Polycystic ovary syndrome (PCOS) is a chronic disorder that involves a hormonal imbalance that causes abnormal functioning of a woman’s ovaries. Women with this disorder have elevated levels of androgens or male hormones. The condition often begins at puberty and worsens as a woman ages.
PCOS affects 6 percent to 15 percent of women in the United States. Among women who are infertile, from 30 percent to 40 percent have this condition.
Women with PCOS experience irregular menstrual periods, or have no period at all. Without a regular menstrual period (every 25 to 35 days), there’s a greater likelihood that no eggs will be released for fertilization.
PCOS is often associated with metabolic syndrome, a term that describes a group of metabolic risk factors that appear in a person. The main features include insulin resistance, high blood pressure and cholesterol abnormalities. Excessive weight or obesity also is common. Any three of the following traits must be present in a woman to meet the criteria for metabolic syndrome:
- Abdominal obesity — waist circumference over 88 cm (35 inches)
- Serum triglycerides (cholesterol) 150 mg/dl or above
- HDL cholesterol 50mg/dl or lower
- Blood pressure of 135/85 or more
- Fasting blood glucose of 110 mg/dl or above
Symptoms of PCOS
In addition to irregular or no menstrual periods, PCOS is often associated with abnormal growth of facial and/or body hair (hirsutism) and excessive acne. Weight gain also is associated with this condition in the majority of cases.
Cause of PCOS
There is no known cause for PCOS. However, women with this condition often have many small cysts on their ovaries, which give the condition its name (polycystic ovary syndrome).
It is believed that genetics (family history) may play a role for some women who have PCOS. The condition is more prevalent among Hispanic women, and also tends to appear in some women who gain a great deal of weight.
Health Risks Associated with PCOS
Women with PCOS are at significantly higher risk for high blood pressure, type 2 diabetes, heart disease, and high lipid (blood fat) levels. Much of this risk can be reversed by weight loss.
If a woman with PCOS does become pregnant, she also faces a high risk of having gestational diabetes.
Diagnosing PCOS
Diagnosing PCOS includes learning about a woman’s menstrual cycle history and testing blood for hormonal levels. An ultrasound test can reveal an abnormal appearance of the ovaries — another indicator of PCOS. The physician also will look for excess hair growth and acne.
Treatment Options
While PCOS can be difficult to treat, a combination of weight loss and medication is often beneficial for many women. The success of medication use often is enhanced by weight loss.
Weight loss through diet and exercise can help many women with PCOS to reduce their symptoms. In some cases, losing just 5 percent of body weight can help a woman return to regular menstrual periods. Weight loss also can help to lower a woman’s risk for other health problems associated with PCOS.
Medication may be prescribed to reduce symptoms or to help a woman become pregnant. The need for medication will vary with each woman and her circumstances. For women who do not wish to become pregnant, birth control pills can help to reduce symptoms. For women who do wish to become pregnant, a fertility pill (clomiphene) can be used to induce ovulation. (During pregnancy, PCOS symptoms generally diminish). A medication called metformin can help to control elevated insulin levels.
Other options exist for women with PCOS who wish to become pregnant, including in vitro fertilization.
PCOS Clinic
For women who experience difficulty with PCOS, Froedtert & the Medical College of Wisconsin offer the PCOS Clinic. A multidisciplinary team of physicians, nurses, dietitians, and other professionals provides medication therapy, personal fitness training, diet consultation, medication and psychological support.
Costs
Costs related to diagnosing metabolic syndrome (often associated with PCOS) may be covered by health insurance.
For More Information
If you are concerned about symptoms that may indicate PCOS, or you are having difficulty becoming pregnant, call 414-805-3666 or 800-272-3666 for information or an appointment.
Glossary
- Anovulation — irregular menstrual periods. A regular period occurs every 25 to 35 days.
- Androgens — hormones that cause the development of male sex characteristics, such as a deep voice, a beard, muscle tone and bone mass.
- Diabetes — a metabolic disease characterized by high blood sugar (glucose) levels. Type 1 diabetes occurs when the body’s immune system destroys the insulin-producing cells of the pancreas. In type 2 diabetes (the most common type), the pancreas can produce insulin, but it is either not enough or the body is unable to use the insulin properly.
- Gestational diabetes — a form of diabetes that appears during pregnancy in a woman who previously did not have diabetes. This usually ends after the baby is born.
- Hirsutism — the presence of hair on the face, breasts, chest, abdomen or inner thighs that is not desired (an abundance of hair).
- Hormones — chemical substances produced in the body that control and regulate the activity of certain cells or organs.
- Insulin — a hormone produced in the pancreas that is released into the blood and travels throughout the body. Insulin helps to regulate metabolism of carbohydrates (sugars and starches), lipids (fats), and proteins. Insulin also is important in regulating cells growth and function.
- Insulin resistant — a condition in which the cells of the body become resistant to the effects of insulin. As a result, higher levels of insulin are needed.
- Metabolic syndrome — a group of metabolic risk factors that appear in a person. The main features include insulin resistance, high blood pressure, cholesterol abnormalities and an increased risk for clotting. Excessive weight or obesity also is common. Any three of the following traits must be present in a woman to meet the criteria for the metabolic syndrome:
- Abdominal obesity: a waist circumference over 88 cm (35 inches)
- Serum triglycerides (cholesterol) 150 mg/dl or above
- HDL cholesterol 50mg/dl or lower
- Blood pressure of 135/85 or more
- Fasting blood glucose of 110 mg/dl or above
- Polycystic ovary syndrome — a condition of women characterized by irregular or no menstrual periods, acne, excess hair growth and obesity. PCOS is a disorder of chronically abnormal ovarian function and abnormally elevated androgen levels.
- Ultrasound — an imaging device that uses high-frequency sound waves. Ultrasound waves are bounced off of tissues, and the echoes are then converted into a picture. Ultrasound allows physicians to view soft tissues and body cavities without using invasive procedures.