but only if you take it every month. It also lowers the risk of cancer. Most doctors use medroxyprogesterone (brand name: Provera) or natural progesterone (brand name: Prometrium).
●Metformin (brand name: Glucophage) – This medicine can help make a woman's periods more regular. But it works only in about half of the women who try it. In women with diabetes, this medicine helps keep blood sugar levels normal.
●Medicated skin lotion or antibiotics to treat acne
●Laser therapy or electrolysis to remove extra hair
Is there anything I can do on my own to treat the condition? — Yes. If you are overweight or obese, losing weight can improve many of your symptoms. Losing just 5 percent of your body weight can help a lot. That adds up to 10 pounds of weight loss for a 200-pound woman.
What if I want to get pregnant? — Don't lose hope. Most women with PCOS are able to get pregnant, but it can take a while. If you are overweight, losing weight can help make your periods regular and improve your chances of getting pregnant. If you lose weight but your periods are still irregular, your doctor can give you medicines to help you ovulate and improve your chances of getting pregnant.
What will my life be like? — Women with PCOS are able to live normal lives. But it is important to see a doctor. Treatments will help your symptoms and protect you from other diseases.
Content adapted from UpToDate Patient Information.