Polycystic Ovarian Syndrome (PCOS): Symptoms, Causes, Treatment
A Common Cause Of Irregular Periods And Infertility
Polycystic Ovarian Syndrome or PCOS affects up to 10% of women of reproductive age and is the most common cause of irregular periods in women. It is important to know about PCOS because it can affect not only your ability to conceive but your general health as well.
Some Common Symptoms Of PCOS Include:
- Amenorrhea (cessation of period) or infrequent periods (more than 35 days between the start of your cycle)
- Irregular bleeding
- Infrequent or no ovulation
- Increased levels of male hormone, like testosterone
- Increase in weight or obesity (many women with PCOS are overweight)
- Diabetes; over production and inefficient use of insulin by the body
- Lipid abnormalities (high or low cholesterol, high triglycerides)
- High blood pressure
- Excess facial and body hair growth
- Male-pattern baldness or thinning hair
- Acne, oily skin, or dandruff
While there is no single test that will tell you that you have PCOS, women with this syndrome usually have irregular menses from the time they start having periods. Therefore, this is the most common and reliable symptom of PCOS. Irregular menses are classified as cycles that are longer than 35 days from the first day of bleeding to the day before the next bleed, or fewer than 8 cycles per year.
Getting Pregnant With PCOS
In response to this common symptom, many women with PCOS are given oral contraceptives to regulate their menses but are not officially diagnosed with PCOS. Many women with PCOS are not formally diagnosed until they seek to get pregnant and have difficulties conceiving. The good news is PCOS is a highly treatable condition and most women affected by this disease can still achieve pregnancy with treatment. Often a woman can improve the chance of pregnancy with minor lifestyle adjustments like achieving weight loss, or through the use of medications to support ovulation, and going through less invasive fertility treatments such as IUI. For women that need additional help conceiving, IVF is a highly effective form of treatment.
How Is PCOS Diagnosed?
To properly diagnose PCOS, an IRMS physician would first need to rule out other possible causes of irregular menses. Usually this involves taking a pregnancy test, checking your thyroid function with a TSH (thyroid stimulating hormone) level, and checking your prolactin level as well. These are all simple blood tests. If your physician suspects PCOS, you may be given medroxyprogesterone acetate (brand name Provera) to see if it will induce a period. This can help differentiate PCOS from other causes of no menses such as ovarian failure and hypothalamic amenorrhea. Women with these conditions have low estrogen levels and usually will not bleed in response to Provera. Women with PCOS will have normal to slightly elevated estrogen levels and will usually have a full period after this medication.
Your IRMS physician will determine the best PCOS treatment options for you based on your individual test results and will create a personalized course of action to help you increase your chances of pregnancy. Your physician may recommend one or more of the following:
- Weight loss
- Use of medications to stimulate ovulation
- Use of other medications such as oral contraceptives or insulin-sensitizing medication to improve irregular, heavy periods and other symptoms
- Timed intercourse or intrauterine insemination (IUI)
- In vitro fertilization (IVF)