What is polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a hormonal imbalance that disrupts ovulation. It is a condition that affects one in 10 women of childbearing age.

If you have PCOS, your ovaries produce unusually high levels of androgens (male hormones), which may disrupt your reproductive hormone balance, resulting in irregular menstrual cycles, missed periods and unpredictable ovulation. On an ultrasound, you may see a higher than normal number of small follicle cysts (fluid-filled sacs with immature eggs) on your ovaries due to lack of ovulation (anovulation). These cysts aren’t dangerous or painful, and, despite the name “polycystic,” not everyone with PCOS has cysts on their ovaries.

Having PCOS may increase the risk of developing metabolic syndrome (high blood pressure, elevated cholesterol, high blood sugar and weight gain). Metabolic syndrome is also a risk factor for health conditions, including heart disease, Type 2 diabetes, sleep apnea and stroke. PCOS can be associated with female infertility.

Your women’s health specialist can help you find lifestyle changes and treatments that can help alleviate symptoms, reduce your risk of complications and improve your chances of having a baby, if that’s your goal.

women enjoying the outdoors after treatment for her Polycystic Ovary Syndrome

Symptoms of PCOS

A diagnosis is typically made when you have at least two of the following clinical findings:

  • An increased number of cysts on one or both ovaries, which, despite the condition’s name, do not occur in all women with PCOS
  • Irregular periods, including missed periods, absence of periods or heavy bleeding (menorrhagia) during periods
  • Higher-than-normal levels of androgens (male hormones) on blood work or physical exam

The symptoms of PCOS can vary widely and are related to the hormonal imbalance. They may include:

  • Irregular periods: Inconsistent ovulation may lead to infrequent or too frequent periods.
  • Darkening of the skin: Patches of dark skin, known as acanthosis nigricans, may develop in the folds of the neck, armpits, groin and under your breasts.
  • Excessive hair growth: Women may experience excessive hair growth on the face, chest, abdomen or upper thighs. This condition, called hirsutism, affects more than seven in 10 women with PCOS.
  • Infertility: Lack of ovulation due to high androgen levels may cause infertility.
  • Hair loss: PCOS may cause thinning hair or hair loss.
  • Skin problems: Women may experience skin tags, oily skin, or severe or persistent acne on the face, chest or upper back.
  • Weight gain or difficulty losing weight: Obesity affects four out of five women with PCOS. Excess weight often centers around the midsection.

When to see a doctor

Visit your OBGYN or primary care physician if you have fewer than eight periods in a year or have periods more frequently than every 21 days. You should also speak to your provider if you are experiencing infertility or if you have symptoms of PCOS.

Your provider can help determine whether PCOS or another condition is causing your symptoms.

What causes PCOS?

The cause of PCOS remains unknown. The condition runs in families, so genetic and environmental factors are thought to play a role. PCOS is more common in women who are obese.

The condition occurs because of a hormonal imbalance. Your ovaries produce estrogen and androgen, and when your ovaries produce too much androgen and not enough estrogen, you can develop PCOS.

Some symptoms of PCOS are related to levels of insulin, another hormone that helps your body’s cells use energy from sugar. Having too much insulin can lead to high androgen levels and weight gain.

PCOS risk factors

Any woman can develop PCOS. The condition affects as many as 10% of women between the ages of 15 and 44, of all races and ethnicities. The following may increase your risk of PCOS:

  • Excess androgen: This hormone may prevent ovaries from releasing eggs and contribute to acne and hair growth.
  • Family history: Your risk of PCOS is higher if you have a mother, sister or aunt with PCOS, insulin resistance or Type 2 diabetes.
  • Insulin resistance: Insulin resistance may lead to higher androgen levels, dark skin patches and weight gain. Insulin resistance also contributes to Type 2 diabetes, a condition associated with PCOS.
  • Low-grade inflammation: Inflammatory markers are higher in women with PCOS.

How to diagnose PCOS

Piecing together a diagnosis for PCOS can sometimes be challenging. The symptoms can impact many aspects of your health, and there is no single test for PCOS. Diagnosis typically begins with a physical and pelvic exam. After that exam, your provider may order additional tests to investigate the potential causes of your symptoms.

Treatment for PCOS

Although PCOS has no cure, you have multiple options for treating your symptoms and related conditions.

Your OBGYN will work with you to create a treatment plan that fits your lifestyle and needs. The best plan for you will depend on many factors, including whether you have other health conditions and would like to become pregnant in the future. Your plan may include a combination of treatments.

Find specialized care for PCOS

The women’s health providers at Baylor Scott & White offer comprehensive care for PCOS and can arrange specialized care for infertility and other complications at our women’s health centers across North and Central Texas.

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