Polycystic Ovary Syndrome
Polycystic ovary syndrome (say "pah-lee-SIS-tik OH-vuh-ree SIN-drohm") is a problem in which a woman's hormones are out of balance. It can cause problems with your periods and make it difficult to get pregnant. PCOS also may cause unwanted changes in the way you look. If it isn't treated, over time it can lead to serious health problems, such as diabetes and heart disease.
Early diagnosis and treatment can help control the symptoms and prevent long-term problems.
What are hormones, and what happens in PCOS?
Hormones are chemical messengers that trigger many different processes, including growth and energy production. Often, the job of one hormone is to signal the release of another hormone.
For reasons that are not well understood, in PCOS the hormones get out of balance. One hormone change triggers another, which changes another. For example:
The sex hormones get out of balance. Normally, the ovaries make a tiny amount of male sex hormones (androgens). In PCOS, they start making slightly more androgens. This may cause you to stop ovulating, get acne, and grow extra facial and body hair.
The body may have a problem using insulin, called insulin resistance. When the body doesn't use insulin well, blood sugar levels go up. Over time, this increases your chance of getting diabetes.
What causes PCOS?
The cause of PCOS is not fully understood, but genetics may be a factor. PCOS seems to run in families, so your chance of having it is higher if other women in your family have it or have irregular periods or diabetes. PCOS can be passed down from either your mother's or father's side.
What are the symptoms?
Symptoms tend to be mild at first. You may have only a few symptoms or a lot of them. The most common symptoms are:
Weight gain and trouble losing weight.
Extra hair on the face and body. Often women get thicker and darker facial hair and more hair on the chest, belly, and back.
Thinning hair on the scalp.
Irregular periods. Often women with PCOS have fewer than nine periods a year. Some women have no periods. Others have very heavy bleeding.
Fertility problems. Many women who have PCOS have trouble getting pregnant (infertility).
How is PCOS diagnosed?
To diagnose PCOS, the doctor will:
Ask questions about your past health, symptoms, and menstrual cycles.
Do a physical exam to look for signs of PCOS, such as extra body hair and high blood pressure. The doctor will also check your height and weight to see if you have a healthy body mass index (BMI).
Do a number of lab tests to check your blood sugar, insulin, and other hormone levels. Hormone tests can help rule out thyroid or other gland problems that could cause similar symptoms.
You may also have a pelvic ultrasound to look for cysts on your ovaries. Your doctor may be able to tell you that you have PCOS without an ultrasound, but this test will help him or her rule out other problems.
How is it treated?
Try to fit in moderate activity and/or vigorous activity often. Walking is a great exercise that most people can do.
Eat heart-healthy foods. This includes lots of vegetables, fruits, nuts, beans, and whole grains. It limits foods that are high in saturated fat, such as meats, cheeses, and fried foods.
Most women who have PCOS can benefit from losing weight. Even losing 10 lb (4.5 kg) may help get your hormones in balance and regulate your menstrual cycle.
If you smoke, consider quitting. Women who smoke have higher androgen levels that may contribute to PCOS symptoms.1
It is important to see your doctor for follow-up to make sure that treatment is working and to adjust it if needed. You may also need regular tests to check for diabetes, high blood pressure, and other possible problems.
It may take a while for treatments to help with symptoms such as facial hair or acne. You can use over-the-counter or prescription medicines for acne.
It can be hard to deal with having PCOS. If you are feeling sad or depressed, it may help to talk to a counselor or to other women who have PCOS.