Layan Alrahmani, MD, is a board-certified OB/GYN and a Maternal Fetal Medicine specialist focusing on the care of high-risk pregnancies.
Polycystic ovary syndrome (PCOS) is a condition that affects about one in 10 women of childbearing age and can impair fertility. Its primary feature is multiple cysts on the ovaries that lead to a cluster of symptoms including irregular menstrual cycles, acne, hirsutism (excess hair growth on the face and/or body), weight gain, and trouble sleeping.
Women with PCOS may also experience metabolic syndrome, insulin resistance, high cholesterol, and hypertension. PCOS may also increase your risk of heart disease, diabetes, and endometrial cancer.
There is no cure for PCOS, but many of the symptoms can be treated or managed with a combination of lifestyle changes and medications. Women with PCOS who wish to become pregnant are often good candidates for fertility treatments.
Researchers don’t know the exact cause of PCOS, but an endocrine system imbalance, genetics, autoimmune disease, insulin imbalance, and environmental factors like endocrine disruptors may contribute. Lifestyle factors that lead to insulin resistance, including being sedentary and eating an unhealthy diet, increase a woman’s risk of PCOS.
There is no cure for PCOS, but its symptoms can be managed with weight loss, home remedies, and medication. Birth control pills help to regulate menstrual cycles. Insulin sensitivity can be improved with the drug metformin, as well as exercise, diet, and weight loss. Over-the-counter remedies can be used to treat acne and excessive facial hair. A surgical procedure known as ovarian drilling is also sometimes recommended.
PCOS often goes undiagnosed until a woman has difficulty conceiving. A gynecologist will diagnose PCOS based on your symptom history, a physical exam, and lab work to test hormone levels, such as testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and anti-Mullerian hormone. The presence of multiple ovarian cysts are confirmed through pelvic exam and ultrasound.
Having polycystic ovary syndrome (PCOS) can make it difficult to lose weight due to hormonal imbalances and insulin resistance. Following the PCOS diet, which focuses on whole grains, high fiber fruits and vegetables, fatty fish, lean protein, nuts, and healthy fats, along with getting regular exercise can help women with PCOS to lose weight and improve their symptoms.
Having polycystic ovary syndrome (PCOS) can make getting pregnant difficult. Some women find lifestyle changes, such as losing weight through diet and exercise, can help. Other women may need fertility treatments to get pregnant. This includes drugs like Clomid, Femara, and gonadotropins, and assisted reproductive technology like intrauterine insemination (IUI) and in vitro fertilization (IVF).
Androgens are sex hormones found in both men and women that are vital for reproductive health, emotional wellbeing, cognitive function, lean muscle tissue growth, and bone strength. Androgens include testosterone, androsterone, and dehydroepiandrosterone (DHEA). Women with PCOS have higher than normal levels of androgens, a condition known as hyperandrogenism.
FSH is a hormone released by the pituitary gland that stimulates an egg follicle to grow each month during the menstrual cycle. Women with polycystic ovary disease have low levels of FSH and do not ovulate on a monthly basis.
Excessive facial and body hair is known as hirsutism. A common symptom of PCOS, women with hirsutism will often experience excess hair growth on the face, neck, chest, back, and toes. Many women with hirsutism use home remedies like shaving, waxing, and depilatory and bleaching creams to remove unwanted hair.
Insulin resistance (IR) is a condition where the body does not respond properly to insulin, a hormone that helps glucose enter cells to be stored for energy. In IR, the pancreas produces enough insulin, but the cells are resistant to it, resulting in high blood sugar levels. IR is common in women with PCOS. Exercise helps to improve insulin sensitivity.
Ovarian cysts are fluid-filled sacs similar to blisters that form on the ovaries. During the process of ovulation, a cyst-like structure called a follicle forms inside the ovary. The mature follicle ruptures when the egg is released during ovulation. Sometimes the process does not conclude appropriately, resulting in an ovarian cyst.
Progesterone is a female sex hormone produced by the ovaries following ovulation. Women with PCOS do not ovulate regularly, resulting in a lack of progesterone and an imbalance of hormones in the ovaries. Progesterone is essential for a healthy pregnancy and is believed to influence the immune system to protect against miscarriage.
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NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. What causes PCOS? Updated January 31, 2017.
NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. Treatments for Infertility Resulting from PCOS. Updated January 31, 2017.
U.S. Department of Health & Human Services: Office on Women’s Health. Polycystic ovary syndrome. Updated April 1, 2019.
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