Polycystic Ovaries (PCOS)

pcosSWhat is polycystic ovarian syndrome (PCOS)?

Polycystic ovarian syndrome (PCOS) is a reproductive endocrine disorder that is often associated with irregular menstrual cycles and infertility.  PCOS is characterized by enlarged ovaries that contain several small cysts, elevated testosterone levels, and irregular periods.  PCOS is one of the most common disorders associated with infertility.

How do you diagnosis polycystic ovarian syndrome (PCOS)?

In 2003, the Rotterdam criteria was established for the diagnosis of PCOS.  Women must meet at least 2 of the 3 criteria for diagnosis:

1)     Polycystic ovaries – At least one ovary measuring greater than 10 cc’s or at least 12 follicles noted on one ovary, usually by pelvic ultrasound.

2)     Elevated androgen levels – Blood work that shows elevated testosterone or androgen levels or clinical signs of this such as: excessive hair growth, moderate to severe acne, and thinning hair.

3)     Irregular menstrual cycles – Women who do not have regular periods or do not ovulate monthly, which is often the reason for infertility.

 Other disorders that mimic signs and symptoms of polycystic ovarian syndrome (PCOS), must also be ruled out.  Your physician will need to obtain a detailed medical history and physical examination, as well as a pelvic ultrasound and laboratory studies in order to determine if you have PCOS.

What is the cause of polycystic ovarian syndrome (PCOS)?

Unfortunately, the exact cause of PCOS is currently unknown.  Much research is currently ongoing to better understand this disorder.  Many believe that there is a strong genetic component to PCOS.  Other factors include: excess insulin, obesity, inflammation, and congenital abnormalities.

How common is PCOS?

  • 5 – 10% of women between the ages of 12 – 45 exhibit symptoms of PCOS.
  • 5 – 7 million women in the U.S. alone suffer from PCOS and many others go undiagnosed.

Is PCOS associated with infertility?

Because a majority of women with polycystic ovarian syndrome (PCOS) have irregular periods and do not ovulate regularly, they do have a much more difficult time getting pregnant. If you have been diagnosed with PCOS or think that you may have this disorder and are attempting to get pregnant, you should seek advice from an infertility specialist.

What are the symptoms of PCOS?

Patients may present with varying symptoms of PCOS.  Here are some of the common symptoms of PCOS:

  • Menstrual abnormalities (most common symptom)
    • Irregular periods
    • No periods
    • Prolonged periods
  • Elevated testosterone levels
    • Excess hair growth (known as hirsutism)
    • Acne
    • Male pattern balding or hair loss
  • Obesity
  • Diabetes or insulin resistance
  • Infertility
  • Polycystic ovaries on ultrasound

Does PCOS need to be treated?

Early diagnosis of polycystic ovarian syndrome (PCOS) and monitoring can help to reduce long term complications such as diabetes, high blood pressure, and heart disease.  Women with PCOS, who struggling with irregular menstrual periods or infertility, may require treatment from their doctor.  Often patients who make lifestyle changes such as healthy dieting, weight loss and exercise can help prevent some of the long term risks associated with PCOS.

How is PCOS treated?

There are different methods for treating PCOS, which depend directly on whether or not you are trying to get pregnant.

Treatment for infertility in PCOS:

  • Medications to induce ovulation (Clomid, Femara, Ovidrel, or HCG injection)
  • Metformin may be used to help you ovulate more regularly
  • Surgical intervention such as ovarian drilling

Treatment for regulation of menstrual cycles:

  • Birth control pills
  • Progesterone only medications
  • Metformin

Treatment of acne and excessive hair growth in PCOS:

  • Birth control pills
  • Spirinolactone (Aldactone)
  • Danazol
  • Surgical intervention such as ovarian drilling
  • Laser hair removal

In order to determine what treatment options is appropriate for you, call today to schedule an appointment with a reproductive endocrinologist and infertility specialist.  Our physicians are specialized to specifically treat women struggling with polycystic ovarian syndrome.