Beyond Irregular Periods

The Far-Reaching Effects of Polycystic Ovary Syndrome

Polycystic Ovary Syndrome PCOS is the most common endocrine disorder among women of reproductive age, affecting 5-6 million American women. Despite its prevalence, PCOS is often underdiagnosed and misunderstood, leading to delays in treatment and management. With wide-ranging symptoms that affect some but not all women with the condition, PCOS can be challenging to diagnose.

Women usually discover they have PCOS in their 20s and 30s when they notice rare or irregular menstrual periods, or have trouble getting pregnant and see a doctor, but the earliest signs can appear in some girls around the time of puberty. 

Common symptoms could include:

• Missed periods, irregular periods, very light periods, or very heavy periods

• Ovaries that are large or have many cysts 

• Extra hair growth, most notably on the face, chest, stomach, or thighs

• Weight gain, especially around the abdomen, and/or obesity

• Persistent acne or oily skin

• Elevated blood glucose and signs of elevated glucose, including patches of skin that appear dark and velvety, most often where your skin folds (think armpits and groin)

Diagnosing PCOS typically involves identifying at least two of the following criteria:

• irregular or absent menstrual periods

• signs of high androgen levels (a male sex hormone), such as unwanted facial or body hair and acne, (especially with elevated androgen laboratory results)

• polycystic ovaries visible on an ultrasound

Blood tests may be performed to measure hormone levels, and are important as they enable your care provider to rule out other conditions that might cause similar symptoms before confirming a diagnosis of PCOS and recommending treatment.

While there is no cure for PCOS, various treatments can help manage its symptoms. These include:

Lifestyle changes: Maintaining a healthy weight through diet and exercise can reduce symptoms and help with ovulation and decrease cardiovascular risks.

Medication: Depending upon the underlying cause of your condition, your doctor may recommend one of the following medications:

• Birth control pills: These help to control menstrual cycles, lower androgen levels, and reduce acne. 

• Diabetes medicine: Used to lower insulin resistance in PCOS, diabetes medication may also reduce androgen levels, slow hair growth, and lead to more regular ovulation.

• Anti-androgens: These medicines work by decreasing the amount of androgens produced by ovaries, and can help with acne and excess hair growth.

• Fertility medication: For those seeking to conceive, fertility treatments such as ovulation-inducing medications or in vitro fertilization (IVF) may be considered. 

PCOS is a complex condition. Early diagnosis and tailored treatment plans can significantly improve quality of life and reduce the risk of long-term health complications. If you’re experiencing symptoms of PCOS, consult with your gynecologic provider to confirm a diagnosis and explore the most appropriate treatment options for your needs.

Themarge Small, MD, FACOG, is an obstetrics & gynecology specialist at SVMC.