What’s Polycystic Ovarian Syndrome?
Last updated on March 6th, 2023 at 08:59 am
5 minutes read.
Polycystic ovary syndrome (PCOS), is a hormonal disorder in females of reproductive age that results in irregular menstruation or menstruation that lasts more days than normal. Also, it causes too much production of male hormones called androgen in your body.
Treatment for PCOS depends on if you wish to become pregnant. People with PCOS may be at higher risk for certain health conditions, like diabetes and high blood pressure. (1, 2)
In this article:
What’s PCOS?
What’s Polycystic Ovarian syndrome?
Polycystic ovary syndrome (PCOS) is a common condition that affects your hormones. It causes irregular menstrual periods, excess hair growth, acne, and infertility
If you have PCOS, many small sacs of fluid called cysts develop along the outer edge of the ovary. The small fluid-filled cysts contain immature eggs. These are called follicles. The follicles fail to regularly release eggs.
PCOS will cause your ovaries to produce unusually high levels of hormones called androgens. This causes your reproductive hormones to become imbalanced.
As a result, people with PCOS often have irregular menstrual cycles, missed periods, and unpredictable ovulation.
Small follicle cysts (fluid-filled sacs with immature eggs) may be visible on your ovaries on ultrasound due to lack of ovulation (anovulation). (1, 2, 3)
However, despite the name “polycystic,” you don’t need to have cysts on your ovaries to have PCOS. The ovarian cysts aren’t dangerous or painful.
PCOS is one of the most common causes of infertility in women and people assigned female at birth (AFAB). It can also increase your risk of other health conditions.
Your healthcare provider can treat PCOS based on your symptoms and if you wish to become pregnant. (4)
The exact cause of PCOS is unknown. However, early diagnosis and treatment along with weight loss may lower the risk of long-term complications such as type 2 diabetes and heart disease. (5)
Symptoms
Symptoms of PCOS often start around the time of the first menstrual period. Sometimes symptoms develop later after you have had periods for a while.
The symptoms of PCOS vary. A diagnosis of PCOS is made when you have at least two of these:
Irregular periods: Having few menstrual periods or having periods that aren’t regular are common signs of PCOS.
So is having periods that last for many days or longer than is typical for a period. For example, you might have fewer than nine periods a year. And those periods may occur more than 35 days apart. (6)
Infertility: PCOS is the most common cause of infertility in people with AFAB. Not ovulating regularly or frequently can result in not being able to conceive. (7, 8 )
Abnormal hair growth: You may grow excess facial hair or experience heavy hair growth on your arms, chest, and abdomen (hirsutism). This affects up to 70% of people with PCOS. (9)
Acne: PCOS can cause acne, especially on your back, chest, and face. This acne may continue past your teenage years and may be difficult to treat. (10)
Obesity: Between 40% and 80% of people with PCOS have obesity and have trouble maintaining a weight that’s healthy for them. (11)
PCOS signs and symptoms are typically more severe in people with obesity.
Darkening of the skin: You may get patches of dark skin, especially in the folds of your neck, armpits, groin (between the legs), and under your breasts. This is known as acanthosis nigricans. (10)
Cysts: Many people with PCOS have ovaries that appear larger or with many follicles (egg sac cysts) on ultrasound. (12, 13)
Skin tags: Skin tags are little flaps of extra skin. They’re often found in your armpits or on your neck. (14)
Thinning hair: People with PCOS may lose patches of hair on their head or start to bald. (15)
Is it possible for one to have PCOS but not have any symptoms?
Yes, it’s possible to have PCOS and not have any symptoms. Many people don’t even realize they have the condition until they have trouble getting pregnant or are gaining weight for unknown reasons.
It’s also possible to have mild PCOS, where the symptoms aren’t severe enough for you to notice.
Many women have PCOS but don’t know it. In one study, up to 70 percent of women with PCOS hadn’t been diagnosed. (5)
Is Polycystic Ovarian Syndrome the same as Ovarian Cyst?
No, they’re not really the same health issue although symptoms may be similar.
Ovarian cysts may be harmless and will disappear naturally on their own after a few months, without the need for medical attention.
The most significant difference between the two conditions is that PCOS results in a substantial hormonal imbalance, which is not generally the case with ovarian cysts. It is also possible for women to have multiple ovarian cysts without suffering from PCOS.
These symptoms of ovarian cysts are very similar to those found in women with polycystic ovarian syndrome, such as irregular or non-existent periods, acne, and weight gain.
Causes
Studies show that the exact cause of PCOS isn’t known. However, factors that might play a role include:
Insulin resistance. Insulin is a hormone that the pancreas makes. It allows cells to use sugar, your body’s primary energy supply.
If cells become resistant to the action of insulin, then blood sugar levels can go up. This can cause your body to make more insulin to try to bring down the blood sugar level.
Too much insulin might cause your body to make too much of the male hormone androgen. You could have trouble with ovulation, the process where eggs are released from the ovary.
One sign of insulin resistance is dark, velvety patches of skin on the lower part of the neck, armpits, groin, or under the breasts. A bigger appetite and weight gain may be other signs. (16)
Low-grade inflammation: White blood cells make substances in response to infection or injury. This response is called low-grade inflammation.
