Polycystic ovary syndrome (PCOS) is a hormone imbalance that can affect ovulation. It can cause problems with your periods and make it hard to get pregnant. PCOS may also cause other symptoms, such as weight gain, acne, or hair growth on the face or body. If it isn't treated, over time it can lead to serious health problems, such as diabetes and heart disease.
Most of those who have PCOS grow many small cysts on their ovaries. That's why it's called polycystic ovary syndrome.
In polycystic ovary syndrome, cysts may form on the ovaries. A cyst is a sac-shaped structure in the body. Cysts usually are filled with fluid.
PCOS is caused by hormones that are out of balance. What causes the imbalance isn't fully understood. But genetics may be a factor. PCOS seems to run in families. Your chance of having it is higher if others in your family have PCOS or have diabetes.
Symptoms of PCOS usually start gradually. They may include acne and oily skin, weight gain and trouble losing weight, extra hair on the face and body, thinning hair on the scalp, irregular periods, problems getting pregnant, and depression. PCOS may be more noticeable after a weight gain.
To diagnose PCOS, the doctor will ask questions about your symptoms and menstrual cycles. The doctor will also do a physical exam. You'll have some lab tests to check your blood sugar, insulin, and other hormone levels. You may also have an ultrasound to look for cysts on your ovaries.
Regular exercise, healthy foods, and weight control are the key treatments for PCOS. Your doctor may prescribe birth control pills to reduce symptoms and help regulate your periods, or fertility medicines for problems getting pregnant. Treatment can reduce symptoms and help prevent long-term health problems.
Symptoms of PCOS tend to start gradually. You may have only a few symptoms or a lot of them. Symptoms may include:
Hormone changes that lead to PCOS often start in the early teens, after the first menstrual period. Symptoms may be more noticeable after a weight gain.
When you have PCOS, your hormones are imbalanced. That can trigger other changes. You may stop ovulating. You may get acne and grow extra facial and body hair, and your chance of getting diabetes may increase. But there are treatments. Treatment can improve symptoms and help prevent serious health problems.
PCOS can affect your reproductive system and how your body handles blood sugar. It can also affect your heart.
Reproductive problems may include:
PCOS can also cause problems with blood sugar. Insulin is a hormone that helps your body's cells get the sugar they need for energy. Sometimes these cells don't fully respond to insulin, which can lead to diabetes.
High insulin levels from PCOS can lead to heart and blood vessel problems. These problems may include:
Polycystic ovary syndrome (PCOS) causes a wide range of symptoms, so it may be hard to know when to see your doctor. But early diagnosis and treatment will help prevent serious health problems, such as diabetes and heart disease. See your doctor if you have symptoms that suggest PCOS.
Call your doctor now or seek immediate medical care if:
Call your doctor if you have:
Taking a wait-and-see approach (called watchful waiting) is not a good choice if you may have PCOS. Early diagnosis and treatment may help prevent future problems.
No single test can show that you have PCOS. To diagnose PCOS, the doctor will:
You may also have a pelvic ultrasound to look for cysts on your ovaries. Your doctor may be able to tell you that you have PCOS without an ultrasound, but this test will help rule out other problems. Your doctor may do other tests to check for problems caused by PCOS.
Regular exercise, healthy foods, and weight control are the key treatments for PCOS. Treatment can reduce unpleasant symptoms and help prevent long-term health problems.
Your doctor may prescribe birth control pills to reduce symptoms and help regulate your menstrual cycles, or fertility medicines for problems getting pregnant.
It's important to see your doctor for follow-up to make sure that treatment is working.
Home treatment can help you manage the symptoms of PCOS and live a healthy life.
A diet that includes lots of fruits, vegetables, whole grains, and low-fat dairy products supplies your body's nutritional needs, satisfies your hunger, and decreases your cravings. And a healthy diet makes you feel better and have more energy.
You may see a registered dietitian who has special knowledge about diabetes.
Choose fitness activities that are right for you to help boost your motivation. Walking is one of the best activities. Having a walking or exercise partner that you can count on can also be a great way to stay active.
This is the weight at which you feel good about yourself, have energy for work and play, and can manage your PCOS symptoms.
If you need to lose weight, doing so will lower your risks for diabetes, high blood pressure (hypertension), and high cholesterol.footnote 1
A modest weight loss can improve high androgen and high insulin levels and infertility. Weight loss of as little as 5% to 7% over 6 months can reduce androgen levels enough to restore ovulation and fertility in more than 75% of women who have PCOS.footnote 2
Losing weight can be hard, but you can do it. The easiest way to start is by cutting calories and becoming more active.
Women who smoke have higher levels of androgens than women who don't smoke.footnote 3 Smoking also increases the risk for heart disease.
Acne treatment may include nonprescription or prescription medicines that you put on your skin (topical) or take by mouth (oral). You may notice an improvement in your acne after using estrogen-progestin hormone pills.
Excess hair growth (hirsutism) slows when high androgen levels decrease. In the meantime, you can remove or treat unwanted hair with:
Hair removal methods differ in cost and long-term effectiveness. Before trying one, ask your doctor about risks of infection and scarring.
As part of treatment for PCOS, medicines can be used to help control reproductive hormone or insulin levels. These medicines can include:
People who have PCOS and are overweight can try to lose weight. Even a modest weight loss may help improve ovulation. If weight loss doesn't help, then medicines may help.
If weight loss and medicines don't work, surgery or IVF may sometimes be an option. A surgery that may be done is ovarian drilling. This involves partly destroying an ovary. It can help with ovulation.
- Fritz MA, Speroff L (2011). Chronic anovulation and the polycystic ovary syndrome. Clinical Gynecologic Endocrinology and Infertility, 8th ed., pp. 495–531. Lippincott Williams and Wilkins.
- Huang I, et al. (2007). Endocrine disorders. In JS Berek, ed., Berek and Novak's Gynecology, 14th ed., pp. 1069–1135. Philadelphia: Lippincott Williams and Wilkins.
- Keefe K, Pal L (2014). Polycystic ovary syndrome. In EG Nabel et al., eds., Scientific American Medicine, chap. 66. Hamilton, ON: BC Decker. https://www.deckerip.com/decker/scientific-american-medicine/chapter/66. Accessed date April 13, 2017.
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