Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome, or PCOS, occurs in approximately 7 percent of the population. Common symptoms include abnormal menses, unwanted facial hair and acne. In severe cases, balding may occur. Because many women with PCOS do not ovulate on a regular basis, infertility is a common complaint.
Many women with PCOS also have trouble metabolizing sugar efficiently, and are prone to problems such as diabetes, high blood pressure and high cholesterol.
Current PCOS diagnostic criteria
Women with PCOS must have at least two of the following symptoms:
- 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 can mimic PCOS and must be excluded before a conclusive diagnosis can be made. These conditions include thyroid disease, hyperprolactinemia, congenital adrenal hyperplasia, hypogonadotropic hypogonadism, and ovarian or adrenal tumors.
On occasion, Cushing’s syndrome and acromegaly (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 hope to become 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, it is essential to maintain a healthy diet and exercise routine. Birth control pills or other medications may help reduce male hormones and restore normal menses.
In some cases, medications to improve glucose (sugar) metabolism are helpful. If diabetes and/or hypercholesterolemia are diagnosed during evaluation, we strongly recommend close management by a primary care physician or endocrinologist.