What is polycystic ovararian syndrome? Causes, symptoms and what to do if you think you have PCOS

An estimated five million women in the US are living with polycystic ovarian syndrome (PCOS). This complex condition can hinder fertility and is associated with metabolic issues leading to diabetes and heart disease.

If you’ve been diagnosed with or suspect you have PCOS, it’s important to know what this means for your health and when it’s important to see a doctor.

What is polycystic ovarian syndrome?

Polycystic ovarian syndrome occurs when your reproductive hormones are out of balance.

“It’s a condition that results in irregular and infrequent ovulation,” said Joseph I. Fernandez, MD, an OBGYN on the medical staff at Baylor Scott & White Clinic – Round Rock. “It usually begins after a woman begins her menstrual cycles or goes through puberty.”

Doctors and researchers aren’t sure exactly what causes this condition, but they suspect that genetic factors play a significant role.

The syndrome is also associated with:

  • Obesity
  • Excess hair growth
  • Acne
  • Infertility

These symptoms are partly a result of the overabundance of male hormones that come with PCOS.

“The name is descriptive of the very small, inactive cysts that are numerous in the ovaries,” Dr. Fernandez said. “They look like strings of pearls.”

Typically, these fluid-filled sacs, called follicles, break open during ovulation, releasing the egg into the fallopian tube. But, in women with PCOS, the sac never matures or breaks, and the follicle remains, preventing ovulation. 

What are the signs or symptoms of PCOS?

To determine if you have PCOS, your doctor will check that you have at least two of the three following symptoms:

  1. Irregular periods or no periods, caused by lack of ovulation
  2. Higher than normal levels of male hormones, resulting in excess hair on the face and body, acne, or a thinning scalp
  3. Multiple small cysts on the ovaries

“Sometimes, these individuals will go months without a menstrual cycle,” Dr. Fernandez said. “That is probably going to be their initial sign.”

Other symptoms could include:

  • Increased hair growth on the lower body, face or chest
  • Oily skin
  • Thinning scalp hair
  • Pelvic pain
  • Sleep apnea

How is PCOS treated?

Because PCOS is most often (but not always) associated with obesity, healthy changes such as losing weight and increasing physical activity can help to decrease symptoms and prevent metabolic issues like diabetes or elevated lipids.

The types of treatment for PCOS may depend on whether or not a woman plans to become pregnant.

“For women who are not ready to achieve pregnancy, oral contraceptives can be used to regulate their cycles,” Dr. Fernandez said. “It’s important for women to have their cycles because when these women don’t ovulate, they are exposed to higher estrogen levels, which can have implications later like an elevated risk for uterine cancer.”

Other hormonal methods like an intrauterine device (IUD) will protect the uterus lining from estrogen exposure.

“For those wanting to get pregnant, many times the treatment requires a change in diet and exercise and the inclusion of an ovulation agent like the medication Clomid,” Dr. Fernandez said.

What should you do if you suspect PCOS?

There’s no single test to determine if you have PCOS. A physical exam, ultrasound and blood tests can help your doctor determine if you have the condition.

Early diagnosis is the best defense against this condition to minimize the effect of male-like hormones on your body. While there are some variations in the diagnosis process, PCOS is often diagnosed based on the patient’s history.

“It’s certainly a condition that should be taken care of because it can cause fertility issues and lead to metabolic, cardiovascular and diabetic issues in the future,” Dr. Fernandez said.

But with healthy lifestyle changes and the right care team on your side, you can live a full life with PCOS and achieve your family goals. If you think you might have PCOS, talk to your OBGYN about next steps.

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What is polycystic ovararian syndrome? Causes, symptoms and what to do if you think you have PCOS