Polycystic ovary syndrome involves a hormone imbalance that interferes with normal ovulation and produces other symptoms. The cause of PCOS is not fully understood, but genetics may be a factor.
Most women with PCOS will have numerous small cysts (less than the size of a pea) on their ovaries at some time. Each small cyst represents a follicle, which contains a single egg that is attempting to develop to a stage where it will be ready to be released from the ovary (a process known as ovulation). However, because of the complex biochemical situation that exists in ovaries with PCOS, the development of these follicles stops too soon, resulting in a collection of small follicles and the lack of ovulation. This lack of ovulation is the reason why women with PCOS commonly have difficulty becoming pregnant.
PCOS may increase your risk of developing other conditions or diseases over time, such as diabetes, high cholesterol, heart disease and endometrial hyperplasia.
The most common symptoms of PCOS include:
- Irregular menstrual cycles
- Acne
- Weight gain
- Abnormal hair growth
- Infertility
- Miscarriages
PCOS is often diagnosed in women who have irregular menstrual cycles and elevated levels of male hormones. Some women with PCOS do not have polycystic ovaries but have other symptoms of the syndrome. Likewise, not all women who have polycystic-appearing ovaries on ultrasound have PCOS. Many women are diagnosed with PCOS after seeking medical attention for infertility.
PCOS has such a wide range of symptoms that no single test can be used to diagnose the syndrome. Several exams and tests to diagnose PCOS may be done, depending on your symptoms:
- Blood tests to measure hormone levels
- Insulin level tests
- Medical history
- Pelvic exam
- Thyroid level tests
- Ultrasound of ovaries and adrenal glands
- Urinalysis
Since there is no specific cure for PCOS, treatment focuses on managing PCOS symptoms and preventing long-term complications.
- Drug therapy may include birth control pills to correct irregular menstrual cycles, insulin-sensitizing medications, fertility medications, weight loss pills and acne medications.
- Cosmetic therapy can include treatments for hair removal and for clearing up acne.
- Hormone replacement therapy may be prescribed to correct the hormone imbalance associated with PCOS.
- Nutritional counseling is available to treat obesity and help alleviate insulin resistance.
- Surgery to remove the ovaries or uterus (bilateral salpingo-oophorectomy or hysterectomy) is an option for women with severely symptomatic PCOS who do not want future pregnancies.
- To stop the progression of hirsutism, most women should first be treated with hormones, most commonly birth control pills. Once the hormone treatment has taken full effect, electrolysis can be used to permanently remove any remaining hairs. Facial creams, waxing and shaving are also helpful in reducing unwanted hair.
