Polycyctic Ovary Syndrome (PCOS)
What is PCOS?
PCOS is a condition in which a woman’s ovaries and, in some cases, the adrenal glands produce more of the hormone androgen than normal. High levels of these hormones interfere with the development and release of eggs as part of ovulation. As a result, fluid filled sacs or cysts can develop on the ovaries. Because women with PCOS do not release eggs during ovulation, it is the most common cause of female infertility.
How does PCOS affect fertility?
A woman’s ovaries have follicles, which are tiny, fluid filled sacs that hold the eggs. When an egg is mature, the follicle breaks open to release the egg so it can travel through the fallopian tubes and into the uterus for possible fertilization. In women with PCOS, immature follicles bunch together to form large cysts or lumps. The eggs mature within the bunched follicles, but the follicle does not break open to release them. As a result, women with PCOS often have menstrual irregularities, such as the absence of menstruation (called amenorrhea) or they have only occasional periods (oligomenorrhea). Because the eggs are not released, most women with PCOS have trouble getting pregnant.
Symptoms of PCOS
In addition to infertility, women may also have:
- Pelvic pain
- Excess hair growth on the face, chest, stomach, thumbs, or toes. (Called hirsutism)
- Male pattern baldness, or thinning hair
- Acne, oil skin, or dandruff
- Patches of thickened and dark brown or black skin
- Women who are obese are more likely to have PCOS
Although is it more difficult for women with PCOS to become pregnant, it is possible. Many who cannot get pregnant naturally need to turn to assistive reproductive technology. Women with PCOS are at higher risk for miscarriage if they do become pregnant.
Women with PCOS are also at higher risk for associated conditions such as:
- Diabetes
- Metabolic syndrome. This is sometimes known as a precursor to diabetes. This syndrome indicates that the body has trouble regulating insulin.
- Cardiovascular disease, including high blood pressure and heart disease.
Diagnosing PCOS
Your physician will take a medical history and do a pelvic exam to feel for cysts on your ovaries. A vaginal ultrasound may also be done. Your physician may recommend blood tests to measure hormonal levels. Other tests may include measuring levels of insulin, glucose, cholesterol, and triglycerides.
Treating PCOS
There is no cure for PCOS. Many of the symptoms can be managed. It is important to have PCOS diagnosed and treated early to help prevent associated problems. There are medications that can help control the symptoms, such as birth control pills to regulate menstruation, reduce androgen (hormone) levels, and clear acne. Other medications can reduce cosmetic problems like hair growth, and control blood pressure and cholesterol.
Lifestyle changes such as exercise, can help weight loss and aid in the reduction of blood pressure. Exercise can also help regulate insulin levels more effectively. Weight loss can help lessen many of the health conditions associated with PCOS and can make symptoms be less severe or even disappear.
Surgical treatment may also be an option, but is not recommended for the first course of treatment.