Research shows that people with PCOS have a type of long-term, low-grade inflammation that leads polycystic ovaries to produce androgens. This can lead to heart and blood vessel problems. (17)
Heredity: Research suggests that certain genes might be linked to PCOS. Having a family history of PCOS may play a role in developing the condition. (18, 19 )
Excess androgen: With PCOS, the ovaries may produce high levels of androgen. Having too much androgen interferes with ovulation.
This means that eggs don’t develop on a regular basis and aren’t released from the follicles where they develop. Excess androgen also can result in hirsutism and acne. (20)
Can PCOS cause a miscarriage?
This may be one of the complications you may experience. (21)
Having PCOS may increase your risk for certain pregnancy complications, although most women and people AFAB with PCOS are able to successfully carry a pregnancy. (22, 23)
Other complications of PCOS related to pregnancy include increased risk of:
- Preterm birth (birth before 37 weeks of pregnancy) or C-section delivery due to obesity, diabetes, or high blood pressure.
Treatment
How is polycystic ovary syndrome treated?
Your healthcare provider will determine treatment based on your symptoms, medical history, and other health conditions, and if you want to get pregnant. Treatments can include medications, lifestyle changes, or a combination of both.
If you want to become pregnant now or in the future, treatment for PCOS includes:
Drugs to induce ovulation (releasing an egg): A successful pregnancy begins with ovulation. Certain drugs have been proven to induce ovulation in people with PCOS.
The medications clomiphene and letrozole: are taken orally, while gonadotropins are given by injection. (31, 32, 33)
Surgery: A surgical procedure can help restore ovulation by removing tissue in your ovaries that produces androgen hormones. With newer medications available, surgeons rarely perform this procedure. (34, 35)
In vitro fertilization (IVF): This is an option for people with PCOS when medication doesn’t help with ovulation. Your provider fertilizes your egg with your partner’s sperm in a lab before transferring it to your uterus. (36, 37 )
If you don’t plan to become pregnant, treatments include:
Hormonal birth control: Options include birth control pills, patches, shots, a vaginal ring, or an intrauterine device (IUD). Hormonal birth control helps to regulate your menstrual cycle, some forms will also improve acne and help with excess hair growth. (38)
Insulin-sensitizing medicine: Metformin is a drug used to treat diabetes. It works by helping your body process insulin. Once insulin is under control, some people with PCOS see improvements in their menstrual cycles. (39, 40 )
Medications to block androgens: Some medications can block the effect of androgens. This helps control acne or hair growth. Talk to your healthcare provider about whether such treatment is right for you.
Natural Remedy
Natural ways to manage and treat PCOS
Diet and lifestyle tips are effective to treat early PCOS.
The treatment for PCOS usually starts with lifestyle changes like weight loss, diet, and exercise.
Losing just 5 to 10 percent of your body weight can help regulate your menstrual cycle and improve PCOS symptoms (41, 42)
Weight loss can also:
- improve cholesterol levels
- lower insulin
- reduce heart disease and diabetes risks
Any diet that helps you lose weight can help your condition. However, some diets may have advantages over others.
Studies comparing diets for PCOS have found that low carbohydrate diets are effective for both weight loss and lowering insulin levels.
A low glycemic index (low GI) diet that gets most carbohydrates from fruits, vegetables, and whole grains helps regulate the menstrual cycle better than a regular weight loss diet (43)
A few studies have found that 30 minutes of moderate-intensity exercise at least 3 days a week can help women with PCOS lose weight. Losing weight with exercise also improves ovulation and insulin levels (44).
Exercise is even more beneficial when combined with a healthy diet. Diet plus exercise helps you lose more weight than either intervention alone, and it lowers your risks for diabetes and heart disease. (45)
There is some evidence that acupuncture can help with improving PCOS, but more research is needed. (46)
When to see a doctor
See your doctor if:
- You’ve missed periods, and you’re not pregnant.
- You have symptoms of PCOS, such as hair growth on your face and body.
- You’ve been trying to get pregnant for more than 12 months but haven’t been successful.
- You have symptoms of diabetes, such as excessive thirst or hunger, blurred vision, or unexplained weight loss.
If your periods are already irregular or absent and you’re trying to get pregnant, do not wait 12 months to see a specialist to be evaluated (47).
Also, keep in mind that if you do not wish to get pregnant, irregular or absent periods are not the birth control in themselves.
It may still be possible to get pregnant even under these conditions. It’s best to use contraception in this case even if you have PCOS.
Also, keep in mind that if you do not wish to get pregnant, irregular or absent periods are not the birth control in themselves.
It may still be possible to get pregnant even under these conditions. It’s best to use contraception in this case even if you have PCOS.
If you have PCOS, plan regular visits with your primary care doctor. You’ll need regular tests to check for diabetes, high blood pressure, and other possible complications.
Conclusion
Polycystic ovary syndrome (PCOS) is a common condition that affects your hormones. It causes irregular menstrual periods, excess hair growth, acne, and infertility
Symptoms include irregular periods, infertility, abnormal hair growth, acne, obesity, darkening of the skin, cysts, skin tags, and thinning hair.
Studies show that the exact cause of PCOS isn’t known. However, factors that might play a role include insulin resistance, low-grade inflammation, heredity, and excess androgen.
The complication may include: Gestational diabetes, preeclampsia, high blood pressure, and Preterm birth
Some medications to induce ovulation may help to treat PCOS. Birth control pills and metformin can both restore more normal menstrual cycles and relieve PCOS. Surgery and IVF can also help if pills prove abortive. However, making some lifestyle change is the first natural step to treating PCOS.
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