Polycystic Ovary Syndrome – Causes, Symptoms, Diagnosis, & Treatment
What is polycystic ovary syndrome?
Polycystic ovary syndrome (PCOS) is a hormonal disorder that causes ovaries enlargement with small cysts on outer edges of the ovaries. This condition affects a woman’s hormone levels, periods, and ovulation. This may lead to frequent, irregular, or prolonged menstrual cycles, excessive male hormone levels, and trouble getting pregnant. This condition also causes abnormal hair growth and acne.
What causes polycystic ovary syndrome?
PCOS is linked to changes in hormone levels that make it harder for the ovaries to release fully-grown (mature) eggs. The reasons for these changes are unclear.
The following hormones are affected:
- Estrogen and progesterone, the female hormones that help a woman’s ovaries release eggs
- Androgen, a male hormone that is found in small amounts in women
Normally, one or more eggs are released during a woman’s cycle. This is known as ovulation. In most cases, this release of eggs occurs about 2 weeks after the start of a menstrual period.
In PCOS, mature eggs are not released. Instead, they stay in the ovaries with a small amount of fluid around them. There can be many of these. However, not all women with the condition will have ovaries with this appearance.
These problems with the release of eggs can contribute to infertility. The other symptoms of this disorder occur due to the hormone imbalance.
Mostly, PCOS is diagnosed in women in their 20s or 30s. However, it may also affect teenage girls. Women with this disorder often have a mother or sister who has similar symptoms.
What are the symptoms of polycystic ovary syndrome?
The symptoms often begin when a woman’s periods start. Symptoms of PCOS include changes in the menstrual cycle, such as:
- Not getting a period after you have had one or more normal ones during puberty (secondary amenorrhea)
- Irregular periods that may come and go, and be very light to very heavy
The following are the other symptoms of PCOS:
- Extra body hair that grows on the chest, belly, face, and around the nipples
- Acne on the face, chest, or back
- Skin changes, such as dark or thick skin markings and creases around the armpits, groin, neck, and breasts
The development of male characteristics is not typical of PCOS and may indicate another problem. The following changes may indicate another problem apart from PCOS:
- Thinning hair on the head at the temples, called male pattern baldness
- Enlargement of the clitoris
- Deepening of the voice
- Decrease in breast size
How is polycystic ovary syndrome diagnosed?
Your doctor will perform a physical exam including a pelvic exam and review symptoms and medical history. The pelvic exam may show:
- Swollen ovaries
- Swollen clitoris (very rare)
The following health conditions are common in women with PCOS:
- High blood pressure
- High cholesterol
- Weight gain and obesity
The following blood tests may be done to check hormone levels:
- Estrogen level
- FSH level
- LH level
- Male hormone (testosterone) level
The following other blood tests may also be done:
- Fasting glucose (blood sugar) and other tests for glucose intolerance and insulin resistance
- Lipid level
- Pregnancy test (serum HCG)
- Prolactin level
- Thyroid function tests
Your doctor may also order the following imaging test or procedure to look at your ovaries:
- Vaginal ultrasound
- Pelvic laparoscopy
How is polycystic ovary syndrome treated?
Weight gain and obesity are common in women with PCOS. Losing weight, even a small amount of weight can help treat the hormone changes and health conditions such as diabetes, high blood pressure, or high cholesterol.
Your doctor may recommend birth control pills to make your periods more regular. These medicines may also help reduce abnormal hair growth and acne after you take them for several months.
A diabetes medicine called Glucophage (metformin) may also be recommended to:
- Make your periods regular
- Prevent type 2 diabetes
- Help you lose weight
Other medicines that may be prescribed to help make your periods regular and help you get pregnant are:
- LH-releasing hormone (LHRH) analogs
- Clomiphene citrate, which helps your ovaries grow and release eggs
Your doctor or nurse may also suggest following treatments for abnormal hair growth:
- Spironolactone or flutamide pills
- Eflornithine cream
Permanent hair removal options include electrolysis and laser hair removal.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.