Polycystic Ovarian Syndrome (PCOS)

PCOS affects a wide variety of females. Some common characteristics of it include acne, excessive hair growth, multiple benign ovarian follicles on ultrasound, irregular periods (specifically infrequent periods or longer-lasting ones), and being overweight or obese. However, not all of these characteristics may be present in every woman with the diagnosis. The “formal” diagnosis is made if at least 2 of them are present. Some other common medical problems that may be present include having a history of gestational diabetes, nonalcoholic fatty liver disease, or a family history of diabetes.

If PCOS is left untreated, it can increase your risk for developing infertility or more serious medical problems such as metabolic syndrome, type 2 (or adult-onset) diabetes, and heart disease. More about metabolic syndrome in a minute**. Some other complications can be diabetes or high blood pressure during pregnancy, miscarriage, nonalcoholic fatty liver disease, and sleep apnea.

Unfortunately, we don’t know what causes PCOS. However, some possible causes include obesity, family history, or insulin resistance. Insulin resistance is when your body doesn’t use insulin like it should, so your blood sugar increases.

While there’s no specific test for PCOS, there are several things that make the diagnosis more likely. These include any of the symptoms that are mentioned above. There are some blood tests that we do to make sure there are no other hormone abnormalities present. We also check your blood sugar and cholesterol levels.  An ultrasound may show enlarged ovaries or several ovarian follicles, although this is not required to make the diagnosis.

The best treatment is with lifestyle changes that help you get healthier and lose weight if needed. Even a small amount of weight loss can regulate your periods and cause you to ovulate. Taking birth control pills can also regulate your menstrual cycle and help with the acne and hair growth. Other medications that might be useful include Metformin, which is also a medicine that we use for diabetes. However, this medicine might also cause you to start ovulating regularly, which increases your risk of getting pregnant. Because of this, if you don’t want to become pregnant, it’s important to also use a type of birth control.

If you are trying to get pregnant, making lifestyle changes is even more important. They can not only increase your chances of ovulating, but can make you healthier for when you do become pregnant. For medication, Metformin is a good choice to start with, and it’s safe to be taking if you do become pregnant. You don’t need to see a specialist right away unless you still don’t become pregnant after a few months.

It’s important to remember that all medications have side effects, so if you can improve things on your own, just by changing your lifestyle, it’s much healthier for you in the long run.

**Metabolic syndrome is a broad diagnosis which consists of several components. Not all of these are needed to make the diagnosis, but the “technical” definition is made if at least 3 of the following are present:
large waist circumference, elevated triglycerides (fatty acids), low HDL (good) cholesterol, increased blood pressure, and increased fasting blood sugar

The reason it’s important to know if you have actual metabolic syndrome is because it can increase your risk for developing type 2 (adult onset) diabetes or heart disease.