Health Services

Polycystic Ovary Syndrome (PCOS)

Definition:
Polycystic ovary syndrome (PCOS) is a chronic endocrine (hormonal) disorder in women. It is characterized by:

  • Elevated levels of male hormones (androgens)
  • Irregular menstrual periods
  • Anovulation - a condition in which the ovaries produce few or no eggs. Ovaries normally produce follicles that develop into eggs. In women with PCOS, the ovaries produce the follicles but the eggs do not mature or leave the ovary. The immature follicles can develop into fluid-filled sacs called cysts. Most women with PCOS have cysts, but all women with ovarian cysts do not necessarily have PCOS.

Causes:
The cause of PCOS is unknown, though genes may play a role. Recent evidence suggests the problem is related to elevated levels of insulin. These high insulin levels stimulate excess production of androgens from the ovaries. This prevents ovulation and leads to enlarged, polycystic ovaries.

Risk Factors:

  • Family members with PCOS
  • Age at onset: 15-30

Symptoms:
PCOS symptoms vary and can occur in any combination. Symptoms include:

  • Irregular menstrual periods
  • No menstrual period (amenorrhea)
  • Chronic pelvic pain
  • Infertility
  • Hair growth on face and body
  • Balding
  • Weight gain
  • Obesity
  • Acne
  • Dark patches of skin
  • Skin tags

Women with PCOS are also at increased risk for:

  • Type 2 diabetes, due to insulin resistance
  • Hyperlipidemia (increased fat and cholesterol in the blood)
  • Overgrowth and thickening of uterine lining (a pre-cancerous condition)
  • Endometrial cancer
  • Breast cancer (possibly)
  • High blood pressure
  • Heart disease

Diagnosis:
Your healthcare provider will ask about your symptoms and medical history, including the regularity of your periods and when they first started. The doctor will also perform a physical exam, including a pelvic exam. There is no test to diagnose PCOS. The doctor evaluates a range of test results and symptoms.

Tests may include:

  • Blood Tests - to check hormone, insulin and blood sugar levels
  • Other Tests - to look for related conditions

Treatment
There is no treatment to cure PCOS. Treatment focuses on:

  • Managing symptoms
  • Preventing complications
  • Inducing ovulation if you wish to get pregnant

Treatments include:

  • Medications
  • Drugs that help cells better use insulin may restore ovary function in some cases.
  • Hormonal Therapy
  • Birth control pills help regulate periods and by causing the endometrium (uterine lining) to shed regularly, they reduce the risk of overgrowth or cancer. They also help control abnormal hair growth and acne. Other hormones (called progestins) may also be used to help regulate menstruation; they can be used monthly or intermittently (either every 3 months or per your doctor's instructions). Fertility drugs may be given instead to stimulate ovulation in women who want to become pregnant.
  • Lifestyle Measures: to achieve weight control

To lower cholesterol levels and reduce the risk of type 2 diabetes, high blood pressure and heart disease:

  • Maintain a healthy weight.
  • Eat a low fat diet.
  • Exercise regularly.
  • Get regular screenings for diabetes and high blood cholesterol and fat levels.

Prevention
There are no guidelines for preventing PCOS, because the cause is unknown.

Revised 05/05