Polycystic Ovary Syndrome: Symptoms, Causes, and Treatment

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.

The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.

Signs and symptoms of PCOS vary. A diagnosis of PCOS is made when you experience at least two of these signs:

  • Irregular periods. Infrequent, irregular or prolonged menstrual cycles are the most common sign of PCOS. For example, you might have fewer than nine periods a year, more than 35 days between periods and abnormally heavy periods.
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PCOS treatment focuses on managing your individual concerns, such as infertility, hirsutism, acne or obesity. Specific treatment might involve lifestyle changes or medication.

Lifestyle changes

Your doctor may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Even a modest reduction in your weight — for example, losing 5 percent of your body weight — might improve your condition. Losing weight may also increase the effectiveness of medications your doctor recommends for PCOS, and can help with infertility.

Medications

To regulate your menstrual cycle, your doctor might recommend:

  • Combination birth control pills. Pills that contain estrogen and progestin decrease androgen production and regulate estrogen. Regulating your hormones can lower your risk of endometrial cancer and correct abnormal bleeding, excess hair growth and acne. Instead of pills, you might use a skin patch or vaginal ring that contains a combination of estrogen and progestin.
  • Progestin therapy. Taking progestin for 10 to 14 days every one to two months can regulate your periods and protect against endometrial cancer. Progestin therapy doesn’t improve androgen levels and won’t prevent pregnancy. The progestin-only minipill or progestin-containing intrauterine device is a better choice if you also wish to avoid pregnancy.
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  • Excess androgen. Elevated levels of male hormone may result in physical signs, such as excess facial and body hair (hirsutism), and occasionally severe acne and male-pattern baldness.
  • Polycystic ovaries. Your ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function regularly.

Your doctor might recommend:

  • A pelvic exam. The doctor visually and manually inspects your reproductive organs for masses, growths or other abnormalities.
  • Blood tests. Your blood may be analyzed to measure hormone levels. This testing can exclude possible causes of menstrual abnormalities or androgen excess that mimics PCOS. You might have additional blood testing to measure glucose tolerance and fasting cholesterol and triglyceride levels.
  • An ultrasound. Your doctor checks the appearance of your ovaries and the thickness of the lining of your uterus. A wandlike device (transducer) is placed in your vagina (transvaginal ultrasound). The transducer emits sound waves that are translated into images on a computer screen.
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