What Is Polycystic Ovary Syndrome (PCOS)?

Medically Reviewed By Sanaz Ghazal, MD, FACOG
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Polycystic ovary syndrome (PCOS) is a hormone disorder that affects females of childbearing age. It involves symptoms that can last a lifetime.

Sex and gender disclaimer

Sex and gender exist on spectrums. This article will use the terms “female” and “women” when discussing people assigned female at birth to reflect language that appears in source materials.

Learn more about the difference between sex and gender here.

This article discusses what PCOS is. It also covers its symptoms, causes, and treatment options.

What is PCOS?

Female sitting and leaning her head against a door
Eliza Alves/Stocksy United

PCOS is a condition that affects 1 in 10 women. It is a disorder that affects the balance of hormones in your body. This typically leads to various symptoms and health risks.

PCOS is the most common cause of infertility in females in the United States.

Many females who have PCOS experience insulin resistance. This is when your body makes insulin but cannot use it properly. Insulin resistance can increase your risk of developing type 2 diabetes.

PCOS also generally results in high levels of androgen hormones. This can cause your body to stop ovulating, and it can also lead to irregular periods.

In order to receive a diagnosis of PCOS, you typically need to present with at least two of the following:

  • irregular periods or no periods at all
  • high levels of androgen hormones
  • cysts on your ovaries

There is currently no cure for PCOS. However, many of the symptoms are treatable.

What are the symptoms of PCOS?

PCOS can cause various symptoms. Some of them may not seem as though they would be connected to a medical condition, which means that many females do not think to mention them to their doctors. This can lead to them not receiving the correct diagnosis of PCOS.

Symptoms of PCOS often begin at or near the time of puberty. However, they can also appear in your late teenage years or during early adulthood.

It is also possible to have PCOS and not experience any symptoms.

Symptoms of PCOS may include the following:

  • menstrual irregularities, including:
    • no periods
    • frequently missed periods
    • extremely heavy periods
    • regular bleeding without ovulation
  • infertility
  • excessive hair growth on the face or body, or hirsutism
  • persistent late onset acne
  • weight gain, difficulty losing weight, or obesity
  • oily skin
  • pelvic pain
  • patches of thick, dark, and velvety skin
  • thinning hair on your head
  • fatigue
  • mood changes or depression
  • sleep issues

Even though PCOS typically causes infertility issues, many females with the condition can and do still become pregnant.

If you are experiencing any of the symptoms of PCOS, contact your doctor.

Visit our hub to read about fertility and conception.

What causes PCOS?

The exact cause of PCOS is unknown.

It is possible that family history and genetics play roles in the development of PCOS. If you have a mother, sister, or aunt who has PCOS, you are 50% more likely to develop the condition yourself.

The increased levels of androgen hormones and insulin resistance are also likely to have some part in the development of PCOS.

It is also clear that weight and PCOS are connected. How they are connected, however, is still not clear. There is an ongoing debate about whether being overweight causes PCOS or whether PCOS causes someone to become overweight.

Many females with PCOS are overweight or have obesity. However, there are those with PCOS who are not overweight. In the same way, there are many females who are overweight and do not have PCOS.

Certain environmental risk factors may also lead to the development of PCOS. These factors include:

  • a low birth weight
  • rapid weight gain as an infant
  • early puberty development and pubic hair
  • childhood obesity
  • an overall unhealthy lifestyle

What are the treatments for PCOS?

There is currently no cure for PCOS. However, many of the symptoms are treatable.

The treatment plan you develop with your doctor depends on factors such as:

  • your specific symptoms
  • any other health issues you may have
  • whether or not you want to become pregnant

PCOS treatment plans are unique to each person, so discuss all your options with your doctor and work with them to develop the right plan for you.

Medical treatments

Doctors often treat the symptoms of PCOS with various medications.

Hormonal birth control

For females with PCOS who do not want to get pregnant, a doctor may recommend hormonal birth control.

