Understanding polycystic ovary syndrome

Last Modified: 9/15/2022


According to the Centers for Disease Control and Prevention (CDC), polycystic ovary syndrome is a common condition related to abnormal hormone levels in the body. It affects as many as 5 million women in the United States. Joshua Leichty, DO, PPG – OB/GYN, helps answer our questions about this lifelong disorder and the steps patients can take to manage the condition.

What is polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a combination of menstrual irregularity, polycystic ovaries, and elevated testosterone in a woman’s body resulting in acne or male-pattern body hair.

What causes PCOS?

The exact cause of PCOS is unknown, however, there is evidence that PCOS occurs due to an abnormal amount of hormones that decrease the ovary’s ability to ovulate, causing outward signs of elevated testosterone levels.

What are the signs and symptoms of PCOS?

The most common signs and symptoms of PCOS include:

  • Severe acne
  • Irregular periods or menstrual bleeding
  • Excess hair growth (male-pattern body hair)
  • Obesity (a BMI greater than 30)
  • Insulin resistance
How is PCOS diagnosed?

Providers can diagnose PCOS in several ways, but the Rotterdam Criteria is the most common. To make a PCOS diagnosis, women must have or experience at least two of these three symptoms:

  • Menstrual irregularity
  • Elevated testosterone levels
  • Polycystic ovaries (present on ultrasound)
How is PCOS treated?

PCOS is treated differently depending on a patient’s specific goals. If women desire pregnancy, they may need help having a menstrual period and begin medications to help them ovulate. There is a strong association between PCOS and elevated BMI, so weight loss is one of the best ways to treat PCOS, regardless of a patient’s goals. Lastly, if women do not desire pregnancy, oral birth control pills are beneficial to control menstrual periods and protect the uterus from endometrial cancer.

Are there any complications associated with PCOS?

Unfortunately, yes. Complications arising from PCOS are mostly associations we’ve found with this syndrome. But, PCOS does increase a woman’s risk of various diseases like obesity, insulin resistance (including type 2 diabetes), high cholesterol, coronary heart disease, sleep apnea, depression and anxiety. PCOS can also cause infertility, which, for many women, is the initial reason they seek care. We have also found a connection between women who do not ovulate over a long period and an elevated risk of abnormal cell growth in the uterus, such as endometrial hyperplasia or endometrial cancer. These are all demonstrated complications and risks that make it crucial for women to seek care when they are concerned or suspect PCOS.   

Is PCOS a manageable condition?

Yes! Two of the most beneficial things a patient living with PCOS can do to manage their condition are to improve their diet and increase their exercise. All of our evidence about PCOS indicates that these lifestyle modifications and interventions are much more effective than minimal treatment for improving insulin resistance and elevated testosterone. In fact, losing just 5-10% of total body weight can help restore regular menstrual cycles and improve infertility.

When should someone seek medical intervention?

If you have regular menstrual cycles but then experience sudden irregularity for 6-12 months, it would be a good idea to speak to a provider. If you were diagnosed with PCOS and are trying to become pregnant without good results, it might be beneficial to seek medical intervention. Your provider can prescribe medications used to assist with ovulation if necessary.

And as previously mentioned, PCOS is not only associated with gynecologic complications but also puts women living with the condition at risk for increased insulin resistance, high cholesterol and obesity. So, if you have concerns about PCOS or other symptoms you may be experiencing, please speak with your OB/GYN or primary care provider to schedule an appointment to discuss possible preventative measures and complications.

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