Polycystic Ovary Syndrome, also known as PCOS, is the most common disorder of the endocrine system found in reproductive-aged women. Of these women, 70% present with complaints of acne, hair loss (alopecia), irregular periods, and excessive hair growth of the face, chin, upper lip, lower abdomen or inner thighs. PCOS occurs when an endocrine imbalance results in elevated levels of estrogen, testosterone and luteinizing hormone (LH), causing a decreased secretion of follicle stimulating hormone (FSH). Multiple follicular cysts develop on one or both ovaries (hence the name polycystic ovary) and produce excessive amounts of estrogen.
50-70% of women with PCOS have some varying degree of insulin resistance. This increases the risk for developing type 2 diabetes. Approximately half of women with PCOS are obese. Obesity increases complications related to poorly regulated blood sugar levels, elevated blood pressure, abnormal hormone levels, and irregular periods. Many times women with PCOS will have anovulatory cycles, meaning they do not ovulate every month. More than half of these women are still fertile and will become pregnant within 12 months. It is important to remember if you have PCOS you can still conceive. If you are not wishing to become pregnant, steps to prevent pregnancy should be taken.
Management goals depend on the presenting symptoms. For those women who are not attempting to get pregnant, oral contraception is the first choice for treatment because they inhibit LH and decrease testosterone levels. Both of these actions can reduce the amount of acne and abnormal hair growth. If pregnancy is the goal of treatment, medications to induce ovulation can be used. If you have a history of PCOS and you are wishing to become pregnant, we suggest making an appointment with a provider to discuss a specialized treatment plan to fit your needs. Due to insulin resistance and the increased risk of developing type 2 diabetes, medications such as Metformin may be used to help control blood sugar levels. With better sugar control women with PCOS may notice an improvement in abdominal obesity, acne and irregular hair growth. It is important to remember that maintaining an overall healthy, well balanced diet can improve symptoms and decrease complications related to PCOS. If you believe you may be suffering from PCOS or have any questions related to this topic please make an appointment with a provider.