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Polycystic Ovary Syndrome (PCOS)

Polycystic (pol-e-SIS-tik) Ovary Syndrome (PCOS) is a disorder in which the ovaries produce excessive amounts of male hormones and develop many small cysts.

Polycystic ovary syndrome (PCOS)

PCOS is caused by hormonal imbalances that prevent ovulation. Your body produces too much of some hormones and not enough of others. Women who are diagnosed with PCOS usually have low levels of follicle stimulating hormone (FSH), yet have high levels of luteinizing hormone (LH). FSH is the hormone that's responsible for stimulating the growth of follicles in the ovaries that contain maturing eggs. If you lack FSH for a long time, your follicles will not mature and release their eggs, resulting in infertility. Instead, the immature follicles in your ovaries develop into small cysts. 

High levels of LH cause your body to produce too much estrogen and androgens (male hormones) - testosterone and DHEAS (dihydroepiandrosterone sulfate). High levels of estrogen can cause the endometrial tissue in your uterus to get very thick, which can lead to heavy and/or irregular periods. If your androgen levels are high for a long time, you may develop acne and hair on your face. 

Women with PCOS have abnormal insulin metabolism which worsens with annovulation, increases androgens and leads to obesity.

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How PCOS is Diagnosed

Your medical history and a pelvic exam are necessary in diagnosing PCOS. However, other tests are needed to confirm the diagnosis. You may need one or more of the following tests:

  • Blood hormone levels - blood tests that reveal the levels of certain hormones in your blood, such as follicle stimulating hormone (FSH), luteinizing hormone (LH), estrogen (estradiol), and androgens (testosterone and DHEAS)
  • Ultrasound - a scan that uses high frequency sound waves to identify the many small cysts in the ovaries
  • Endometrial biopsy - a procedure in which a sample of your endometrial tissue is examined to help explain why your periods are irregular

  Listen to Dr. Greenhouse with Conceive On-Air discuss PCOS

Frequently Asked Questions: PCOS

Q What are common symptoms of PCOS?

A You may have heavy, irregular periods, or you may stop menstruating entirely. You probably won't be able to tell if you are ovulating until your doctor does a few tests. Other symptoms include acne, excessive hair growth on the face, obesity, and infertility. 

Q What causes PCOS?

A The cause of this disorder is unknown, however, heredity and insulin metabolism play a significant role.

Q Are there treatments for PCOS?

A Your treatment will depend on your specific needs. Obesity may make the condition worse, so losing weight may help improve the hormonal imbalance. If your goal is to become pregnant, then your doctor may prescribe a medication to stimulate ovulation. Other medications such as hormones or insulin metabolism can improve irregular or heavy periods, and other symptoms. Early diagnosis and treatment can reduce the development of acne and facial hair.

Q Are there any long-term risks associated with PCOS?

A Yes. Long-term exposure to high levels of estrogen (and not enough progesterone) can lead to an increased risk of uterine cancer. Treatments such as birth control pills are available to reduce this risk. Women who have PCOS may also be at increased risk for diabetes. Your doctor may want you to have a screening test for diabetes.

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