What is PCOS?

Polycystic ovarian syndrome, or PCOS, is a condition characterized by irregular periods, evidence of excess hormones, and enlargement of the ovaries on ultrasound with multiple small fluid-filled sacs or follicles.

PCOS is more common in obese women and is one of the most common causes of female infertility. First and foremost, though, it is a diagnosis of exclusion. Meaning, if you have any of these three issues, your doctor should first rule out other causes of these symptoms.

What does it all mean?

First, think of a normal menstrual cycle. Your ovary produces an egg, which is released at ovulation, and if a week later that egg hasn’t been fertilized, your body starts all over by having a period. In PCOS, the ovary is making all of the correct hormones, but not making them in the proper way or amount to cause ovulation. Instead, the ovary becomes filled with lots of tiny eggs, that only compounds the problem by making even more unorganized hormones. No ovulation, means no regular periods. Extra hormones can mean acne after puberty, patches of thick dark skin, or extra hair growth on the face, chin, chest or abdomen.

Why do we care?

Not only due to the issues above, such as infertility and hair growth, PCOS is related to other long term health concerns. PCOS is closely linked to insulin resistance, a condition in which the body is unable to properly process sugar in the blood. This increases the risk of type 2 diabetes and cardiovascular disease. We also see an increased risk of metabolic syndrome, which includes abnormalities in the blood pressure, cholesterol, triglycerides, glucose, and waist circumference. Irregular periods, especially skipping periods, can also put you at risk for an overgrowth of the lining of the uterus, a precursor for cancer, called hyperplasia.

Can it be treated?

There are treatments available, including medications to improve the symptoms, regulate menses, improve insulin response, and increase fertility. Obese patients will also see improvement in symptoms with weight loss.

 

Blog post by Lindsey M. Turner, M.D., FACOG

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