What is PCOS?
PCOS Polycystic ovary syndrome is a common condition that affects your hormones. It causes irregular menstrual periods, excess hair growth, acne and infertility. Treatment for PCOS depends on if you wish to become pregnant. People with PCOS may be at higher risk for certain health conditions, like diabetes and high blood pressure. PCOS is the most common cause of anovulatory infertility, meaning that infertility results from the absence of ovulation, the process that releases a mature egg from the ovary every month. Many women don’t find out that they have PCOS until they have trouble getting pregnant.
What is PCOS?
Polycystic ovary syndrome, or PCOS, is a set of symptoms related to a hormonal imbalance that can affect women and girls of reproductive age. PCOS may cause menstrual cycle changes, skin changes such as increased facial and body hair and acne, abnormal growths in the ovaries, and infertility. Often, women with PCOS have problems with their metabolism also. PCOS is one of the most common causes of infertility in women and people assigned female at birth (AFAB). It can also increase your risk of other health conditions. Your healthcare provider can treat PCOS based on your symptoms and if you wish to become pregnant.
What are the symptoms of polycystic ovary syndrome (PCOS)?
- Irregular periods: Abnormal menstruation involves missing periods or not having a period at all. It may also involve heavy bleeding during periods.
- Abnormal hair growth: You may grow excess facial hair or experience heavy hair growth on your arms, chest and abdomen (hirsutism). This affects up to 70% of people with PCOS.
- Acne: PCOS can cause acne, especially on your back, chest and face. This acne may continue past your teenage years and may be difficult to treat.
- Obesity: Between 40% and 80% of people with PCOS have obesity and have trouble maintaining a weight that’s healthy for them.
- Darkening of the skin: You may get patches of dark skin, especially in the folds of your neck, armpits, groin (between the legs) and under your breasts. This is known as acanthosis nigricans.
- Cysts: Many people with PCOS have ovaries that appear larger or with many follicles (egg sac cysts) on ultrasound.
- Skin tags: Skin tags are little flaps of extra skin. They’re often found in your armpits or on your neck.
- Thinning hair: People with PCOS may lose patches of hair on their head or start to bald.
- Infertility: PCOS is the most common cause of infertility in people AFAB. Not ovulating regularly or frequently can result in not being able to conceive.
Do You Have PCOS?
Sometimes symptoms are clear, and sometimes they’re less obvious. You may visit a dermatologist (skin doctor) for acne, hair growth, or darkening of the skin in body creases and folds such as the back of the neck (acanthosis nigricans), a gynecologist (doctor who treats medical conditions that affect women and female reproductive organs) for irregular monthly periods, and your family doctor for weight gain, not realizing these symptoms are all part of PCOS. Some women will have just one symptom; others will have them all. Women of every race and ethnicity can have PCOS. It’s common for women to find out they have PCOS when they have trouble getting pregnant, but it often begins soon after the first menstrual period, as young as age 11 or 12. It can also develop in the 20s or 30s.
What Are the Risk of PCOS?
Metabolic syndrome: This group of symptoms raises the risk of cardiovascular disease. The symptoms include high triglyceride and low HDL (“good”) cholesterol levels, high blood pressure, and high blood sugar levels.
What are the Process to Diagnosed PCOS ?
No single test can diagnose PCOS. Your doctor will start by asking about your symptoms and medical history and by doing a physical exam, and possibly a pelvic exam. They might give you blood tests to measure your hormone levels, blood sugar, and cholesterol. An ultrasound can check your ovaries for cysts, look for tumors, and measure the lining of your uterus.
- Talk to you about your symptoms and medical history.
- Ask about your biological family’s medical history.
- Take your weight and blood pressure.
- Perform a physical exam, looking specifically for excess facial hair, hair loss, acne, discolored skin and skin tags.
- Perform a pelvic exam to look for other causes of abnormal bleeding.
- Order blood tests to check hormone levels and glucose levels.
- Perform a pelvic ultrasound to look at your ovaries, check the thickness of your uterine lining and look for other causes of abnormal bleeding.
What Are the Treatment of PCOS?
See your health care provider if you have irregular monthly periods, are having trouble getting pregnant, or have excess acne or hair growth. If you’re told you have PCOS, ask about getting tested for type 2diabetes and how to manage the condition if you have it. There are also medicines that can help you ovulate, as well as reduce acne and hair growth. Make sure to talk with your health care provider about all your treatment options.
Popular Treatment of PCOS
- This is the most common treatment for infertility in women with PCOS. The American College of Obstetricians and Gynecologists (ACOG) recommends that clomiphene should be the primary medication for PCOS patients with infertility.
- Clomiphene indirectly causes eggs to mature and be released.
- Women treated with clomiphene are more likely to have twins or triplets than women who get pregnant naturally. Women who conceive with the aid of clomiphene are slightly more likely to have multiples, most commonly twins.
- Although this insulin-sensitizing drug is normally used to treat diabetes, it may also be used as an adjunct to increase or regulate ovulation in women with PCOS.
- Metformin can be used alone or used with clomiphene when clomiphene alone is not successful.
- Evidence shows that metformin—both alone and in combination with clomiphene—increases ovulation, but it does not increase the rate of pregnancy.
- Metformin is not approved by the FDA for treating PCOS-related infertility.
- This drug transiently slows estrogen production and causes the body to make more follicle-stimulating hormone (FSH), a hormone needed for ovulation.
- An NICHD-supported study found that letrozole is more effective than clomiphene in causing ovulation and improving live-birth rates.
- Studies of letrozole in animals have shown that it causes birth defects if used during pregnancy, but there have been no studies of this drug in pregnant women.
Yes, you can get pregnant if you have PCOS. It can make it hard to conceive while also increasing your risk for certain pregnancy complications, but many people with PCOS do get pregnant on their own. Your healthcare provider will work with you to develop a treatment plan to help you ovulate. Your treatment plan could include medication or assisted reproductive technologies like in vitro fertilization (IVF).Talk to your healthcare provider to make sure you understand your treatment plan and how you can increase your chances of a healthy pregnancy.
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