Polycystic Ovarian Syndrome (PCOS)

Polycystic ovary syndrome (PCOS), also known as polycystic ovarian syndrome, is a common health problem caused by an imbalance of reproductive hormones. The hormonal imbalance creates problems in the ovaries. The ovaries make the egg that is released each month as part of a healthy menstrual cycle. With PCOS, the egg may not develop as it should or it may not be released during ovulation as it should be.

PCOS can cause missed or irregular menstrual periods. Irregular periods can lead to:

  • Infertility (inability to get pregnant). In fact, PCOS is one of the most common causes of infertility in women.
  • Development of cysts (small fluid-filled sacs) in the ovaries
Who gets PCOS?

Between 5% and 10% of women between 15 and 44, or during the years you can have children, have PCOS.1 Most women find out they have PCOS in their 20s and 30s, when they have problems getting pregnant and see their doctor. But PCOS can happen at any age after puberty.2

Women of all races and ethnicities are at risk of PCOS. Your risk of PCOS may be higher if you have obesity or if you have a mother, sister, or aunt with PCOS.

Symptoms
  • Irregular menstrual cycle
  • Too much hair
  • Acne
  • Thinning hair
  • Weight gain
  • Darkening of skin
  • Skin tags
What Causes PCOS?

The exact cause of PCOS is not known. Most experts think that several factors, including genetics, play a role:

  • High levels of androgens. Androgens are sometimes called "male hormones," although all women make small amounts of androgens. Androgens control the development of male traits, such as male-pattern baldness. Women with PCOS have more androgens than normal. Higher than normal androgen levels in women can prevent the ovaries from releasing an egg (ovulation) during each menstrual cycle, and can cause extra hair growth and acne, two signs of PCOS.
  • High levels of insulin. Insulin is a hormone that controls how the food you eat is changed into energy. Insulin resistance is when the body's cells do not respond normally to insulin. As a result, your insulin blood levels become higher than normal. Many women with PCOS have insulin resistance, especially those who have overweight or obesity, have unhealthy eating habits, do not get enough physical activity, and have a family history of diabetes (usually type 2 diabetes). Over time, insulin resistance can lead to type 2 diabetes.
How is PCOS treated?

There is no cure for PCOS, but you can manage the symptoms of PCOS. You and your doctor will work on a treatment plan based on your symptoms, your plans for having children, and your risk of long-term health problems such as diabetes and heart disease. Many women will need a combination of treatments, including:

  • Steps you can take at home to help relieve your symptoms
    • Losing weight. Healthy eating habits and regular physical activity can help relieve PCOS-related symptoms. Losing weight may help to lower your blood glucose levels, improve the way your body uses insulin, and help your hormones reach normal levels. Even a 10% loss in body weight (for example, a 150-pound woman losing 15 pounds) can help make your menstrual cycle more regular and improve your chances of getting pregnant.3 Learn more about healthy weight.
    • Removing hair. You can try facial hair removal creams, laser hair removal, or electrolysis to remove excess hair. You can find hair removal creams and products at drugstores. Procedures like laser hair removal or electrolysis must be done by a doctor and may not be covered by health insurance.
    • Slowing hair growth. A prescription skin treatment (eflornithine HCl cream) can help slow down the growth rate of new hair in unwanted places.
  • Medicines
    • Hormonal birth control, including the pill, patch, shot, vaginal ring, and hormone intrauterine device (IUD). For women who don't want to get pregnant, hormonal birth control can:
      a) Make your menstrual cycle more regular
      b) Lower your risk of endometrial cancer
      c) Help improve acne and reduce extra hair on the face and body (Ask your doctor about birth control with both estrogen and progesterone.)
    • Anti-androgen medicines. These medicines block the effect of androgens and can help reduce scalp hair loss, facial and body hair growth, and acne. They are not approved by the Food and Drug Administration (FDA) to treat PCOS symptoms. These medicines can also cause problems during pregnancy.
    • Metformin. Metformin is often used to treat type 2 diabetes and may help some women with PCOS symptoms. It is not approved by the FDA to treat PCOS symptoms. Metformin improves insulin's ability to lower your blood sugar and can lower both insulin and androgen levels. After a few months of use, metformin may help restart ovulation, but it usually has little effect on acne and extra hair on the face or body. Recent research shows that metformin may have other positive effects, including lowering body mass and improving cholesterol levels.
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