Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome

As the leading cause of infertility and the most common hormone disorder among women of childbearing age (15-45) Polycystic Ovary Syndrome (PCOS) affects as many as 7 million women in the United States alone. Named for the presence of small “clusters” of small cysts frequently present on the ovaries, Polycystic Ovary Syndrome is characterized by excess male hormone production, infrequent ovulation, and polycystic ovaries (ovaries with many small fluid-filled cysts that hold eggs yet to be released during ovulation).

Because Polycystic Ovary Syndrome presents an array of physical symptoms that seem unrelated, and may or may not be present in all women with Polycystic Ovary Syndrome, diagnosis is often difficult. Excessive facial and body hair growth, irregular menstrual cycles, cysts on the ovaries are brought about by the excess production of androgens (a.k.a. male hormones). In many patients, the excess production of insulin, a hormone secreted by the pancreas that is involved in the regulation of blood sugar levels, can also bring about some of these symptoms

While the exact causes of Polycystic Ovary Syndrome remain unknown, a specialist in reproductive endocrinology can diagnose Polycystic Ovary Syndrome and help craft a plan that addresses treatment for PCOS.

Symptoms of Polycystic Ovary Syndrome

As Polycystic Ovary Syndrome is associated with a hormone imbalance, there is the potential for a very visible set of symptoms. Because PCOS is a syndrome, however, diagnosis comes from a collection of physical signs and symptoms. As such, it is possible for different women to have different characteristics of Polycystic Ovary Syndrome, and no single test can be used to diagnose this syndrome. If you experience any combination of the following, you should contact a specialist in reproductive endocrinology.

• Irregular menstrual cycles -- Fewer periods than normal or periods marked by heavy or excessive bleeding.
• Infertility -- Polycystic Ovary Syndrome inhibits a woman’s ability to from eggs in a normal way, which may lead to an inability to conceive.
• Unwanted body or facial hair growth -- Because Polycystic Ovary Syndrome involves the excess production of androgens, it can lead to thicker and darker facial hair as well as increased hair growth on other parts of the body.
• Thinning scalp hair -- While other areas of the body may experience additional hair growth, hair on the scalp may become noticeably thinner.
• Weight gain -- Another common symptom of Polycystic Ovary Syndrome is that women gain weight easily while having difficulty taking it back off.
• Changes in skin appearance -- There are also a variety of skin changes that can accompany Polycystic Ovary Syndrome. They can include:
• • Face, chest, and/or back acne
  • The appearance of skin tags concentrated primarily in the armpit and neck area
  • A condition known as acanthosis nigricans, which leads to darkening of the skin in places where skin may fold, such as the neck, groin, and armpits areas

If you exhibit the above symptoms and your doctor diagnoses you with Polycystic Ovary Syndrome (PCOS), the next step is to identify the proper treatment for PCOS.

Treatment for PCOS

Because signs and symptoms vary, so too will treatment for PCOS. There are a number of topical and hormone-related treatment options that can address the physical symptoms of PCOS and help to re-establish a basic homeostasis of hormone levels. Treatment for PCOS may include any number of the following:

• Oral contraceptives -- Birth control pills are hormone-based and, as such, may help to reduce androgen levels. This can reduce problems associated with irregular menstrual periods and with excess male hormone effects, including acne and hair growth.
• Insulin-sensitizing drugs -- While primarily prescribed for diabetes-related symptoms, these types of drugs can lower insulin levels and help to decrease excess male hormone levels. In some instances, they may also be used to support fertility treatments (see below).
• Inducing ovulation (‘fertility drugs’) -- For women who wish to become pregnant, there are a number of drugs and/or techniques that can be used to induce ovulation. For a detailed list, please visit our Polycystic Ovary Syndrome resources page.
• Anti-androgen drugs -- Used as a treatment for PCOS, anti-androgen drugs can be used to treat a variety of different Polycystic Ovary Syndrome symptoms, including excess facial and body hair growth, thinning scalp hair, and acne. They are often prescribed in combination with oral contraceptives. Note: these medications have not been approved by the FDA as a specific treatment for PCOS.
• Topical anti-hair drugs -- Lotions containing an active ingredient eflornithine hydrochloride are sometimes effective in treatment of excess facial hair growth in PCOS as it blocks a follicular hair growth enzyme.
• Additional hair growth treatment options for PCOS -- bleaching, shaving, electrolysis, laser treatment, and the application of certain creams can help to control hair growth. Certain techniques, such as tweezing and waxing, however, are not recommended as they can lead to excessive skin irritation and possibly even damage the skin.
• Scalp hair loss treatment -- While results are usually mixed for this type of treatment for PCOS, topical applications such as minoxidil and/or the use of anti-androgen pills have proven modestly effective in helping to limit thinning scalp hair resulting from Polycystic Ovary Syndrome.
• Nutrition attention -- Because Polycystic Ovary Syndrome affects the way the body handles the food you eat, proper nutrition can play a key role in managing your symptoms. Reproductive endocrinology experts recommend reducing your intake of refined carbohydrates, such as starches and sugars, and replacing them with more complex carbohydrates, such as fruits and vegetables. Carefully tracking the total number of calories you eat and ensuring sufficient protein levels is also advised.
• Physical activity -- In addition to proper nutrition, exercising 30 minutes a day or more has also proven beneficial in treatment for PCOS when addressing weight issues.

Find more information regarding these and other options as treatment for PCOS on our Polycystic Ovary Syndrome page.

Learn More About Polycystic Ovary Syndrome

The Hormone Foundation is the public education affiliate of The Endocrine Society. As such, our main goal is to be a leading informational online resource for those with Polycystic Ovary Syndrome and other hormone-related illnesses.

Editors:

Ricardo Azzizz, MD, MPH, MBA

Onno E. Janssen, MD

March 2008

To learn more about The Hormone Foundation and the offerings we provide, from educational programs and publication resources to strategic partnerships and expert research, please contact us today. And, as always, if you have suggestions for ways we can make this site a more comprehensive resource for this living with Polycystic Ovary Syndrome, please let us know.

Additional Information About the Endocrine System:

Hormone Therapy and Menopause

Diabetes Types

Thyroid Disease Symptoms