One of the most common causes of female infertility, polycystic ovary syndrome affects 1 in 10 women between the ages of 15 and 44. The symptoms often mimic those commonly experienced during adolescence, which causes many women to go undiagnosed until their 20s and 30s when they have difficulty getting pregnant and they consult a physician.
What is Polycystic Ovarian Syndrome?
Polycystic ovary syndrome, also known as polycystic ovarian syndrome (PCOS), is a hormone imbalance affecting the ovaries that is typically marked by higher-than-normal androgen (male hormones such as testosterone) levels.
The ovaries are part of the woman’s reproductive system and are responsible for producing the egg each month that is released as part of a healthy menstrual cycle. In women with PCOS, that egg may develop only sporadically, resulting in irregular menstrual periods. PCOS has been linked to other health problems such as diabetes, high blood pressure, unhealthy cholesterol, sleep apnea, depression, anxiety and endometrial (uterine) cancer. However, research has not been able to determine if these conditions cause PCOS, if PCOS causes them, or if there a common link that causes both PCOS and these other health conditions.
What Causes PCOS?
The cause of PCOS is unknown, but genetics and sometimes body weight are believed to play a role. Women whose mother or sister has had PCOS or type 2 diabetes are more likely to develop PCOS. Women who have been diagnosed with PCOS often display high levels of androgens, and they may have insulin resistance as well. Insulin resistance leads to the development of diabetes.
Common Symptoms of PCOS
As previously mentioned, the symptoms of PCOS are similar to those that commonly occur during female adolescence and puberty: irregular periods, acne, and facial hair growth. Often times the signs and symptoms develop around the time of the first menstrual period, but can vary based on the individual.
Common symptoms of polycystic ovarian syndrome include:
- Irregular periods: The most common symptom of PCOS is menstrual irregularity, which can mean infrequent, irregular or prolonged menstrual cycles. Some women with PCOS may stop having a period altogether.
- Acne on the face, chest and upper back
- Unwanted hair growth: An estimated 70% of women with PCOS also have a condition called hirsutism, which refers to excessive body hair on the face, chin, chest or other parts of the body where typically only men have hair.
- Hair loss or thinning hair on the scalp, similar to male-pattern baldness, may occur in older women with PCOS
- Weight gain or difficulty losing weight
- Skin darkening most commonly underneath breasts, in the groin and along the neck creases
- Skin tags, or small excess flaps of skin, typically in the armpits or neck area
- Higher than normal levels of androgens as indicated by blood testing
- Multiple small (5-7 mm in diameter) cysts present on one or both ovaries
Diagnosis and Treatment
Diagnosis is based on your medical history, blood testing, and sometimes pelvic ultrasound. To rule out other conditions, your doctor will assess your symptoms, personal and family medical history, and conduct a physical exam which may include a pelvic exam, pelvic ultrasound (sonogram), and/or blood tests.
High cholesterol, diabetes, and other hormone-related conditions such as thyroid disease can be mistaken for PCOS. If other conditions have been ruled out and you have two or more of the symptoms listed above, you may have PCOS.
At this time, there is no cure for PCOS. However, your doctor can work with you to develop a personalized treatment plan to help manage your symptoms.
Your treatment plan may include one or a combination of the following:
- Lifestyle changes such as diet and exercise may help improve your condition, increase the effectiveness of other treatment methods, and help with infertility.
- Combination birth control pills with estrogen and progestin may help decrease androgen production and regulate estrogen. In some cases, this can also be achieved with a birth control skin patch or a vaginal ring instead of a pill.
- Progestin therapy can help regulate your period and help protect against endometrial cancer, however, unlike combination birth control methods, taking progestin may not reduce your androgen levels or prevent pregnancy.
- Hair removal through the use of medication, topical cream, laser hair removal or electrolysis
- Ovulation stimulation
- Family planning counseling
When to Seek Help
If you are experiencing irregular periods or any of the other symptoms above, call (919) 960-2720 to schedule an appointment with Chapel Hill Gynecology. Dr. Karen Clark has extensive experience in treating women with polycystic ovary syndrome (PCOS) and the hormonal imbalances that it causes, and can help create a treatment plan tailored to your specific needs.