Common Conditions
PCOS
Polycystic ovary syndrome, or PCOS, occurs in approximately 7% of the population. Common features include abnormal menses, unwanted facial hair and acne. In severe cases, balding may occur.
Many women with PCOS also have trouble metabolizing sugar efficiently and are prone to problems such as diabetes, high blood pressure and high cholesterol.
Because many women with PCOS do not ovulate on a regular basis, infertility is a common complaint.
To receive the diagnosis of PCOS, a patient must have several key features of the syndrome, and the exclusion of other diagnoses. The current PCOS diagnostic criteria are to have two of the following features:
- Irregular menses or ovulation
- Visible evidence of increased male hormones (facial hair, acne) and/or elevated circulating male hormones.
- Ultrasound showing polycystic ovaries (increased number of egg follicles on the ovary).
Other conditions which can mimic PCOS and must be excluded include: thyroid disease, hyperprolactinemia, congenital adrenal hyperplasia, hypogonadotropic hypogonadism, and ovarian or adrenal tumors. On occasion, Cushings Syndrome and acromegally (excess growth hormone) should be investigated.
Treatment for PCOS can be highly varied and individualized, depending on a patient’s goals and symptoms. For women who desire to get pregnant, ovulation induction with medications such as clomiphene citrate is often effective. Some women will not ovulate even with high doses of clomiphene citrate or other medicines taken by mouth. These women may require injections to induce ovulation.
For women who want to manage long-term complications of PCOS, diet and exercise are essential. Medications such as birth control pills will help reduce the male hormones and to restore normal menses. In some cases medications to improve glucose (sugar) metabolism are helpful. If diabetes and/or hypercholesterolemia are diagnosed during evaluation, close management by a primary care physician or endocrinologist is essential.