Birth control options include:

  • the pill
  • the patch
  • injections
  • an implant
  • a ring
  • an intrauterine device

Hormonal birth control can help you manage your PCOS symptoms by:

  • regulating your menstrual cycle
  • lowering your risk of endometrial cancer
  • helping improve acne and reduce excess hair growth on your face and body

Other medication treatments

Other medications your doctor may recommend to treat your PCOS symptoms include:

  • Metformin: Metformin is often prescribed to those with PCOS to help manage their insulin resistance. However, metformin is not approved by the Food and Drug Administration (FDA) as a treatment for PCOS, and it is no longer recommended as a first-line treatment. Your doctor may still recommend it.
  • Clomiphene (Clomid) and letrozole (Femara): These are medications commonly used to induce ovulation.
  • Spironolactone: This is a medication that helps curb your androgen levels. This is another treatment that is not approved by the FDA for the treatment of PCOS. However, doctors still commonly prescribe it.
  • Prescription creams: These treatments can help manage symptoms such as excess hair and acne.

Lifestyle treatments

Certain lifestyle changes can help you manage your PCOS and the symptoms you experience.

Weight reduction

For some females with PCOS, it is often more challenging to lose weight and maintain weight loss than it is for those without it. However, even a 5% loss in your weight can help improve many of the symptoms of PCOS.

Losing weight, especially if you are overweight or have obesity, can help with symptoms such as:

  • restoring hormone production
  • improving mood changes
  • reducing hair growth on your face and body
  • reducing your hair loss
  • improving acne

Weight loss can also help reduce your risk of type 2 diabetes and cardiovascular disease. Another benefit of losing excess weight is that it can help regulate your menstrual cycle and restore ovulation.

Diet and exercise

Being more physically active and adopting a regular exercise routine can help you lose weight. However, it can also help reduce depression associated with PCOS.

Following a healthy diet is also key to reducing your weight and managing your PCOS symptoms.

Recommendations for a healthy diet include:

  • plenty of fruits and vegetables, with 5 portions per day being the minimum recommendation
  • whole foods, such as wholegrain breads and cereals as well as brown rice
  • lean meats, such as fish and chicken
  • legumes
  • foods high in antioxidants, such as berries and green tea
  • lean proteins from non-animal sources

Visit our hub to learn more about food, nutrition, and diet.

What are the potential complications of PCOS?

PCOS can lead to many health risks. Those with PCOS who are overweight have a higher risk of these issues.

Some potential health complications connected to PCOS include:

  • Diabetes: Over 50% of females with PCOS develop type 2 diabetes before the age of 40 years.
  • Heart disease: Having PCOS puts you at higher risk of developing heart disease, and this risk increases with age.
  • High blood pressure: Having high blood pressure can lead to damage to your heart, kidneys, and brain.
  • High cholesterol: Having high cholesterol can increase your risk of developing heart disease even more.
  • Sleep apnea: This is a condition that causes you to stop breathing while you are sleeping. It also increases your risk of developing heart disease and type 2 diabetes.
  • Stroke: Plaque that clogs your blood vessels can lead to blood clots, which can cause a stroke.

PCOS has also been linked to anxiety and depression.

PCOS and pregnancy

Females who have PCOS are at higher risk of certain complications during pregnancy. Losing excess weight can help reduce the risk of some of these complications. You should work closely with your doctor to make sure you are able to have a healthy pregnancy and delivery.

Some pregnancy complications associated with PCOS include:

Summary

PCOS is a common hormonal disorder among females of reproductive age.

Symptoms tend to begin around puberty, but they may not appear until your late teenage years or early adulthood.

The main symptoms of PCOS are irregular periods, weight gain, infertility, and cysts on the ovaries. Because many of these symptoms are similar to those of other conditions, many people do not receive a diagnosis until they try to become pregnant.

Although there is currently no cure for PCOS, many of the symptoms are treatable. If you are experiencing any of the symptoms, contact your doctor.

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Medical Reviewer: Sanaz Ghazal, MD, FACOG
Last Review Date: 2022 May 23
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