Polycystic ovary syndrome (PCOS) is a problem with hormones that happens during the reproductive years. If you have PCOS, you may not have periods very often. Or you may have periods that last many days. You may also have too much of a hormone called androgen in your body.
With PCOS, many small sacs of fluid develop along the outer edge of the ovary. These are called cysts. The small fluid-filled cysts contain immature eggs. These are called follicles. The follicles fail to regularly release eggs.
The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may lower the risk of long-term complications such as type 2 diabetes and heart disease.
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:
PCOS signs and symptoms are typically more severe in people with obesity.
See your health care provider if you're worried about your periods, if you're having trouble getting pregnant, or if you have signs of excess androgen. These might include new hair growth on your face and body, acne and male-pattern baldness.
The exact cause of PCOS isn't known. 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.
Complications of PCOS can include:
Obesity commonly occurs with PCOS and can worsen complications of the disorder.
There's no single test to specifically diagnose polycystic ovary syndrome (PCOS). Your health care provider is likely to start with a discussion of your symptoms, medications and any other medical conditions. Your provider also may ask about your menstrual periods and any weight changes. A physical exam includes checking for signs of excess hair growth, insulin resistance and acne.
Your health care provider might then recommend:
If you have a diagnosis of PCOS, your provider might recommend more tests for complications. These tests can include:
PCOS treatment focuses on managing the things that are concerning you. This could include infertility, hirsutism, acne or obesity. Specific treatment might involve lifestyle changes or medication.
Your health care provider may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Even a modest reduction in your weight -- for example, losing 5% of your body weight -- might improve your condition. Losing weight may increase the effectiveness of medications your provider recommends for PCOS, and it can help with infertility. Your health care provider and a registered dietitian can work with you to determine the best weight-loss plan.
To regulate your periods, your health care provider might recommend:
To help you ovulate so that you can become pregnant, your health care provider might recommend:
If needed, talk with your health care provider about procedures that may help you become pregnant. For example, in vitro fertilization may be an option.
To reduce excessive hair growth or improve acne, your health care provider might recommend:
To help ease the effects of PCOS, try to:
For PCOS, you may see a specialist in female reproductive medicine (gynecologist), a specialist in hormone disorders (endocrinologist) or an infertility specialist (reproductive endocrinologist).
Here's some information to help you get ready for your appointment.
Before your appointment, make a list of:
Some basic questions to ask include:
Don't hesitate to ask other questions as they occur to you.
Your health care provider is likely to ask you a number of questions, including:
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