What exactly is PCOS?

"What is polycystic ovary syndrome (PCOS)? Polycystic (pah-lee-SIS-tik) ovary syndrome (PCOS) is a health problem that can affect a woman's:..."

• Menstrual cycle
• Ability to have children
• Hormones
• Heart
• Blood vessels
• Appearance

With PCOS, women typically have:

• High levels of androgens (AN-druh-junz). These are sometimes called male hormones, though females also make them.
• Missed or irregular periods (monthly bleeding)
• Many small cysts (sists) (fluid-filled sacs) in their ovaries

What are the symptoms of PCOS?

The symptoms of PCOS can vary from woman to woman. Some of the symptoms of PCOS include:

• Infertility (not able to get pregnant) because of not ovulating. In fact, PCOS is the most common cause of female infertility.
• Infrequent, absent, and/or irregular menstrual periods
• Hirsutism (HER-suh-tiz-um) — increased hair growth on the face, chest, stomach, back, thumbs, or toes
• Cysts on the ovaries
• Acne, oily skin, or dandruff
• Weight gain or obesity, usually with extra weight around the waist
• Male-pattern baldness or thinning hair
• Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black
• Skin tags — excess flaps of skin in the armpits or neck area
• Pelvic pain
• Anxiety or depression
• Sleep apnea — when breathing stops for short periods of time while asleep

Diabetes medications. The medicine metformin (Glucophage) is used to treat type 2 diabetes. It has also been found to help with PCOS symptoms, though it isn’t approved by the U.S Food and Drug Administration (FDA) for this use. Metformin affects the way insulin controls blood glucose (sugar) and lowers testosterone production. It slows the growth of abnormal hair and, after a few months of use, may help ovulation to return. Recent research has shown metformin to have other positive effects, such as decreased body mass and improved cholesterol levels. Metformin will not cause a person to become diabetic.
Fertility medications. Lack of ovulation is usually the reason for fertility problems in women with PCOS. Several medications that stimulate ovulation can help women with PCOS become pregnant. Even so, other reasons for infertility in both the woman and man should be ruled out before fertility medications are used. Also, some fertility medications increase the risk for multiple births (twins, triplets). Treatment options include:

• Clomiphene (KLOHM-uh-feen) (Clomid, Serophene) — the first choice therapy to stimulate ovulation for most patients.
• Metformin taken with clomiphene — may be tried if clomiphene alone fails. The combination may help women with PCOS ovulate on lower doses of medication.
• Gonadotropins (goe-NAD-oh-troe-pins) — given as shots, but are more expensive and raise the risk of multiple births compared to clomiphene.

Another option is in vitro fertilization (IVF). IVF offers the best chance of becoming pregnant in any given cycle. It also gives doctors better control over the chance of multiple births. But, IVF is very costly.

How does PCOS affect a woman while pregnant?

Women with PCOS appear to have higher rates of:

• Miscarriage
• Gestational diabetes
• Pregnancy-induced high blood pressure (preeclampsia)
• Premature delivery

Does PCOS put women at risk for other health problems?

Women with PCOS have greater chances of developing several serious health conditions, including life-threatening diseases. Recent studies found that:

• More than 50 percent of women with PCOS will have diabetes or pre-diabetes (impaired glucose tolerance) before the age of 40.
• The risk of heart attack is 4 to 7 times higher in women with PCOS than women of the same age without PCOS.
• Women with PCOS are at greater risk of having high blood pressure.
• Women with PCOS have high levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol.
• Women with PCOS can develop sleep apnea. This is when breathing stops for short periods of time during sleep.

Women with PCOS may also develop anxiety and depression. It is important to talk to your doctor about treatment for these mental health conditions.
Women with PCOS are also at risk for endometrial cancer. Irregular menstrual periods and the lack of ovulation cause women to produce the hormone estrogen, but not the hormone progesterone. Progesterone causes the endometrium (lining of the womb) to shed each month as a menstrual period. Without progesterone, the endometrium becomes thick, which can cause heavy or irregular bleeding. Over time, this can lead to endometrial hyperplasia, when the lining grows too much, and cancer.