Polycystic Ovary Syndrome - The Basics

Written by the doctors and editors at UpToDate

What is polycystic ovary syndrome? — Polycystic ovary syndrome is a condition that can cause
women to have irregular periods, get acne (oily skin and pimples), grow extra facial hair, or lose hair
from their head. The condition can also make it hard to get pregnant. People sometimes call polycystic
ovary syndrome "PCOS." It is very common – about 5 to 8 percent of all women have PCOS. Most
women with PCOS are overweight or obese.

What causes PCOS? — In women with PCOS, the ovaries do not work normally and produce too
much testosterone. Testosterone is called a "male hormone," but women have it too. Normally the
ovaries produce very small amounts, but in PCOS, they make more.

About once a month, a woman's ovaries are supposed to make a structure called a "follicle"
As the follicle grows, it makes hormones. Then, it releases an egg. This is called "ovulation." But in
women with PCOS, the ovary makes many small follicles instead of one big one. Hormone levels can
get out of balance. And ovulation doesn't happen every month the way it is supposed to. Doctors
aren't sure why this happens to some women.

What are the symptoms of PCOS? — Women with the condition might:

  • Have fewer than 8 periods a year

  • Grow thick, dark hair in places where only men tend to grow hair, such as on the upper lip, chin, sideburn area, chest, and belly

  • Gain weight and become obese

  • Have acne (oily skin and pimples on their face)

  • Lose hair from their head like men do

  • Have trouble getting pregnant without medical help

Should I see a doctor or nurse, even if my symptoms are mild? — Yes. Women with PCOS are
more likely to have other health problems, too. These include:

  • Diabetes (high blood sugar)

  • High cholesterol levels

  • Sleep apnea, a sleep disorder that causes people to briefly stop breathing while they sleep

The risk of heart disease might also be higher in women with PCOS, but more research is needed for
doctors to be sure.

Are there tests I should have? — Your doctor or nurse will decide which tests you should have
based on your age, symptoms, and individual situation. Possible tests include:

  • Blood tests to measure levels of hormones, blood sugar, and cholesterol

  • A pregnancy test if you have missed any periods

  • Pelvic ultrasound – This test uses sound waves to make a picture of your uterus and ovaries.

Doctors sometimes use this test to help figure out if you have polycystic ovaries.

How is PCOS treated? — The most common treatment is to take birth control pills. But there are
other treatments than can help with symptoms, too.

  • Birth control pills – This is the main treatment for PCOS. The pills don't cure the condition. But

    they can improve many of its symptoms, like irregular periods, acne, and facial hair. Birth control pills also protect women from cancer of the uterus.

  • Anti-androgens – These medicines block hormones that cause some PCOS symptoms like acne and facial hair growth. Spironolactone (brand name: Aldactone) is the anti-androgen that many doctors use.

  • Progestin – This hormone can make your periods regular, but only if you take it every month. It also lowers the risk of cancer of the uterus. Most doctors use medroxyprogesterone (brand name: Provera) or natural progesterone (brand name: Prometrium).

  • Metformin (brand name: Glucophage) – This medicine can help make a woman's periods more regular. But it works only in about half of the women who try it. In women with diabetes, this medicine helps keep blood sugar levels normal.

  • Medicated skin lotion or antibiotics to treat acne

  • Laser therapy or electrolysis to remove extra hair

Is there anything I can do on my own to treat the condition? — Yes. If you are overweight or
obese, losing weight can improve many of your symptoms. Losing just 5 percent of your body weight
can help a lot. That adds up to 10 pounds of weight loss for a 200-pound woman.

What if I want to get pregnant? — Don't lose hope. Most women with PCOS are able to get
pregnant, but it can take a while. If you are overweight, losing weight can help make your periods
regular and improve your chances of getting pregnant. If you lose weight but your periods are still
irregular, your doctor can give you medicines to help you ovulate and improve your chances of getting
pregnant.

What will my life be like? — Women with PCOS are able to live normal lives. But it is important to
see a doctor. Treatments will help your symptoms and protect you from other diseases.