December 15, 2017

Patient Education

Polycystic Ovarian Syndrome (PCOS)

PCOS (or polycystic ovarian disorder) is best described as an endocrine disorder present in about five to 10 percent of women. It can cause abnormal periods and can also be associated with acne and extra hair growth. While there is no specific test to make the diagnosis, we can look in three main areas. Women can have menstrual abnormalities, abnormal lab findings or abnormal ultrasound findings. There are several different guidelines used to determine the diagnosis, but many physicians will consider it when two out of the three categories are met.

Symptoms, including missed periods or irregular bleeding, typically mean that the ovaries are not ovulating at a regular interval. Acne can be severe. Some women have coarse or dark hair growth on the face, nipples, stomach, or thighs. Many of these women are also overweight. Laboratory values can be abnormal. It is important to rule out other endocrine issues that can cause similar symptoms. Ultrasound sometimes can be used to help make the diagnosis. The ovary may have a specific pattern of multiple small cysts that mimic a “string of pearls.”  However, only 50 percent of women with PCOS show this particular sign.  This ultrasound finding can also be present in women who don’t have PCOS. 

Most women are able to lead a perfectly normal life. Treatment is aimed at improving symptoms since there is no cure. Birth control pills are usually the first choice for controlling periods, improving acne and excessive hair growth, maintaining a thin uterine lining and preventing uterine cancer in women who do not currently desire pregnancy. The birth control patch or ring will also help. Some patients will also need routine screening for cholesterol and diabetes.  Regular exercise and nutrition are very important in addressing weight concerns for PCOS patients. 

While many women will ovulate and become pregnant on their own, some may have difficulty.  If a patient does not want to be pregnant, we recommend that she use some type of contraception. Patients who want to become pregnant, but who are having trouble, can consider several options for treatment. This typically involves a detailed history, physical exam, and possibly some blood work to determine the best option. If a woman is overweight, weight loss may also increase the chance of pregnancy. If you are concerned that you may have some of these problems, please come in and see your doctor.