You Wanted to Know: Polycystic Ovary Syndrome

PCOS

Excess body hair, bad skin and extra weight – these are a few bothersome symptoms of polycystic ovary syndrome (PCOS), a condition that is very common, though not frequently discussed. PCOS affects an estimated 5 to 12% of all premenopausal women and is one of the most common metabolic disorders. It causes a variety of distressing symptoms and contributes to obesity, insulin resistance and even infertility.

@LgrayLisa asked me about her recent PCOS diagnosis on Twitter:

PCOS2

The cause of PCOS is not well understood, but the majority of its symptoms are caused by hormone imbalances. Women with PCOS have an excess of androgens (“male” hormones like testosterone) that can cause unwanted hair growth on the face and body (for example, on the chin, upper lip, cheeks, around the nipples and on the belly), thinning hair on the head and acne.

Women with PCOS also tend to have irregular or absent ovulation and excess unopposed estrogen in the body. This can cause irregular and/or heavy menstrual bleeding and contribute to infertility. Excess estrogen may also raise the risk of endometrial cancer over the long run.

Diagnosing PCOS can be tricky because there isn’t one simple test for it. If you or your doctor are concerned that your symptoms may be due to PCOS, your doctor may want to test your blood sugar and insulin levels, as well as several hormone levels. Some women with PCOS have a particular pattern of cysts on their ovaries that can be seen on ultrasound (which is what gives the condition its name), but ultrasound alone is not enough to make the diagnosis.

About half of women with PCOS are obese and most have some degree of insulin resistance, which raises the risk for type 2 diabetes. Weight loss may help decrease testosterone, regulate ovulation and improve infertility and insulin resistance in women with PCOS. Certain medications that regulate insulin levels may also lower the risk of diabetes and make ovulation more regular, helping women who are experiencing trouble with fertility. Though it may take longer to conceive or require assistance with medications that promote ovulation, most women with PCOS are still able to get pregnant.

For women who are not looking to have a baby, birth control pills are one of the mainstays of therapy for PCOS. Birth control pills may help control irregular bleeding, reduce unwanted hair and lower the risk of endometrial cancer.