What are the causes, symptoms and treatment for Polycystic Ovary Syndrome (PCOS)?

Are you having trouble getting pregnant? Do you have irregular or missed periods? Have you noticed unexplained weight gain or unusual hair growth on different parts of your body? You may have a common, treatable diagnosis: Polycystic Ovary Syndrome (PCOS).

Causes of PCOS

Although concrete causes are unknown, PCOS has been linked to insulin resistance, which may cause higher androgen levels. Androgens are male sex hormones that are present in women, but usually only in small amounts. Higher levels of androgens may cause issues with your menstrual cycle, as well as symptoms of PCOS. When you don't make enough hormones needed to ovulate, small fluid-filled cysts, called follicles, may form and do not regularly release eggs. This causes problems with your menstrual cycle and leads to many symptoms of PCOS.

Another contributing factor to PCOS is obesity, which may cause insulin resistance, which increases the risk for diabetes type 2 and therefore heighten androgen levels. Heredity can also play a role in the cause of PCOS.

Symptoms of PCOS

Symptoms of PCOS can include:

• Difficulty getting pregnant
• Missed, irregular, heavy or light periods
• Cysts on ovaries
• Weight gain, particularly around the abdomen
• Acne
• Thinning hair
• Skin tags on neck or armpits
• Excess body hair, especially on stomach, chest and back
• Thick or dark skin patches in armpits, under breasts or on back of neck

If you're experiencing symptoms, make an appointment with your primary care provider for an evaluation.

Diagnosing PCOS

Your primary care provider will perform a physical examination, including a pelvic exam to check your reproductive organs. If your provider believes you may have PCOS, you'll have further tests that may include a pelvic ultrasound and blood tests.

An ultrasound uses sound waves to create images internally to see the size of your ovaries and if they have cysts. Additionally, a transvaginal ultrasound will show the thickness of the lining of the uterus.

A blood test may check for your hormone levels, including androgens. Your provider may likely check your blood glucose levels, as well as cholesterol and triglyceride levels.

If your provider assesses you may have PCOS, you'll likely be referred to a women’s health specialist for more testing and potential treatment upon diagnosis of PCOS.

Treating PCOS

There are several treatments for PCOS, depending on the severity of your symptoms, age and overall health. If you plan to become pregnant in the future, a different course of treatment may be considered.

If you are planning to get pregnant, treatments may include:

• Changes to your diet and activity to lose weight and help your body use insulin more efficiently
• Medications for ovulation may help ovaries release eggs normally. As with any medication, there are risks involved such as multiple births, ovaries releasing too many hormones, abdominal bloating and pelvic pain.
• Medications to help lower insulin resistance. Some health providers may also consider the use of oral contraceptive pills or hormones to assist in creating a better hormone balance.

If you are not planning to get pregnant, treatment may include:

• Birth control pills to control cycles of menstruation, lowering androgen levels and reducing acne
• Diabetes medication to lower insulin resistance, which may help androgen levels and help you ovulate more regularly
• Changes to diet and activity to lose weight and help your body use insulin more efficiently
• Medications for other symptoms like hair growth and acne

What’s good to know about PCOS is that it’s a very common issue for women who are trying to become pregnant. If you’re experiencing several symptoms of PCOS and think you may need treatment, make an appointment with your primary care provider for an examination.