How Much Do You Really Know About Polycystic Ovary Syndrome (PCOS)?
Polycystic ovary syndrome (PCOS) is a medical condition that affects one out of every ten women of childbearing age. Women with PCOS have hormonal imbalances and metabolism issues, which can have an impact on their overall health and appearance. Infertility is also caused by PCOS, which is a common and treatable condition.
What is polycystic ovary syndrome (PCOS)?
PCOS affects between 5% and 10% of women between the ages of 15 and 44, or during the reproductive years.1 Most women discover they have PCOS in their 20s and 30s, when they have difficulty getting pregnant and visit their doctor. However, PCOS can occur at any age after puberty.2
PCOS can affect women of all races and ethnicities. Obesity and having a mother, sister, or aunt with PCOS may increase your risk of developing the condition.
What are the symptoms of PCOS?
Some of the symptoms of PCOS include:
- Irregular menstrual cycle. Women with PCOS may miss periods or have fewer periods (fewer than eight in a year). Or, their periods may come every 21 days or more often. Some women with PCOS stop having menstrual periods.
- Too much hair on the face, chin, or parts of the body where men usually have hair. This is called "hirsutism." Hirsutism affects up to 70% of women with PCOS.
- Acne on the face, chest, and upper back
- Thinning hair or hair loss on the scalp; male-pattern baldness
- Weight gain or difficulty losing weight
- Darkening of skin, particularly along neck creases, in the groin, and underneath breasts
- Skin tags, which are small excess flaps of skin in the armpits or neck area
What causes PCOS?
The precise cause of PCOS is unknown. Most experts believe that a variety of factors, including genetics, are at work:
- High levels of androgens. Androgens are sometimes referred to as "male hormones," despite the fact that all women produce small amounts of androgens. Androgens regulate the development of male characteristics such as male-pattern baldness. Women with PCOS have higher levels of androgens than normal. High androgen levels in women can prevent the ovaries from releasing an egg (ovulation) during each menstrual cycle, as well as cause extra hair growth and acne, both of which are symptoms of PCOS.
- High levels of insulin. Insulin is a hormone that regulates how food is converted into energy. Insulin resistance occurs when the cells of the body do not respond normally to insulin. As a result, your insulin blood levels rise above normal. Many women with PCOS have insulin resistance, especially those who are overweight or obesity, have unhealthy eating habits, do not get enough physical activity, and have a family history of diabetes (usually type 2 diabetes). Over time, insulin resistance can lead to type 2 diabetes.
Can I still get pregnant if I have PCOS?
Yes. PCOS does not preclude you from becoming pregnant. PCOS is one of the most common, but treatable, causes of female infertility. The hormonal imbalance in women with PCOS interferes with the growth and release of eggs from the ovaries (ovulation). You cannot become pregnant if you do not ovulate.
Your doctor can advise you on methods to help you ovulate and increase your chances of getting pregnant. You can also use our Ovulation Calculator to determine which days of your menstrual cycle are the most fertile.
Will my PCOS symptoms go away at menopause?
Both yes and no. PCOS has a wide-ranging impact on the body's systems. As they approach menopause, many women with PCOS notice that their menstrual cycles become more regular. However, because their PCOS hormonal imbalance does not change with age, they may continue to experience PCOS symptoms.
Furthermore, the risks of PCOS-related health issues such as diabetes, stroke, and heart attack rise with age. These risks may be greater in PCOS women than in non-PCOS women.
Types of medicines that treat PCOS and its symptoms
- Hormonal birth control, including the pill, patch, shot, vaginal ring, and hormone intrauterine device (IUD). For women who don't want to get pregnant, hormonal birth control can:
- Make your menstrual cycle more regular
- Lower your risk of endometrial cancer
- Help improve acne and reduce extra hair on the face and body (Ask your doctor about birth control with both estrogen and progesterone.)
- Anti-androgen medicines. These medicines block the effect of androgens and can help reduce scalp hair loss, facial and body hair growth, and acne. They are not approved by the Food and Drug Administration (FDA) to treat PCOS symptoms. These medicines can also cause problems during pregnancy.
- Metformin. Metformin is often used to treat type 2 diabetes and may help some women with PCOS symptoms. It is not approved by the FDA to treat PCOS symptoms. Metformin improves insulin's ability to lower your blood sugar and can lower both insulin and androgen levels. After a few months of use, metformin may help restart ovulation, but it usually has little effect on acne and extra hair on the face or body. Recent research shows that metformin may have other positive effects, including lowering body mass and improving cholesterol levels.
How does PCOS affect pregnancy?
PCOS can cause problems during pregnancy for you and for your baby. Women with PCOS have higher rates of:
- Gestational diabetes
- Cesarean section (C-section)
Your baby also has a higher risk of being heavy (macrosomia) and of spending more time in a neonatal intensive care unit (NICU).
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