What Is Polycystic Ovary Syndrome?
Polycystic ovary syndrome (PCOS) is a hormonal condition in women in which levels of androgens (male hormones) are elevated, resulting in irregular menstrual periods because monthly ovulation is not occurring.
PCOS occurs in about 5 to 10 percent of women.
What Are Symptoms of Polycystic Ovary Syndrome?
Symptoms of PCOS include:
- Absent, irregular, and/or infrequent menstrual periods
- This can increase a woman’s risk of endometrial overgrowth (called endometrial hyperplasia) or endometrial cancer
- Women with PCOS often have fewer than six to eight menstrual periods per year
- Increased body hair growth
- Male pattern hair growth can often occur on the upper lip, chin, sideburn area, neck, chest, abdomen, upper arms, and inner thighs
- Scalp hair loss
- Weight gain and obesity
- Increased risk of heart disease (in women with PCOS who are obese and who also have insulin resistance or diabetes)
- Sleep apnea
- Women with PCOS are at increased risk for other problems such as:
What Causes Polycystic Ovary Syndrome?
The cause of polycystic ovary syndrome (PCOS) is not completely understood. It is believed that abnormal levels of the pituitary hormone luteinizing hormone (LH) and high levels of male hormones (androgens) interfere with normal ovarian functioning.
Risk factors for developing PCOS include:
- Family history of diabetes
- Being overweight or obese
- Race and ethnicity - African American and Hispanic women are more likely to develop PCOS
How Is Polycystic Ovary Syndrome Diagnosed?
A diagnosis of polycystic ovary syndrome (PCOS) is based on a patient’s symptoms, blood tests, and a physical examination.
A woman must have two out of three of the following criteria to be diagnosed with PCOS:
- Irregular menstrual periods caused by lack of ovulation or irregular ovulation
- Evidence of elevated androgen levels
- Signs such as excess hair growth, acne, or male-pattern balding
- Blood tests that indicate high androgen levels
- Polycystic ovaries on pelvic ultrasound
In addition to the diagnostic criteria, doctors must rule out other causes of elevated androgen levels or irregular periods in order to diagnose PCOS.
Blood tests that may be used to diagnose PCOS include:
What Is the Treatment for Polycystic Ovary Syndrome?
Treatment for polycystic ovary syndrome (PCOS) includes:
- Oral contraceptives with combined estrogen and progestin
- Antiandrogen drugs (such as spironolactone) to decrease the effect of androgens to slow hair growth and reduce acne
- Skin treatments (e.g., medicated lotions) or oral antibiotics for acne
- Progestin to treat menstrual irregularity
- Treatments for excess hair growth
- Laser therapy
- Treatments for scalp hair loss
- Hair replacement and wigs
- Weight loss
- Metformin (Glucophage) improves the effectiveness of insulin produced by the body
- Infertility treatments
- Treatments work best in women with PCOS who are not obese
- Weight loss is the primary treatment
- Clomiphene may be used to trigger ovulation
- Letrozole is used to treat breast cancer, but some studies have shown that live birth rates are higher in obese women with PCOS when treated with letrozole rather than clomiphene
- Gonadotropin therapy (follicle-stimulating hormone [FSH] injections)
When Should You Take a Pregnancy Test If You Have PCOS?
Because women with polycystic ovary syndrome (PCOS) often have irregular menstrual periods, it may be difficult to know when ovulation happens or if pregnancy has occurred. It can also impact fertility, making it more difficult to become pregnant and increasing the chances of miscarriage.
Even in women who have PCOS, pregnancy tests should be taken if a woman suspects she may be pregnant. Early pregnancy symptoms in women with PCOS are similar to those of women without PCOS. Women with PCOS are usually advised not to take pregnancy tests before a missed period and to avoid using “early result” pregnancy tests because false negatives are more likely to occur with those types of tests.
Women who have PCOS and get a positive pregnancy test from an over-the-counter (OTC) test should confirm the result with a blood test from their doctor.