Polycystic ovarian syndrome, also known as Stein-Leventhal Syndrome, is among the most common endocrine (hormone) problems women face. In fact, according to the Office on Women’s Health of the U.S. Department of Health and Human Services, the condition affects as many as five million girls and women, and can impact their health for life. Yet very few people know much about it.
What Is Polycystic Ovarian Syndrome?
Polycystic ovarian syndrome, commonly known as PCOS, is a health condition that’s caused by an imbalance in a woman’s hormone system. It can affect her appearance, menstrual cycle, and fertility, as well as her cardiac health. It’s also associated with diabetes and other conditions.
It’s not entirely clear why some women develop PCOS, but genetics may play a role. It’s caused by an excess of androgens, which are male hormones that both men and women have naturally in their bodies. When an imbalance of androgens occurs in women, it can have affects throughout the body, especially on the reproductive system.
If a woman’s ovaries (reproductive organs) don’t produce the right balance of hormones, her eggs won’t fully mature. Instead, several eggs may partially develop. In this case, ovulation, the regular (usually monthly) release of one, or occasionally two, mature eggs, won’t occur. Without ovulation, your menstrual period is irregular, and eggs can’t travel to the uterus to be fertilized—and therefore you can’t get pregnant. PCOS is the most common cause of female infertility, according to the Centers for Disease Control and Prevention.
What Are the Symptoms of PCOS?
They vary from woman to woman, but these symptoms are very common:
- Infertility.
- Irregular or absent menstrual periods.
- Increased hair growth on the face, back, chest, and toes.
- Thinning hair or male pattern baldness.
- Acne or oily skin.
- Dandruff.
- Weight gain or obesity.
How Is it Diagnosed?
There is no single test used to diagnose PCOS. Your physical exam and medical history, combined with various tests, will help your physician make a diagnosis. According to WomensHealth.gov, your doctor may perform blood tests to identify any imbalances in androgen hormones, and to measure blood sugar levels, which can indicate insulin resistance or diabetes (not uncommon among women with PCOS). A pelvic ultrasound may be used to visualize cysts on the ovaries and the endometrium (lining of the uterus), which may be thickened as a result of irregular or absent periods.
If you do have PCOS, your treatment plan will depend on whether or not you have any accompanying health complications, like diabetes.
What Other Complications Are Associated With PCOS?
When PCOS is treated with appropriate medications, medical treatments, diet, and exercise, many women remain healthy and can even become pregnant if so desired. Without treatment, however, the hormone imbalance can affect many different areas of the body, including the metabolic and cardiac (heart and blood vessel) systems. Damage to these systems can result in insulin resistance and can lead to diabetes. A woman with PCOS may also develop high blood pressure, damage to her blood vessels, and heart disease.
What if You Become Pregnant?
Women with PCOS are at higher risk for certain complications of pregnancy including miscarriage, gestational diabetes (diabetes during pregnancy), preeclampsia (high blood pressure during pregnancy), and premature delivery. PCOS patients should be monitored closely during pregnancy, and may require extra medical care.
The obesity that often accompanies PCOS is one of the major contributors to the development of more advanced disease. "The thing that’s hard about PCOS is that so many women become overweight; the overlap between obesity-related insulin resistance and PCOS is huge," says Amanda Calhoun, MD, an ob-gyn with Kaiser Permanente in Richmond, California. However, "The great part about insulin resistance, which is so common with obese patients with PCOS, is this: Losing just five to 15 percent of your body weight is associated with significant increase in fertility. If you take that weight off and decrease the fatty cells, you can often manage the rest of your health well."
What Other Treatments Are Available?
There is no cure for PCOS, but there are many treatment options out there. In addition to diet, exercise, and weight management recommendations, PCOS patients may be prescribed birth control pills to regulate hormones and menstrual cycles. They may also need medication to manage insulin resistance, diabetes, heart disease, or hypertension (high blood pressure) and, if they want to become pregnant, they may need fertility treatments.
PCOS patients may also need medical treatment to help with acne and excess hair growth, and some women opt for bariatric or gastric surgery to help with weight loss. Other surgical options may increase chances for ovulation and fertility for patients who don’t respond to fertility treatments.
Women who suspect they may have PCOS should see a gynecologist ASAP. While their condition may influence their health for life, much of their wellbeing rests with appropriate medical care and in making healthy lifestyle choices.
Amanda Calhoun, MD, reviewed this article.
Sources
Amanda Calhoun, MD. Ob-Gyn, Kaiser Permanente, Richmond, CA.
"Infertility FAQs." Centers for Disease Control and Prevention. Page last updated June 20, 2013.
"What is PCOS?" PCOS Foundation. Page accessed February 10, 2015.
"Polycystic Ovarian Syndrome (PCOS) Fact Sheet." Women’s Health.gov/Office on Women’s Health, U.S. Department of Health and Human Services. Page last updated December 23, 2014.
"Understanding Ovulation." American Pregnancy Association. Page last updated March 2011.
