A family member, friend, co-worker, or neighbor: You probably know someone with polycystic ovary syndrome (PCOS). As many as 5 million women in the U.S.—up to 8 percent—have it.
Like the name sounds, PCOS is a disorder that is associated with multiple small cysts on the ovaries. Those cysts can sometimes make ovaries swell to twice their normal size.
But that’s only part of the condition—one of the most common hormonal disorders in women of reproductive age. Other symptoms include irregular menstrual cycles, acne, unwanted facial hair, and weight gain. PCOS is also one of the leading causes of infertility, or trouble getting pregnant.
The disorder stems from a hormone imbalance. All women make small amounts of male hormones, known as androgens, but women with PCOS make even more.
While PCOS has a number of potential complications, it’s a condition that many patients can manage, thanks to medication and lifestyle changes.
What are the symptoms?
Health care providers look for three characteristic features to diagnose PCOS: no ovulation, which will result in irregular or no menstrual periods; high androgen levels, which can result in excess hair on the face or body; and cysts (fluid-filled sacs) on one or both ovaries.
If your medical history suggests that you might have PCOS, your provider will rule out other conditions that may cause similar symptoms.
What causes PCOS?
The exact causes of PCOS aren’t known at this time.
High levels of androgens, or male sex hormones, play an important part. Excess weight and family history—which which play a part in insulin resistance—can also contribute to PCOS. Insulin is a hormone that helps us regulate our blood sugar.
How is it diagnosed?
If you or someone you know has one or more PCOS symptoms, make sure to see a health care provider. Many women with PCOS are never diagnosed.
“They just assume that this is normal,” said Lisa Halvorson, M.D. “I suspect that many with PCOS never receive a diagnosis.”
Dr. Halvorson is the chief of the Gynecological Health and Disease Branch of the Division of Extramural Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, a division of NIH.
To diagnose PCOS, your health care provider may do a physical exam, pelvic exam, blood tests, and an ultrasound.
When is it diagnosed?
Most of the time, PCOS is diagnosed in women in their 20s or 30s. However, it can also affect teenage girls. Symptoms often begin when a girl's period starts.
Women and girls with this disorder often have a mother or sister who has similar symptoms. Researchers are trying to better understand the genetic link.
What are some complications from the disorder?
Many women with PCOS experience trouble getting pregnant since they may not ovulate, or produce eggs. Working with a health care provider, making lifestyle changes, and taking medication can often help patients get pregnant.
Women with PCOS also have an increased risk for sleep apnea, metabolic syndrome, type 2 diabetes, obesity, heart disease and high blood pressure, and endometrial cancer.
How is PCOS treated?
There is currently no cure for PCOS, but there are ways to manage its symptoms.
For women experiencing infertility who may also be overweight, healthy lifestyle changes can help. Those include a low-carbohydrate diet and regular exercise. A low-carb diet usually focuses on protein, like meat, poultry, fish, and eggs, and some non-starchy vegetables.
“The best thing that they can do is lose weight,” said Dr. Halvorson. “If they lose weight—and not necessarily a huge amount, as little as 10 to 20 pounds—they may start ovulating again, will regularize their menstrual cycles, and may get pregnant.”In addition to lifestyle changes, medication can help some PCOS patients.
For infertility, there are oral medicines that encourage ovulation. Providers may also prescribe medicine traditionally used for type 2 diabetes, to help with ovulation and treat the risk of diabetes.
Other medicines include pills and creams to treat excess hair growth, and birth control pills or anti-androgen pills to help to decrease androgen production. An added bonus: Birth control pills also help protect against endometrial cancer.