
What is PCOS?
It is one of the most common causes of female infertility, affecting 6% to 12% (as many as 5 million) of reproductive age women. But it’s a lot more than that. This lifelong health condition continues far beyond the child-bearing years. PCOS is a metabolic disorder that is more severe than PCOD. (poly cystic ovarian disease).
Women with PCOS are often insulin resistant; their bodies can make insulin but can’t use it effectively, increasing their risk for type 2 diabetes. They also have higher levels of androgen’s (male hormones that females also have), which can stop eggs from being released (ovulation) and cause irregular periods, acne, thinning scalp hair, and excess hair growth on the face and body.
Women with PCOS can develop serious health problems, especially if they are overweight:
- Diabetes—more than half of women with PCOS develop type 2 diabetes by age 40
- Gestational diabetes (diabetes when pregnant)—which puts the pregnancy and baby at risk and can lead to type 2 diabetes later in life for both mother and child
- Heart disease—women with PCOS are at higher risk, and risk increases with age
- High blood pressure—which can damage the heart, brain, and kidneys
- High LDL (“bad”) cholesterol and low HDL (“good”) cholesterol—increasing the risk for heart disease
Weight
Does being overweight cause PCOSexternal icon? Does PCOS make you overweight? The relationship is complicated and not well understood. Being overweight is associated with PCOS, but many women of normal weight have PCOS, and many overweight women don’t.
Family History
Women whose mother or sister has PCOS or type 2 diabetes are more likely to develop PCOS.
Insulin Resistance
Lifestyle can have a big impact on insulin resistance, especially if a woman is overweight because of an unhealthy diet and lack of physical activity. Insulin resistance also runs in families. Losing weight will often help improve symptoms no matter what caused the insulin resistance.
Do You Have PCOS?
Sometimes symptoms are clear, and sometimes they’re less obvious. You may visit a dermatologist (skin doctor) for acne, hair growth, or darkening of the skin in body creases and folds such as the back of the neck (acanthosis nigricans), a gynaecologist (doctor who treats medical conditions that affect women and female reproductive organs) for irregular monthly periods, and your family doctor for weight gain, not realizing these symptoms are all part of PCOS. Some women will have just one symptom; others will have them all. Women of every race and ethnicity can have PCOS.
It’s common for women to find out they have PCOS when they have trouble getting pregnant, but it often begins soon after the first menstrual period, as young as age 11 or 12. It can also develop in the 20s or 30s.
To determine if you have PCOS, your doctor will check that you have at least 2 of these 3 symptoms:
- Irregular periods or no periods, caused from lack of ovulation
- Higher than normal levels of male hormones that may result in excess hair on the face and body, acne, or thinning scalp hair
- Multiple small cysts on the ovaries
Just having ovarian cysts isn’t enough for a diagnosis. Lots of women without PCOS have cysts on their ovaries and lots of women with PCOS don’t have cysts.
Treatment
See your health care provider if you have irregular monthly periods, are having trouble getting pregnant, or have excess acne or hair growth. If you’re told you have PCOS, ask about getting tested for type 2 diabetes and how to manage the condition if you have it. Making healthy changes such as losing weight if you’re overweight and increasing physical activity can lower your risk for type 2 diabetes, help you better manage diabetes, and prevent or delay other health problems.
There are also medicines that can help you ovulate, as well as reduce acne and hair growth. Make sure to talk with your health care provider about all your treatment options.
- What are Common signs and symptoms of polycystic ovary syndrome (PCOS)
- Irregular menstrual periods—Menstrual disorders can include absent periods, periods that occur infrequently or too frequently, heavy periods, or unpredictable periods.
- Infertility—PCOS is one of the most common causes of female infertility.
- Obesity—As many as 4 in 5 women with PCOS are obese.
- Excess hair growth on the face, chest, abdomen, or upper thighs—This condition, called hirsutism, affects more than 7 in 10 women with PCOS.
- Severe acne or acne that occurs after adolescence and does not respond to usual treatments
- Oily skin
- Patches of thickened, velvety, darkened skin called acanthosis nigricans
- Multiple small fluid-filled sacs in the ovaries
FAQs
What Causes PCOS?
A: The exact causes aren’t known at this time, but androgen levels that are higher than normal play an important part. Excess weight and family history—which are in turn related to insulin resistance—can also contribute.
Although the cause of PCOS is not known, PCOS may be related to many different factors working together. These factors include insulin resistance, increased levels of hormones called androgens, and an irregular menstrual cycle.
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What is insulin resistance?
A: Insulin resistance is a condition in which the body’s cells do not respond to the effects of insulin. When the body does not respond to insulin, the level of glucose in the blood increases. This may cause more insulin to be produced as the body tries to move glucose into cells. Insulin resistance can lead to diabetes mellitus. It also is associated with acanthosis nigricans.
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What can high levels of androgen's lead to?
A: When higher than normal levels of androgen’s are produced, the ovaries may be prevented from releasing an egg each month (a process called ovulation). High androgen levels also cause the unwanted hair growth and acne seen in many women with PCOS.
What can irregular menstrual periods lead to?
A: Irregular menstrual periods can lead to infertility and, in some women, the development of numerous small fluid-filled sacs in the ovaries.
What are the health risks for women with PCOS?
A: PCOS affects all areas of the body, not just the reproductive system. It increases a woman’s risk of serious conditions that may have lifelong consequences.
Insulin resistance increases the risk of type 2 diabetes and cardiovascular disease. Another condition that is associated with PCOS is metabolic syndrome. This syndrome contributes to both diabetes and heart disease.
Some women with PCOS develop a condition called endometrial hyperplasia in which the lining of the uterus becomes too thick. This condition increases the risk of endometrial cancer.
Women with PCOS also may be at higher risk of sleep disorders, such as sleep apnea. The risk of depression also is higher with PCOS.
Are treatments available for women with PCOS?
A: A variety of treatments are available to address the problems of PCOS. Treatment is tailored to each woman according to symptoms, other health problems, and whether she wants to get pregnant.
How can insulin-sensitizing drugs help treat women with PCOS?
A: Insulin-sensitizing drugs used to treat diabetes frequently are used in the treatment of PCOS. These drugs help the body respond to insulin. In women with PCOS, they can help decrease androgen levels and improve ovulation. Restoring ovulation may help make menstrual periods regular and more predictable.
What effect can weight loss have on women with PCOS?
A: For women who are overweight, weight loss alone may regulate the menstrual cycle. Even a small loss of weight may be helpful in making menstrual periods more regular. Weight loss also has been found to improve cholesterol and insulin levels and relieve symptoms such as excess hair growth and acne.
What can be done to increase the chances of pregnancy for women with PCOS?
A: Successful ovulation is the first step toward pregnancy. For women who are overweight, weight loss may accomplish this goal. Medications also may be used to cause ovulation. Surgery(Laparoscopic cystectomy) has been used when medical management does not work.