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What Is Polycystic Ovary Syndrome?
Polycystic ovary syndrome (PCOS) is a common reproductive hormone problem where a hormonal imbalance affects the ovaries’ ability to make and release eggs during the menstrual cycle.
PCOS can cause abnormal development of an egg or improper release of an egg during ovulation. It may result in irregular periods, infertility, and developing ovarian follicles (fluid-filled sacs that form on or inside the ovaries).
How common is polycystic ovary syndrome?
The Centers for Disease Control and Prevention (CDC) estimates PCOS affects up to five million people.
PCOS most commonly affects those aged 15 to 44. The onset of PCOS varies from person to person, but it occurs most often in the early teenage years after your first period.
But PCOS also may appear later in life. Doctors often diagnose PCOS in people having difficulty getting pregnant in their 20s and 30s.
What causes polycystic ovary syndrome?
Polycystic ovary syndrome does not have a known cause. It may be the result of several factors, including:
- Genetics. PCOS often is found in mothers, daughters, and female siblings.
- High levels of androgens, which prevent ovulation and can cause extra hair growth, male-pattern baldness, or acne. Androgens are also referred to as male hormones, even though all females make small amounts of androgens.
- High levels of insulin, a hormone that controls how the food that you consume becomes energy. People with PCOS often experience insulin resistance in which the body does not respond normally to insulin and the level of insulin in the blood becomes higher than normal.
- Low-grade inflammation may stimulate androgen production and lead to PCOS.
What are polycystic ovary syndrome risk factors?
Polycystic ovary syndrome affects people of all races and ethnicities. Your risk of PCOS may be higher if you are obese or have a mother, sister, or aunt with PCOS.
PCOS has been linked to other health problems. Doctors aren't sure if PCOS causes these health problems, if these health problems cause PCOS, or if both are caused by other conditions.
These health problems may include:
- Depression and anxiety.
- Diabetes — Diabetes or prediabetes affects more than half of people with PCOS.
- Endometrial cancer (cancer in the lining of the uterus) — Occurs more frequently in people with PCOS because they may experience problems with ovulation, obesity, insulin resistance, and diabetes.
- High blood pressure — The leading cause of heart attack and stroke.
- Sleep apnea (momentary and repeated stops in breathing while sleeping) — Many people with PCOS are overweight or obese, which can cause sleep apnea and increase your risk of heart attack and diabetes.
- Unhealthy cholesterol level — People with PCOS tend to have higher levels of LDL (bad cholesterol) and low levels of HDL (good cholesterol). High LDL cholesterol levels can lead to heart attack and stroke.
Complications of PCOS
If left untreated, PCOS symptoms can lead to serious medical issues, such as heart disease, obesity, diabetes, and infertility.
The risk of PCOS-related health problems, like heart attack, stroke, and diabetes, increases with age.
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What Are the Signs and Symptoms of Polycystic Ovary Syndrome?
Polycystic ovary syndrome can cause many signs and symptoms, including:
- Acne on the face, chest, and upper back.
- Breathing problems while sleeping, which may be due to insulin resistance and obesity.
- Changes in the hair on your head and body. You may have thinning hair on your scalp or your facial hair may get thicker or darker. You may also notice more hair on your chest, belly, and back.
- Depression and mood swings.
- Enlarged ovaries and fluid-filled sacs around the eggs. This can cause fertility issues such as the failure of the eggs to properly release and miscarriages.
- High blood sugar and insulin resistance, which can lead to the onset of obesity.
- Higher levels of androgens.
- Oily skin.
- Period problems. Irregular periods are the most common PCOS symptom. They can include abnormally short or long cycles, heavy bleeding, or skipping periods for several months.
- Skin tags or the darkening of skin along neck creases, in the groin, and underneath the breasts.
- Trouble getting pregnant after trying for 12 months. PCOS affects ovulation, and proper ovulation is required for pregnancy to occur.
- Upper body obesity. Too much or too little insulin can cause this symptom of PCOS.
- Weight gain and difficulty losing weight.
The symptoms of PCOS may lessen once you reach perimenopause, which is the process of change leading up to menopause. Some people with PCOS experience more regular menstrual cycles during perimenopause. But others continue to have PCOS symptoms until they reach menopause and stop getting a period.
Can I get pregnant with PCOS?
You can still become pregnant even with polycystic ovary syndrome. Though it's one of the most common causes of female infertility, it's also one of the most easily treated.
However, PCOS also can cause problems during pregnancy such as:
If you have PCOS and are considering getting pregnant, you can reduce your risk of problems during pregnancy with lifestyle choices. You should consider reaching a healthy weight and blood sugar level before getting pregnant and taking folic acid.
When should I see my doctor about my PCOS symptoms?
You should seek treatment if you:
- Bleed more than normal during your period.
- Have irregular vaginal bleeding.
- Have been trying to get pregnant for more than a year.
- Notice abnormal hair growth or changes in hair thickness or color.
- Suffer diabetes symptoms, such as blurred vision, tingling in the hands or feet, or frequent urination.
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How Do You Diagnose Polycystic Ovary Syndrome?
PCOS can be hard to diagnose.
Your doctor will do a complete physical exam to look for signs of PCOS, including extra body hair, acne, hair loss, skin discoloration, and high blood pressure. Measuring your height and weight can help your doctor see if you have a healthy body mass index (BMI).
They'll also do a complete assessment of your PCOS symptoms and medical history to rule out other possible conditions.
Once other conditions have been eliminated, you may be diagnosed with PCOS if you have at least two of the following:
- Irregular periods.
- Extra hair growth, acne, or thinning hair on the scalp (all signs that you may have high levels of androgens).
- Heightened levels of androgens in blood.
- Multiple follicles on one or both ovaries.
Tests to diagnose PCOS
Your doctor will also likely do a series of tests, such as:
- Blood tests — To measure your blood sugar, insulin, cholesterol, and hormones, including estradiol (E2), the most active estrogen in the body. These tests may help rule out other problems that cause symptoms similar to PCOS, such as thyroid disease.
- Pelvic exam or ultrasound — To look and feel for any abnormalities, such as a mass or swollen ovaries.
- Ultrasound — Of your ovaries and uterus, to look for follicles.
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How Do You Treat Polycystic Ovary Syndrome?
There's no cure for PCOS, but there are ways to manage your symptoms.
Lifestyle changes
You doctor may suggest eating a healthy diet, getting more exercise, or losing weight. Losing weight also can help regulate the menstrual cycle and improve your chances of getting pregnant.
Medicine for PCOS
Your doctor may prescribe medicine to help you ovulate, regulate your menstrual cycle, and reduce excessive hair growth.
There are a few medications used to treat PCOS:
- Antiandrogen medications — These medicines block the effect of androgens, helping to reduce facial and body hair growth, scalp hair loss, and acne. These medicines aren't safe if you're pregnant, however, and aren't currently FDA-approved.
- Eflornithine hydrochloride cream — A prescription skin treatment that can help slow the rate of hair growth in unwanted places.
- Hormonal birth control — Can help to make the menstrual cycle more regular, lower your risk of endometrial cancer, improve acne, and reduce extra hair growth.
- Metformin — Used to treat type 2 diabetes, it can help to lower your blood pressure, insulin levels, and androgen levels. It can also help to restart ovulation, improve cholesterol levels, and lower body mass.
Last reviewed by a UPMC medical professional on 2024-09-05.
