What Is Polycystic Ovary Syndrome?
Polycystic ovarian syndrome (PCOS) affects a woman’s reproductive hormones. This imbalance in hormones causes irregular menstrual cycles (periods) and may make it difficult to become pregnant. One in 10 women have PCOS, but many don’t know they have the condition until they seek fertility treatment.
PCOS Symptoms
PCOS prevents your ovaries from consistently releasing a mature egg each month. This causes you to have menstrual irregularities like missed periods, no periods, or heavy bleeding.
Women with PCOS may experience no symptoms or a range of symptoms:
- Ovarian cysts
- Excess hair growth on the face, chest, belly, or upper thighs
- Hair loss
- Infertility
- Insulin resistance
- Patches of darker, velvety skin
- Pelvic pain
- Acne that doesn’t respond to treatment
- Weight gain, especially around the waist.
PCOS Hair Loss
Some women with PCOS notice hair loss around the temples and front of the head. Increased male hormones are responsible for the condition, which is called androgenic alopecia. This type of hair loss is a rare symptom of PCOS and may improve with medical treatment.
Find a PCOS Specialist Near Me
How to Diagnose & Test for PCOS
No single test can diagnose PCOS. Your health care provider will use a variety of information to make a diagnosis:
- Your health history
- Your medications
- Your menstrual cycles
- Physical symptoms like acne and excessive hair growth
This information may be enough to diagnose you without further testing. However, your doctor may order additional blood or imaging tests to rule out other conditions. For instance, women with PCOS may have insulin resistance, so your doctor may order a blood test to check your blood sugar.
PCOS Ultrasound
While you may not need an ultrasound for a PCOS diagnosis, your provider may use the imaging tool to assess your reproductive health. The device uses sound waves to create digital images of your ovaries and uterus. In women with PCOS, the ovaries may look enlarged or have multiple cysts, and the endometrium (uterine lining) may be thick.
PCOS Diagnostic Criteria
You must meet two of these criteria to be diagnosed with PCOS:
- Cysts on one or both of your ovaries
- Irregular menstrual periods or no periods at all
- Physical and chemical signs of high levels of androgens, such as excess body hair or acne
What Causes PCOS?
Doctors aren’t sure what causes PCOS, but environmental and genetic factors may contribute to the hormonal imbalance. A problem with the way your body uses insulin may also contribute to PCOS symptoms because higher levels of insulin cause your ovaries to produce more male hormones.
Is PCOS Hereditary?
No single gene is responsible for PCOS, but doctors think the condition may have a genetic link. Therefore, if your female relatives have PCOS, you may be at increased risk.
How Do You Get PCOS?
PCOS is not contagious, meaning you can’t catch it from someone else in the same way you can catch the flu or a cold. But research suggests genetic or chemical changes may cause PCOS. Researchers are still uncertain about exactly how you develop PCOS.
PCOS Treatment
PCOS treatment varies depending on your age, symptoms, and goals. For example, if you want to become pregnant, you will follow a different treatment than if you only want to manage PCOS symptoms.
Regardless of your goals, treatment should protect the lining of your uterus. Women with PCOS don’t have regular periods, so their endometrium doesn’t shed regularly. This may lead to a buildup of tissue that causes a pre-cancerous condition known as endometrial hyperplasia. Taking medication to encourage ovulation (a phase of your menstrual cycle when your ovary releases an egg) or taking a medication that contains progesterone helps protect the uterus.
Many women with PCOS see their menstrual cycles regulate as menopause (the stage of life when your ovaries stops releasing eggs) nears. So, as you age, you may be able to stop taking some medications for PCOS. However, women with PCOS complications, such as type 2 diabetes, should not stop taking medication for those conditions. Your health care provider will help you determine the medicines you can stop and those you should continue taking.
PCOS Medication
Birth control pills are the primary treatment for women who aren’t trying to become pregnant. Oral contraceptives contain female reproductive hormones to help with PCOS symptoms:
- Decrease acne and hair growth
- Lower male hormones such as testosterone
- Protect the uterus
- Regulate menstruation
Your doctor may also prescribe spironolactone to decrease male hormones and metformin to help your body use insulin effectively. In addition, topical creams can slow facial hair growth, while antibiotics and retinoids (Vitamin A compounds) can treat acne.
Can You Get Pregnant with PCOS?
Many women with PCOS can become pregnant. To induce ovulation, your health care provider may prescribe an oral fertility medication. The medication prompts your body to release an egg for fertilization. Once you ovulate, you may become pregnant within a similar time frame to women without PCOS.
Pregnancy and PCOS
PCOS is not considered a condition that causes high-risk pregnancy. However, if you have PCOS, you may be at greater risk for complications during pregnancy, including miscarriage, gestational diabetes, and preeclampsia (high blood pressure during pregnancy). These conditions can be managed with medications and lifestyle changes as recommended by your OB/GYN.
PCOS and Weight Gain
Approximately 50% of women with PCOS struggle with obesity and weight loss. The combination of insulin resistance and increased male hormones make weight gain easier weight loss more difficult. However, losing even 10 percent of your body weight can help regulate your periods and improve other symptoms.
Eating a high-fiber, low-sugar diet and exercising 30 minutes most days of the week can help. Talk with your doctor about other ways to manage your weight.
Endometriosis vs. PCOS
Both endometriosis and PCOS affect women during their reproductive years, but the cause and symptoms of the conditions differ. If you have endometriosis, cells that should be in the lining of your uterus grow outside your uterus. PCOS affects the ability of the eggs in your ovaries to grow and release. You can have both conditions simultaneously.
Why Choose University of Utah Health?
At U of U Health, our Women’s Health Services team provides comprehensive, nationally recognized, top-quality care for PCOS. Fertility specialists at the Utah Center for Reproductive Medicine (UCRM) are experts in reproductive endocrinology and help many women with PCOS build families. Our gynecologists help women manage PCOS symptoms and guide them through the transition from birth control pills to post-menopausal therapy.
Schedule an Appointment
Our providers are here to provide solutions for your PCOS. If you want to manage PCOS symptoms, schedule an appointment with a Women’s Health provider by calling 801-213-2995. If you need help getting pregnant, schedule an appointment with one of our fertility experts at UCRM by calling 801-581-3834.
