What You Need to Know About Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) can cause hormonal changes in a woman, affecting her physical characteristics, ability to become pregnant, and future health outlook.

September is Polycystic Ovary Syndrome (PCOS) Awareness Month—are you aware of this significant health condition? If not, you are not alone. Although PCOS is the most common hormonal disorder in women of childbearing age, many people are not familiar with this condition. However, you need to understand PCOS because there is a chance that it might affect you or a woman you love. One in ten American women has PCOS, and PCOS is the most common cause of infertility.

At Lompoc Valley Medical Center, serving women—and advancing knowledge about women’s health conditions—is part of our core mission. Here is what you need to know about PCOS and why it matters.

What is PCOS?

Polycystic ovary syndrome is a hormonal condition that affects women during their reproductive years—a period defined as after the onset of a woman’s first menstrual period, spanning throughout the time when she can become pregnant and ending at the time of menopause.

In PCOS, a woman’s body makes too much androgen, which is the male sex hormone. Although all women have a little bit of androgen in their bodies, women with PCOS have too much. This can cause challenges with the menstrual cycle, and many women with PCOS also have difficulties getting pregnant.

Women with PCOS may have multiple fluid-filled sacs on their ovaries (called “cysts”), which is how the condition gets its name. However, not all women who are diagnosed with PCOS will have cysts present on their ovaries. Additionally, many women have cysts on their ovaries but no symptoms of a hormonal imbalance—these women are not considered to have PCOS.

What are the risk factors for PCOS?

Although there is no definitive cause of PCOS, risk factors seem to make some women more likely to develop the condition.

These risk factors include:

• Being overweight or obese
• Having insulin resistance or metabolic syndrome
• Having family members with PCOS
• Being of Mexican-American heritage

One of the most important things you can do to avoid developing PCOS is maintaining normal body weight, especially if you have other risk factors that make you vulnerable to developing the condition.

What are the symptoms of PCOS?

Although PCOS is a complex medical condition, many women will experience similarities in their symptoms. Some of the most common symptoms of PCOS include:

• There are signs of too much male sex hormone, such as acne, excessive body hair (such as facial hair), or male-pattern hair balding.
• Irregular periods (usually very light) and long stretches between cycles—usually 35 or more days between periods. Some women may have no periods at all.
• Signs of insulin resistance, such as darkening the skin on the back of the neck (a sign known as “acanthosis nigracans”).
• Problems getting pregnant.

For most women, the symptoms of PCOS develop during adolescence. However, because there is an overlap between PCOS symptoms and the onset of puberty, a diagnosis of PCOS is usually not made during a woman’s teenage years.

How is PCOS diagnosed?

Medical providers use a combination of methods to make a diagnosis of PCOS. First, a medical provider will interview a woman about her medical past, paying special attention to her menstrual history and the nature of her menstrual cycles. A medical provider will also conduct a physical exam, looking for excess male sex hormone signs, like atypical hair patterns.

Blood tests to measure the level of male sex hormones can help establish PCOS diagnosis, and other potential conditions can also be ruled out by checking blood hormone levels. A medical provider may also look directly at a woman’s ovaries by using an ultrasound machine—this can help see if there are numerous small-fluid-filled cysts on the ovaries (in PCOS, there are usually 12 or more cysts on one or both ovaries).

To be officially diagnosed with PCOS, you must have two of three conditions present:

• Evidence of too much male hormone (either based on a physical exam or a blood test)
• Menstrual irregularities
• Numerous cysts present on your ovaries

Many women with PCOS, unfortunately, experience a delay in diagnosis. Some researchers have shown that up to a third of women with PCOS do not receive an official diagnosis until two years after they begin seeking medical care for their symptoms. It can be very frustrating to wait so long to receive a diagnosis, especially if you are attempting to become pregnant. This is why being aware of PCOS, and considering it early on during a medical investigation, can be very helpful.

What other conditions may cause PCOS-like symptoms?

When medical providers evaluate women for PCOS, they also must consider other types of conditions that may cause similar symptoms. Part of the initial evaluation of PCOS is first making sure that other health concerns are not present, which is why PCOS is considered a “diagnosis of exclusion.”

Other conditions that health providers like to rule out, or at least consider when evaluating a person for PCOS, include:

• A tumor that secretes the male sex hormone
• Thyroid disease
• Other hormonal conditions like hyperprolactinemia and congenital adrenal hyperplasia

A medical provider will use similar diagnostic tools—such as questions about your medical history, physical exam, blood tests, and ultrasounds—to investigate for other potential sources of your symptoms.

How is PCOS managed?

While there is no cure for PCOS, many treatments are available that can help women with symptoms. These treatment options include:

• Combined oral contraceptives: An combined oral contraceptive, also known as a birth control pill, can help women with PCOS have more regular menstrual cycles. This type of medication can also help reduce the amount of male hormone circulating within the body, improving a woman’s symptoms of excess body hair or acne.
• Spironolactone: If a woman with PCOS does not have enough relief from her symptoms after using a birth control pill, she may use spironolactone, an anti-male hormone medication. This can help reduce the growth of excess body hair.
• Weight loss: Losing weight can help manage many aspects of PCOS, such as insulin resistance and changes in menstrual periods. Many women find that their periods become more predictable and regular after they lose weight. This positive change can, in turn, help them become pregnant. Women can lose weight by changing their diet and exercising and through weight loss medications or surgery.
• Metformin: This medication is generally used to treat type 2 diabetes, but it can help with symptoms of PCOS and aid in weight loss.

If you have been diagnosed with PCOS, your medical provider will discuss your treatment goals (including whether or not you would like to become pregnant) before choosing which type of treatment is right for you. However, all women with PCOS who are overweight or obese can see a benefit from weight loss.

What are the effects of PCOS on a woman’s overall health?

Even though PCOS typically cannot be reversed or cured, it is possible for women with PCOS to live full lives without complications. If a woman with PCOS is trying to get pregnant, some medications can help increase her likelihood of conceiving.

How can PCOS impact a women’s fertility?

Because PCOS can cause a woman to have long menstrual cycles, it can be difficult to become pregnant. When women are only ovulating (releasing an egg cell) a few times a year, or sometimes not at all, it is tough for a sperm to fertilize an egg.

Luckily, there are many options available to women with PCOS who desire pregnancy. Weight loss can help women with PCOS start ovulating more regularly, which can help them become pregnant. There are also medications available that can help stimulate a women’s ovaries to make more eggs. Two medications that are approved for this purpose are called clomiphene and letrozole. If a woman with PCOS cannot conceive after losing weight and trying these medications, she may consider in vitro fertilization (IVF) treatments.

What other conditions are associated with PCOS?

If you or a woman you love is diagnosed with PCOS, it is essential to be aware of the other medical conditions associated with this diagnosis. Women with PCOS are more likely to develop cardiovascular disease, type 2 diabetes, fatty liver disease, obstructive sleep apnea, and mood disorders like depression or anxiety. Women with PCOS are also at higher risk of developing endometrial cancer (uterine cancer); however, this risk can be reduced when they begin treatment with birth control pills.

How to learn more about PCOS

At Lompoc Valley Medical Center, we are devoted to helping you navigate life’s health challenges. Our expert women’s health providers can help you every step of the way to address symptoms related to hormonal imbalances and infertility.

If you are struggling with symptoms of PCOS or trying unsuccessfully to conceive, contact us to schedule an appointment today.