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Polycystic Ovary Syndrome (PCOS)

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What is Polycystic Ovary Syndrome (PCOS)?

Polycystic Ovary Syndrome (PCOS), sometimes called Polycystic Ovarian Disease, is a hormonal disorder that affects between 6 to 10% of women.

PCOS causes the ovaries to produce higher than normal amounts of androgens (male hormones). This interferes with egg production. The eggs that the ovaries normally produce develop into cysts, little sacs filled with liquid. Instead of being released during ovulation, as an egg would be released, the cysts build up in the ovaries and can become enlarged.

PCOS can also affect many systems in the body and have long-term health consequences.

What are the symptoms of PCOS?

The most common symptoms of PCOS are:

  • infrequent periods (oligomenorrhea);
  • no periods at all (amenorrhea);
  • excessive bleeding during your period (polymenorrhea);
  • enlarged ovaries with multiple small painless cysts or follicles that form in the ovary;
  • skin tags, teardrop-sized pieces of skin that can be as large as raisins and are typically found in the armpits or neck area (also called acrochordons);
  • a disorder that causes darkening and thickening of the skin on the neck, groin, underarms or skin folds (also called acanthosis nigricans);
  • thinning hair;
  • excess hair all over the body, including the face (hirsutism);
  • acne;
  • weight gain and obesity;
  • increased blood sugar; and
  • infertility.

What causes PCOS?

No one knows what causes PCOS. Some researchers think that it may be caused by high insulin production. Insulin is a hormone that controls blood sugar levels. When too much insulin is produced the body releases extra male hormones.

PCOS also seems to run in families.

How is PCOS diagnosed?

A doctor will perform a physical examination and ask about your medical history. She will ask questions about your family history as well as your period and its regularity. She will check your weight and look for physical symptoms, like acne, hair growth and darkened skin. She might also ask for blood tests to measure insulin and other hormone levels. These tests may be used to diagnose PCOS or to rule out other conditions like thyroid or other ovarian problems.

Another test, called an ultrasound, is used to look at the ovaries and to see if you have cysts.

Is there a cure for PCOS?

There is no cure for PCOS, but there are treatments available that can help balance the hormones in your body, or relieve some of the symptoms, such as acne and weight gain. Some of these treatments you can do yourself. For others, you need to see a doctor.

What can I do to help myself?

There are some products that may help you fight hair loss and facial hair.

  • Hair loss: Some women use a thickening shampoo and conditioner, or talk to their doctors about safe hair regrowth treatments.
  • Facial hair: Waxing, tweezing, bleaching, shaving, and depilatory creams are effective for hair removal. Electrolysis and laser treatments are other effective methods, but are expensive. Sometimes health care plans will cover these procedures.

What can a doctor help me with?

PCOS is best treated by an endocrinologist, a doctor who specializes in hormone disorders.

You can see a doctor for help with PCOS symptoms such as acne and weight loss:

  • Sometimes acne gets better when you are taking birth control pills or antiandrogens (drugs that lower the amount of male hormones in the body). Antiandrogens can usually be taken along with birth control pills. You can also see a dermatologist (a doctor who specializes in skin problems) for acne treatment, as well as medication to reduce discoloration on the neck, armpits and breasts.
  • Weight loss can help deal with many of the symptoms, but it can be difficult for girls and women with PCOS to lose weight. A doctor or a registered dietician can help. They can look at your medications, food intake, and exercise program and come up with a weight-management program.

Insulin-sensitizing medications are also useful for many women with PCOS.

What are the possible health problems associated with PCOS?

PCOS might be a problem of the ovaries, but it changes the body's hormone levels and can affect the whole body. Untreated PCOS can lead to:

  • infertility;
  • excessive hair growth;
  • diabetes;
  • heart disease;
  • bleeding in the uterus;
  • increased risk of miscarriage;
  • increased risk of gestational diabetes (diabetes during pregnancy);
  • sleep apnea (brief periods when you stop breathing during sleep); and
  • uterine cancer.

Not all women with PCOS will develop all of these conditions, but having PCOS increases the risks.

Having PCOS can be hard on your self-esteem because the symptoms are so noticeable. If you have PCOS you can try to focus on what you can change about the unpleasant PCOS symptoms and put the rest of your energy into the parts of your life that PCOS can't touch - friends, family, school, work, and the other things you enjoy.