What is polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a hormone imbalance that can affect ovulation. It can cause problems with your periods and make it hard to get pregnant.

Doctors don't know for sure what causes PCOS, but it seems to run in families. It also seems to be linked to obesity and a risk for diabetes.

You may have other symptoms. These include weight gain, acne, too much hair on your face or body, high blood pressure, and high blood sugar. Your ovaries may have cysts on them. These cysts are growths filled with fluid.

Keep in mind that even though you may not have regular periods, you can still get pregnant. Talk to your doctor about birth control if you don't want to get pregnant.

With PCOS, you may go for months or longer with no period. Your doctor may recommend medicines that can help get your cycles back to normal.

When you have PCOS, your hormones are imbalanced. That can trigger other changes. You may stop ovulating. You may get acne and grow extra facial and body hair, and your chance of getting diabetes may increase. But there are treatments. Treatment can improve symptoms and help prevent serious health problems.

Symptoms of PCOS tend to start gradually. You may have only a few symptoms or a lot of them. Symptoms may include:

• Acne and oily skin.
• Weight gain and trouble losing weight.
• Extra hair on the face and body. You may get thicker, darker facial hair and more hair on your chest, belly, and back.
• Thinning hair on the scalp.
• Irregular periods. Often those with PCOS have fewer than nine periods a year. Some have no periods. Others have heavy bleeding.
• Fertility problems. You may have trouble getting pregnant.
• Depression.
• Insulin resistance and too much insulin. They can cause things like upper body obesity and skin tags.
• Breathing problems while sleeping (obstructive sleep apnea). This is linked to both obesity and insulin resistance.

Hormone changes that lead to PCOS often start in the early teens, after the first menstrual period. Symptoms may be more noticeable after a weight gain.

Regular exercise, healthy foods, and weight control are the key treatments for PCOS. Your doctor may prescribe birth control pills to reduce symptoms and help regulate your periods, or fertility medicines for problems getting pregnant. Treatment can reduce symptoms and help prevent long-term health problems.

People who have PCOS and are overweight can try to lose weight. Even a modest weight loss may help improve ovulation. If weight loss doesn't help, then medicines may help.

The medicines letrozole, clomiphene, and metformin may be used to help with ovulation in people who have PCOS. If these medicines don't work, gonadotropins may be tried.

If weight loss and medicines don’t work, surgery or IVF may sometimes be an option. A surgery that may be done is ovarian drilling. This involves partly destroying an ovary. It can help with ovulation.

To diagnose PCOS, the doctor will ask questions about your symptoms and menstrual cycles. The doctor will also do a physical exam. You'll have some lab tests to check your blood sugar, insulin, and other hormone levels. You may also have an ultrasound to look for cysts on your ovaries.

As part of treatment for PCOS, medicines can be used to help control reproductive hormone or insulin levels. These medicines can include:

• Combination estrogen and progestin hormones. These are in birth control pills, vaginal rings, and skin patches. These hormones correct irregular or absent menstrual cycles. They may also improve acne problems and reduce unwanted hair growth or loss.
• Progestin. This can help regulate your menstrual period and may help protect against endometrial cancer.
• Androgen-lowering spironolactone. This is often used with estrogen-progestin therapy to reduce acne and unwanted hair growth or loss.
• Metformin. This diabetes medicine is used for controlling insulin, blood sugar levels, and androgen levels.
• Fertility medicines. These include clomiphene and letrozole, and gonadotropin injections (LH and FSH).

• Take your medicines exactly as prescribed. Call your doctor if you think you're having a problem with your medicine.
• Eat a healthy diet. Include vegetables, fruits, beans, and whole grains in your diet each day.
• If you're overweight, talk to your doctor about safe ways to lose weight. Losing weight can help with many of the symptoms of PCOS.
• Get at least 30 minutes of exercise on most days of the week. Walking is a good choice. Or you can run, swim, cycle, or play team sports.
• If you have symptoms that bother you, such as acne and excess hair growth, talk to your doctor about treatment options. Medicines can help. For unwanted hair growth, some prefer to use home treatments. These can include shaving, waxing, or other methods to remove the hair.
• If you're feeling sad or depressed, consider talking to a counselor or to others who have PCOS. It may help.

PCOS is caused by hormones that are out of balance. What causes the imbalance isn't fully understood. But genetics may be a factor. PCOS seems to run in families. Your chance of having it is higher if others in your family have PCOS or have diabetes.

Polycystic ovary syndrome (PCOS) is a hormone imbalance that can affect ovulation. It can cause problems with your periods and make it hard to get pregnant. PCOS may also cause other symptoms, such as weight gain, acne, or hair growth on the face or body. If it isn't treated, over time it can lead to serious health problems, such as diabetes and heart disease.

Most of those who have PCOS grow many small cysts on their ovaries. That's why it's called polycystic ovary syndrome.

PCOS can affect your reproductive system and how your body handles blood sugar. It can also affect your heart.

Reproductive problems may include:

• Infertility. This happens when the ovaries aren't releasing an egg every month.
• Repeat miscarriages.
• Gestational diabetes during pregnancy.
• Increased blood pressure during pregnancy or delivery, having a larger than normal or smaller than normal baby, or having a premature baby.
• Precancer of the uterine lining (endometrial hyperplasia).
• Uterine (endometrial) cancer.

PCOS can also cause problems with blood sugar. Insulin is a hormone that helps your body's cells get the sugar they need for energy. Sometimes these cells don't fully respond to insulin, which can lead to diabetes.

High insulin levels from PCOS can lead to heart and blood vessel problems. These problems may include:

• Hardening of the arteries (atherosclerosis).
• Coronary artery disease and heart attack.
• High blood pressure.
• High cholesterol.
• Stroke.