Definition

Polycystic ovary syndrome (PCOS) is a chronic endocrine disorder in women. With PCOS, the ovaries make the follicles, but the eggs do not mature or leave the ovary. The immature follicles can turn into fluid-filled sacs called cysts .

  • Ovary and Fallopian Tube

    Ovarian Cyst

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  • Causes

    The cause is not exactly known. Genes may play a role. The problem appears related to insulin resistance that creates high levels of insulin. These high insulin levels cause too much androgen from the ovaries. This prevents ovulation and leads to enlarged, polycystic ovaries. Excess androgen is also associated with:

        
  • Hirsutism —undesired hair growth on face and body
  • Insulin resistance
  • Acne
  • Risk Factors

    Factors that may increase your chances of developing PCOS include:

        
  • Family members with PCOS
  • Irregular menstrual cycles
  • Obesity
  • Sedentary lifestyle
  • Symptoms

    Some women may not have symptoms. In others, they may appear between the ages of 15-30 years. In women who have symptoms, PCOS may cause:

        
  • Infertility
  • Amenorrhea —irregular menstrual periods or no menstrual period
  • Obesity
  • Dark patches of skin on neck, groin, and arm pit
  • Hair loss
  • Women with PCOS are also at increased risk for:

        
  • Type 2 diabetes
  • Hyperlipidemia —increased fat and cholesterol in the blood
  • High blood pressure
  • Metabolic syndrome —a combination of obesity, and elevated blood pressure, blood glucose, and cholesterol, and increased tendency to blood clotting and inflammatory states
  • Heart disease
  • Endometrial hyperplasia—a precancerous condition marked by overgrowth and thickening of uterine lining
  • Endometrial cancer
  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. An ultrasound may be done to look for multiple cysts on the ovaries.

    Urine and blood tests may be done to look for potential causes or check for pregnancy.

    Treatment

    Treatment differs according to whether you want to conceive or not. The goal of treatment is to target the underlying insulin resistance that accompanies PCOS diagnosis.

    Other treatment steps may include:

        
  • Managing symptoms
  • Weight loss if overweight
  • Healthy eating
  • Exercise
  • Medications to improve insulin resistance, glucose intolerance, and prediabetes management
  • Oral contraceptive
  • Inducing ovulation (if you want to get pregnant)     
  • Metformin or clomiphene citrate
  • Advanced reproductive technologies
  • Preventing complications
  • Anti-androgenic medications for blocking future hirsutism (unwanted hair growth)
  • Hormonal Therapy

    Birth control pills regulate periods. Also, by causing the uterine lining to shed regularly, they reduce the risk of overgrowth or cancer. They also control abnormal hair growth and acne by suppressing androgen. Fertility drugs may be given instead to stimulate ovulation in women who want to become pregnant.

    Prevention

    There are no current guidelines to prevent PCOS.