Polycystic ovarian syndrome — or PCOS — can cause issues with fertility; treatment depends on the desire to become pregnant.
Polycystic ovarian (or ovary) syndrome is a common hormonal disorder, affecting 5 to 10 percent of women. Symptoms of polycystic ovarian syndrome vary from person to person, but usually include:
- irregular periods;
- problems with weight;
- male pattern hair growth;
- and difficulty achieving pregnancy.
The ovaries may also look like they contain several small cysts, or follicles, on ultrasound. This disorder affects both adolescents and adult women.
How is PCOS diagnosed?
Diagnosis is made based on a combination of patient symptoms, physical exam findings and laboratory tests. There is no one single test used to diagnose. Women usually report infrequent periods and may report coarse hair growth on the face, breasts, abdomen and thighs. Sometimes they are experiencing acne and hair loss from the head as well. Routine laboratory tests are drawn to check for high glucose, cholesterol and male hormones.
A variety of less common disorders can present similarly, so it is routine to obtain laboratory tests, and sometimes a urine collection, to exclude other disorders.
What are the associated risks?
Women with polycystic ovary syndrome are more likely to be overweight, or obese. They are at an increased lifetime risk of developing pre-diabetes, diabetes, high blood pressure and high cholesterol. This elevates the risk of developing heart disease and of having a heart attack.
Women with PCOS typically do not ovulate regularly. This can cause problems with fertility. Over time, this also increases the risk of acquiring pre-cancerous and cancerous changes to the lining of the uterus. A biopsy of the lining of the uterus may be recommended to check for these changes.
What’s included in polycystic ovarian syndrome treatment?
Treatment is determined by whether or not the patient wants to become pregnant. For women who do not, birth control pills are often used to regulate periods and to help with abnormal hair growth and acne. Additional medications or creams may be recommended. If the woman does want to become pregnant, fertility medications may be prescribed. Oral medications, such as Clomiphene citrate, or Letrozole, are often tried first and can help with ovulation.
A medication called Metformin may be prescribed to lower insulin levels. This can also regulate periods over time. Weight loss can also help with ovulation and regulation of periods.
Treatment should be modified according to an individual patient’s needs. Talk with your provider to learn more.
This post was written by Michelle Roach, M.D., who leads the Polycystic Ovarian Syndrome Program at Vanderbilt University Medical Center. This program offers comprehensive, personalized care to help you manage your PCOS symptoms. Our care team also offers health screenings for women with PCOS to reduce your risk of developing other health problems.
Do you think you might have polycystic ovary syndrome? Or are you having difficulty conceiving? Find out more by scheduling an appointment at the Vanderbilt Center for Women’s Health: (615) 343-5700.
Michelle Roach, M.D., is co-director of the PCOS clinic, part of the Women’s Health program at Vanderbilt University Medical Center, and an assistant professor in the Department of Obstetrics and Gynecology. Her clinical interests are in polycystic ovary syndrome, infertility and gynecologic surgery.