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Unraveling PCOS: Understanding This Complex Condition

By Brittany Simon, MD November 14, 2023 Posted in: Women's Health

Unless you have it, you might not know about polycystic ovary syndrome (PCOS). Or you might assume it’s only about irregular periods and infertility.

This lifelong endocrine and metabolic disorder is one of the most common causes of infertility, affecting as many as 5 million (6-12%) women of reproductive age in the US. Managing the condition is important not only for fertility but also because long-term complications include type 2 diabetes, heart disease and endometrial cancer.

Women with PCOS may have irregular periods and difficulty getting pregnant. The ovaries may not function properly and become bigger, with follicles containing immature eggs around the edge of each ovary.

High levels of male hormone androgens like testosterone are often associated with PCOS. Excess androgens in the body can cause excess facial and body hair, severe acne and male-pattern baldness. Insulin resistance is also associated with PCOS and is what leads to type 2 diabetes. 

Researchers do not know the precise cause of PCOS. Factors include androgen levels, excess weight, family history and insulin resistance, but the exact relationships are still being studied. 

PCOS Symptoms

A variety of symptoms spur women to seek diagnosis and treatment. These include: 

  • Irregular monthly periods (heavy, long, intermittent, unpredictable or absent)

  • Infertility (one of the most common causes of female infertility)

  • Weight gain, especially around the belly

  • Acne or oily skin

  • Excess hair growth (face, chest abdomen, upper thighs) 

  • Male-patterned hair thinning or baldness

  • Darkened skin patches (acanthosis nigricans)

PCOS and Weight 

The relationship between weight and PCOS is complicated and not well understood. Not every overweight or obese woman gets PCOS and women of average weight can have PCOS. For those with this condition, losing excess weight can improve symptoms. 

PCOS Treatments

While there is no cure, symptoms can be addressed with treatments and lifestyle changes. For some women, the priority may be infertility, for others it may be severe acne or diabetes. 

Regardless of symptoms, an important step may be getting tested for type 2 diabetes and screening for high cholesterol. Your provider may recommend lifestyle changes which can help you better this condition.

Medicines may be prescribed to help you ovulate, ease periods, reduce acne or address hair growth. In some cases, surgery may be recommended for infertility or women may be referred for in-vitro fertilization (IVF).

Just because a condition is not well known does not mean you should suffer in silence. Ongoing research may offer new hope for women with PCOS. Meanwhile, reach out to your provider who can partner with you to manage symptoms and reduce your risk for long-term complications. 

Brittany Simon, MD
Brittany Simon, MD

Brittany Simon, MD is an OB/GYN with CHI Health.

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