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. 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.

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.

No single test can show that you have PCOS. To diagnose PCOS, the doctor will:

• Ask questions about your past health, symptoms, and menstrual cycles.
• Do a physical exam to look for signs of PCOS, such as extra body hair and high blood pressure. This may include a pelvic exam. The doctor will also check your height and weight to see if you have a healthy body mass index (BMI).
• Do a number of lab tests to check your blood sugar, insulin, and other hormone levels. Hormone tests can help rule out thyroid or other gland problems that could cause similar symptoms.

You may also have a pelvic ultrasound to look for cysts on your ovaries. Your doctor may be able to tell you that you have PCOS without an ultrasound, but this test will help rule out other problems. Your doctor may do other tests to check for problems caused by PCOS.

Weight loss may help improve ovulation in people with PCOS who are overweight. The medicines clomiphene and letrozole can also be used to help with ovulation. If that doesn't work, other medicines may help. If weight loss and medicines don’t work, surgery or IVF may sometimes be an option.

• 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.