Polycystic ovary syndrome (PCOS) is one of the most common causes of female infertility in the United States, affecting up to 12% of the population. For approximately five million American women each year, PCOS is a health condition that does more than affect their fertility; it is a lifelong health condition that extends long past the childbearing years.
What is PCOS?
PCOS stands for polycystic ovary syndrome or polycystic ovarian syndrome. It is an imbalance of hormones, which especially affects insulin. PCOS can cause insulin resistance, which can lead to Type 2 Diabetes.
PCOS is also known to affect ovulation to the point where the ovaries may not make the egg they are supposed to release each month as part of your menstrual cycle. This can complicate the process of getting pregnant, among other things.
What Are the Symptoms of PCOS?
The most common symptom of PCOS is difficulty getting pregnant, but the signs of the condition can become apparent beginning just after the first menstrual period, in girls as young as 11 or 12. The manifestations of PCOS symptoms vary by individual. Some women have clear symptoms, and some do not. Your doctor will confirm PCOS if you have at least two of these symptoms:
- Irregular or no periods due to a lack of ovulation
- Darkened skin in the creases of the neck or under the breasts
- Higher male hormones that increase hair growth on the face
- Acne on the chest, face, or upper back
- A thinning head of hair
- Too much hair on the chin or face, or other places where men usually grow hair
- Multiple small ovarian cysts inside the body
- Small excess skin flaps, called skin tags, on the neck or under the arms
There is no clear-cut test for PCOS, and those affected may actually find themselves caught off guard by their diagnosis. Let’s say you visit your dermatologist for acne, darkening of the skin, or hair growth, only to discover that the root cause of these symptoms is PCOS. You may visit a gynecologist for irregular periods and find out PCOS is the underlying cause. Weight gain may prompt a visit to your primary care doctor, and testing shows PCOS is the culprit. Some women have all of these symptoms while others have just one or two.
If you suspect you may have PCOS, your doctor may conduct a few tests to confirm the diagnosis, such as:
- A pelvic exam to feel for masses or growths on the reproductive organs
- An ultrasound to check the thickness of the uterine lining and the appearance of your ovaries
- Blood tests to measure glucose tolerance, because PCOS causes insulin resistance
- Blood tests to measure androgens, because PCOS causes an increase of male hormones
What Health Complications Does PCOS Cause?
PCOS symptoms can be troubling on their own, but the condition has also been linked several other health problems such as:
- Depression and anxiety, although we don’t currently understand the connection between PCOS and these disorders
- Diabetes, which can develop in more than half of the women that have PCOS
- Gestational diabetes, which is diabetes that occurs during pregnancy
- Heart disease, for which the risk grows higher as you age
- High blood pressure that can cause damage your brain, heart, and kidneys
- High LDL, the bad cholesterol that can lead to heart and artery disease
- Sleep apnea, where the body stops breathing during sleep
- Stroke, where plaque causes a blood vessel blockage, blood clots, and other serious illness
Some or even all of these complicating health conditions can occur in a PCOS patient. That makes treating the condition complex and often long-term. Jacksonville Center for Reproductive Medicine not only focuses on fertility issues caused by PCOS, but in maintaining an overall healthy lifestyle to combat the other serious health problems that can emerge later in life due to PCOS.
How Can PCOS be Treated?
While PCOS cannot be cured, it can be treated. Doctors focus on managing symptoms and improving your quality of life while protecting your health. Jacksonville Center for Reproductive Medicine believes in a partnership with patients, and works hard to sit down with patients and find an individualized treatment plan to combat the long-term effects of PCOS.
Specific treatment options vary by individual and the symptoms as they manifest themselves. It can be a complicated process should you experience several symptoms simultaneously.
If you have PCOS, the treatment options could include lifestyle changes. For example, women who are overweight and are diagnosed with PCOS, have a higher overall risk of developing serious health problems. Even weight loss of just 5% can significantly impact PCOS symptoms. Your doctor may recommend exercise programs or a dietician to help you reduce your weight to better manage your health. Some of the lifestyle changes your doctor may suggest could include:
- Maintaining healthy weight
- Limiting carbohydrates
- Increasing daily physical activities
Depending on your symptoms, medication may also help. If you have irregular periods as a result of your PCOS diagnosis, your doctor may recommend the contraceptive pill or progestogen tablets to stabilize your period cycles. Combination birth control pills that contain progestin and estrogen can regulate your body’s estrogen product and decrease androgen. The goal with this treatment is to regulate your hormones and lower the risk of endometrial cancer. This can help with abnormal bleeding and even acne and excess hair growth.
Can I Become Pregnant if I Have PCOS?
While infertility is one potential outcome of having PCOS, most women of reproductive years can still become pregnant. The goal in these cases is to reduce the level of androgens, which are male hormones that interfere with the regular development of eggs.
If a healthy egg isn’t released by the ovaries each month, there is no chance of sperm reaching the egg and fertilization (and ultimately, pregnancy) to occur. The doctor may recommend birth control pills to help jump start the body’s fertility in an on-again-off-again medication cycle. Other medications may help you ovulate, including:
- Clomiphene, also called Clomid, or Serophene is taken at the beginning of your monthly fertility cycle
- Metformin may be prescribed if clomiphene doesn’t work
- A follicle-stimulating hormone (FSH) and a luteinizing hormone
- A medication called Letrozole (Femara)
If medications don’t help you get pregnant, you may be a candidate for In Vitro Fertilization (IVF), a manual process of fertilizing the eggs with sperm in a laboratory setting. Women with PCOS have a 20 to 40% chance of getting pregnant with IVF treatment; however this number declines if you are overweight and over the age of 35.
Jacksonville Center for Reproductive Medicine treats women with PCOS. We are standing by to help find the most effective treatments to improve your health. Please talk with us if you’re worried about the symptoms of PCOS. We can help.