The Basics of Polycystic Ovary Syndrome: What You Need to Know

Heather Bartos, M.D., OBGYN

If you’re a woman in your childbearing years, you’ve most likely heard the term polycystic ovary syndrome (PCOS). In fact, it’s common enough that you probably know someone who has PCOS, or maybe you’ve even experienced it yourself. So what exactly is this prevalent syndrome that many women face, and how does it affect the menstrual cycle and fertility? Heather Bartos, M.D., chief of obstetrics and gynecology and physician on the medical staff at Texas Health Frisco, gives us the rundown on polycystic ovary syndrome.

 

What is PCOS?

Our bodies are ruled by hormones, and when these hormones don’t function as they should, problems can arise.

According to the Office on Women’s Health, when a woman’s reproductive hormones are out of balance, the ovaries don’t operate properly. This can lead to issues with the egg being released, which can cause irregular periods. Irregular periods, in turn, can result in fertility complications. PCOS may also cause a woman to develop cysts on her ovaries.

 

What causes PCOS?

Bartos states that we don’t know what exactly causes polycystic ovary syndrome. However, practitioners generally agree that there are three different factors at play.

First – insulin resistance.

“Women with polycystic ovary syndrome are often insulin resistant,” Bartos references the CDC. “Their bodies can make insulin but can’t use it effectively, [therefore] increasing their risk for type 2 diabetes.”

Second – higher levels of male hormones called androgens.

Normally, women make a small number of androgens. But when these levels exceed the normal range for women, it can impact ovary function.

Lastly – your genes.

“Most likely, genetics are at play, too,” Bartos says. Family history appears to be involved in more ways than one.

 

What are the symptoms to look out for?

Bartos mentions that there are several possible symptoms that come with having PCOS.

“Acne, hair growth [on the face and body], or darkening of the skin in body creases and folds such as the back of the neck (acanthosis nigricans) may appear,” Bartos lists from the CDC guidance on PCOS. “Irregular monthly periods, weight gain, and thinning scalp hair [are other common symptoms].”

She says some symptoms may be obvious while others aren’t. Additionally, some women may present with only one symptom, while other women experience the whole range.

 

Who is most at risk for developing PCOS?

The Office on Women’s Health estimates that around 5%-10% of women in their childbearing years (ages 15-44) have PCOS. Oddly enough, the majority of women discover they have PCOS when they are trying to get pregnant but aren’t able to.

Bartos states that the CDC says women of all races and ethnicities can develop PCOS. Being overweight or having family members (like a mom, sister, or aunt) who have PCOS, insulin resistance, or type 2 diabetes increases the risk of developing PCOS.

 

How is PCOS diagnosed?

“There’s no test to definitively diagnose PCOS,” claims Bartos. “Your doctor is likely to start with a discussion of your medical history, including your menstrual periods and weight changes. A physical exam will include checking for signs of excess hair growth, insulin resistance, and acne.”

Essentially, your doctor will be looking for signs of an irregular period, high levels of androgens, and/or cysts on the ovaries. To be diagnosed, two of these three symptoms must be present.

It’s important to note that having ovarian cysts does not always mean a diagnosis of PCOS. The CDC claims many women with polycystic ovary syndrome don’t have cysts and many women without PCOS do have cysts.

 

What are the treatments?

While there is not a cure for polycystic ovary syndrome, the symptoms are manageable, according to the Office on Women’s Health. Losing weight, getting tested for insulin resistance or type 2 diabetes, and certain types of hormonal medications are helpful for controlling the symptoms of PCOS.

“If you’re looking to get pregnant, there are medicines that can assist ovulation [and] reduce acne and hair growth,” Bartos says.

Physical activity for weight loss is a great way to manage PCOS while simultaneously preventing other health issues from arising.

Finally, Bartos adds, “New types of diets show immense promise in the treatment of polycystic ovary syndrome.”

 

Is PCOS preventable?

“PCOS can’t be prevented entirely because most cases are genetically acquired,” notes Bartos, “though the way it’s inherited is poorly understood.”

It’s known that PCOS runs in families, so it definitely has a genetic component. Despite this, certain lifestyle changes may help prevent it. Things like eating healthy and staying active can reduce the risk of developing polycystic ovary syndrome if you have certain genetic predispositions for it.

Lastly, Bartos brings up an interesting perspective for women to consider if they find themselves diagnosed with PCOS.

“I tell patients that it’s a ‘syndrome’, not a ‘disease’, which means you may wax and wane into it throughout your life depending on [many] other factors like weight gain, stress, etc.”

To find an OB/GYN near you, visit TexasHealth.org.

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