What is PCOS?

Published on Jan 22, 2020

If you’ve been recently diagnosed with polycystic ovarian syndrome (PCOS), you probably have a lot of questions about the condition. You may be wondering if it impacts your ability to get pregnant. PCOS is quite common among women of childbearing age, affecting nearly one in 10 women in this age group.  

It’s a hormonal disorder in which the ovaries produce higher-than-normal amounts of androgens, or male sex hormones, which causes problems with ovulation. In a healthy menstrual cycle, the ovaries develop and release an egg each month. With PCOS, the egg many not develop as it should or the egg may not be released during ovulation. Some women with PCOS may also develop small fluid-filled sacs, or cysts, in their ovaries.

PCOS is among the most common causes of infertility in women. But beyond fertility issues, it can also trigger a variety of other health problems. Women with PCOS have a higher risk of developing type 2 diabetes, high blood pressure, heart problems, and endometrial cancer—a cancer of the lining of the uterus. In addition, the condition is linked to sleep apnea, depression, and anxiety.

Symptoms

Some of the most common symptoms of PCOS include:

  • Irregular or missed periods
  • Weight gain or difficulty losing weight
  • Excess hair growth on the face, chest, abdomen or upper thighs, a condition known as hirsutism
  • Acne or oily skin
  • Thinning hair; male-pattern baldness
  • Small flaps of skin, called skin tags, in the armpits or the neck area
  • Dark or thick skin patches on the back of the neck, in the armpits and under the breasts

Risk factors and causes

The exact cause of PCOS is not clear, but experts think several factors may play a role. These include:

  • Genetics: Because the symptoms of PCOS tend to run in families, experts think that the condition may be related to one or more genetic mutations. Women who have a mother or sister with PCOS are more likely to develop the condition.
  • Hormonal imbalance: Women with PCOS have higher than normal levels of androgens (sometimes called “male hormones”), which can prevent the ovaries from releasing eggs during their period. These sex hormones also cause many of the physical symptoms related to PCOS, including increased facial and body hair, and acne.
  • High levels of insulin: Many women with PCOS have insulin resistance, meaning their cells do not respond normally to insulin, a hormone that allows the body to convert sugars from food into energy. As a result, many women end up with high levels of insulin in the blood, which can eventually lead to type 2 diabetes.

Diagnosis

There is no single test to diagnose PCOS; however, your healthcare provider may do a physical exam, take a medical history, and blood work, to rule out other possible causes. To determine whether you have PCOS, your doctor will look for at least two of these three characteristic symptoms:

  • Irregular or no periods
  • Higher than normal levels of male hormones
  • Multiple small cysts on the ovaries

Treatment

While there is no cure for PCOS, there are a variety of treatment options to help manage the symptoms associated with the condition. The type of treatment will depend on your age, your overall health and whether you’re planning to get pregnant in the future.

Many women with PCOS have difficulty becoming pregnant, but it does not mean they’re infertile. In fact, many women with the condition become pregnant naturally or with the help of fertility treatments. Your treatment options may include:

  • Losing weight: Adopting more healthful eating habits and physical activity can help you lose weight and relieve PCOS symptoms. Losing even 10 percent of your body weight can help make your periods more regular and increase your chances of getting pregnant.
  • Medications: Medicines (such as birth control pills) may help regulate periods, lower androgen levels, and reduce acne. For patients with PCOS who also have diabetes, taking your prescribed diabetes medications is important to help lower insulin levels and may reduce some of the symptoms associated with PCOS. For those who want to get pregnant, there are a variety of medications that can help you ovulate.
  • In vitro fertilization (IVF): If ovulation medicines don’t work, IVF may be an option. IVF is a treatment where a female’s egg and male’s sperm are fertilized in the lab, and the resulting embryo is then transferred into the woman’s uterus.

Pregnancy risks

Women with PCOS who are pregnant are at greater for risk for complications during their pregnancy. These complications include:

  • Miscarriage
  • Gestational diabetes, a type of diabetes only pregnant women get
  • Preeclampsia, a sudden rise in blood pressure after the 20th week of pregnancy, which can lead to organ damage, seizures, and even death
  • Pre-term birth (delivery before 37 weeks), which is associated with health risks for the baby

PCOS is often seen as a fertility problem, but it’s associated with a variety of other health issues that have a long-term impact on your health. It’s important to seek the support of a healthcare provider to help manage the condition. Talk to your doctor about treatment options, lifestyle changes, and potential risks, including those associated with pregnancy.

References

  • 1. Centers for Disease Control and Prevention. PCOS and Diabetes. Accessed January 7, 2020.
  • 2. Franks, Stephen. Polycystic Ovarian Syndrome: Not Just a Fertility Issue. Women’s Health. July 1, 2015. Accessed January 15, 2020.
  • 3. Johns Hopkins Medicine. Polycystic Ovary Syndrome (PCOS). Accessed January 7, 2020.
  • 4. National Institute of Child Health and Human Development. Does PCOS Affect Pregnancy? Accessed January 15, 2020.
  • 5. National Institute of Child Health and Human Development. What Causes PCOS? Accessed January 9, 2020.
  • 6. PCOS Awareness Association. Overview. Accessed January 7, 2020.
  • 7. PCOS Awareness Association. Treatment. Accessed January 7, 2020.
  • 8. U.S. Department of Health & Human Services. Office On Women’s Health. Polycystic ovary syndrome. Accessed January 7, 2020.
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