PCOS (Polycystic Ovary Syndrome)

Polycystic Ovary Syndrome

What is polycystic ovary syndrome? — Polycystic ovary syndrome, or "PCOS," is a condition that can cause irregular periods, acne (oily skin and pimples), extra facial hair, or hair loss from the head. The condition can also make it hard to get pregnant. It is very common – about 5 to 8 percent of all women have PCOS. Most, but not all, people with PCOS are overweight or obese.
What causes PCOS? — In PCOS, the ovaries do not work normally and produce too much testosterone. Testosterone is called a "male hormone," but all people have some testosterone. Normally the ovaries produce very small amounts, but in PCOS, they make more.
About once a month, the ovaries are supposed to make a structure called a "follicle" (figure 1). As the follicle grows, it makes hormones. Then, it releases an egg. This is called "ovulation." But in people with PCOS, the ovary makes many small follicles instead of one big one. Hormone levels can get out of balance. And ovulation doesn't happen every month the way it is supposed to. Doctors aren't sure why this happens in some cases.
What are the symptoms of PCOS? — Symptoms can include:
Having fewer than 8 periods a year
Growing thick, dark hair on the upper lip, chin, sideburn area, chest, or belly
Acne (oily skin and pimples on their face)
Hair loss from the head
Trouble getting pregnant without medical help
Weight gain and obesity (although not everyone with PCOS has this problem)
Should I see a doctor or nurse, even if my symptoms are mild? — Yes. PCOS increases your risk of other health problems, including:
Diabetes (high blood sugar)
High cholesterol levels
Sleep apnea, a sleep disorder that causes people to briefly stop breathing while they sleep
Depression or anxiety
Eating disorders, such as binge eating or bulimia
Losing interest in sex
Are there tests I should have? — Your doctor or nurse will decide which tests you should have based on your age, symptoms, and individual situation. Possible tests include:
Blood tests to measure levels of hormones, blood sugar, and cholesterol
A pregnancy test if you have missed any periods
Pelvic ultrasound – This test uses sound waves to make a picture of your uterus and ovaries. Doctors sometimes use this test to help figure out if you have polycystic ovaries.
How is PCOS treated? — The most common treatment is to take birth control pills. But there are other treatments than can help with symptoms, too.
Birth control pills – This is the main treatment for PCOS. The pills don't cure the condition. But they can improve many of its symptoms, like irregular periods, acne, and facial hair. Birth control pills also lower your risk of cancer of the uterus.
Anti-androgens – These medicines block hormones that cause some PCOS symptoms like acne and facial hair growth. Spironolactone (brand name: Aldactone) is the one that many doctors use.
Progestin – This hormone can make your periods regular, but only if you take it regularly. It also lowers the risk of cancer of the uterus. Most doctors use medroxyprogesterone (brand name: Provera) or natural progesterone (brand name: Prometrium).
Metformin (brand name: Glucophage) – This medicine can help make your periods more regular. But it works only in about half of the people who try it. In people with diabetes, this medicine helps to lower blood sugar levels.
Medicated skin lotion or antibiotics to treat acne
Laser therapy or electrolysis to remove extra hair
Is there anything I can do on my own to treat the condition? — Yes. If you are overweight or obese, losing weight can improve many of your symptoms. Losing just 5 percent of your body weight can help a lot. As an example, for a person who weighs 200 pounds, this would mean 10 pounds of weight loss.
What if I want to get pregnant? — Most people with PCOS are able to get pregnant, but it is usually easier for those who are not overweight. If you are overweight, losing weight can help make your periods more regular and improve your chances of getting pregnant. If you lose weight but your periods are still irregular, your doctor can give you medicines to help you ovulate and improve your chances of getting pregnant.
What will my life be like? — It is possible to live a full and normal life with PCOS. But it is important to see a doctor. Treatments will help your symptoms and protect you from other diseases.
It's also important to talk to your doctor or nurse if you feel depressed or anxious, think you might have an eating disorder, or have problems with sex. There are treatments that can help with these problems, too.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
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