Polycystic Ovary Syndrome (PCOS) is a common hormonal condition impacting women during their reproductive years. It’s characterized by a hormonal imbalance that affects the ovaries and ovulation, the monthly release of an egg. The name refers to the small, fluid-filled sacs that can develop on the ovaries, though not everyone with PCOS has them. The condition, which affects an estimated 6% to 13% of reproductive-age women, can begin around the first menstrual period or develop later in life.
Key Symptoms and Underlying Causes
The signs of Polycystic Ovary Syndrome vary but are driven by hormonal disruptions. One of the most common signs is an irregular menstrual cycle, such as having fewer than nine periods a year or cycles that are more than 35 days apart. Another frequent symptom group stems from elevated levels of male hormones, known as androgens. This can lead to excess facial and body hair (hirsutism), severe acne, and male-pattern baldness.
These symptoms result from two interconnected issues: hormonal imbalances and insulin resistance. Women with PCOS often have hormone levels that disrupt ovulation, such as higher luteinizing hormone (LH) and lower follicle-stimulating hormone (FSH). Many individuals also have insulin resistance, where the body’s cells don’t respond properly to insulin. This resistance prompts the pancreas to produce more insulin, which can cause the ovaries to produce more androgens, worsening symptoms. Research also suggests genetics and long-term, low-grade inflammation contribute to the condition.
Diagnosis and Treatment Approaches
Diagnosing PCOS requires a comprehensive evaluation, as no single test can confirm the condition. A healthcare provider will look for at least two of three specific signs: irregular periods indicating a lack of regular ovulation, high androgen levels, and the presence of polycystic ovaries on an ultrasound. The diagnostic process includes a physical exam, a discussion of menstrual history, and blood tests. These blood tests measure hormone levels and can also check for issues related to insulin resistance by measuring glucose and cholesterol.
Management of PCOS focuses on addressing an individual’s main concerns, from regulating menstrual cycles to managing metabolic issues. Lifestyle modifications are a primary component of treatment. Losing a small percentage of body weight through a healthy diet and regular exercise can help regulate the menstrual cycle and improve the body’s use of insulin. For medical treatments, hormonal birth control may be prescribed to regulate periods and reduce androgen levels, while other medications can manage insulin resistance or target specific symptoms.
Associated Long-Term Health Conditions
PCOS is associated with an increased risk for several long-term health problems, making ongoing management important. The hormonal disruptions that interfere with ovulation are a leading cause of infertility. The metabolic issues central to the condition, particularly insulin resistance, elevate the risk of developing type 2 diabetes, with more than half of women with PCOS developing it by age 40.
The condition is also linked to other metabolic complications, including high cholesterol and high blood pressure, which increase the risk of heart disease. Individuals with PCOS who experience infrequent menstrual periods for many years have a higher risk of developing endometrial cancer because the uterine lining does not shed regularly. Working with a healthcare provider to manage the condition helps mitigate these long-term risks.