Do you have missed periods or heavy bleeding during menstruation? Do you have excess hair growth or acne? Have you been struggling to get pregnant for more than 12 months? You may have Polycystic Ovary Syndrome (PCOS) if you struggle with any of these issues.

At Ms.Medicine, we are focused on elevating healthcare for women, so we want to discuss this health condition that affects 1 in 10 women of reproductive age. And what better time to do so than September – Polycystic Ovarian Awareness Month? Let’s get to it.

What is Polycystic Ovary Syndrome (PCOS)?

Polycystic Ovary Syndrome (PCOS) is a common health condition that occurs when your ovaries produce an excess of androgens or male sex hormones. This imbalance in reproductive hormones leads to many symptoms, including irregular menstruation and ovulation, changes to your physical appearance, and an increased likelihood of other health issues.

PCOS is one of the most common causes of infertility in women. Those with PCOS are also often resistant to insulin.

Why is it called PCOS?

PCOS refers to the small, fluid-filled cysts on some people's ovaries with the syndrome. These cysts develop as a result of irregular ovulation. However, they are not always present in women with PCOS.

Who can be diagnosed with PCOS?

PCOS only affects women or people assigned females at birth. Most people are diagnosed with PCOS in early adulthood or when they are trying to get pregnant.

What causes PCOS?

The exact cause of PCOS is unknown, but there seems to be a genetic component. Researchers know the syndrome is associated with high androgen levels and insulin resistance. High insulin levels cause ovaries to produce androgens, and, in turn, high androgen levels prevent regular ovulation. These issues contribute to PCOS symptoms.

What are the signs and symptoms of PCOS?

There is a myriad of symptoms associated with PCOS. Some include irregular periods (missing periods, not having any period, heavy bleeding during periods), overgrowth of hair in areas where men usually grow hair (face, chin, etc.), acne, thinning hair on your head, weight gain and obesity, darkening of the skin (particularly in folds of your neck, underarms, groin, and under your breasts), skin tags, ovarian cysts, and infertility.

PCOS can be so mild that the symptoms aren’t severe enough to be noticed. Some women with PCOS only realize they have the condition once they struggle to get pregnant or gain weight for unknown reasons.

How do you get diagnosed?

If these symptoms resonate with you, talking to a healthcare provider is essential. No one test diagnoses PCOS, but your provider can diagnose you based on your medical history and a series of exams and tests. Examples include:

Physical exam
Pelvic exam
Pelvic ultrasound (sonogram)
Blood tests

These tests mainly look for signs of high androgen levels and to rule out other potential health issues.

Providers may diagnose patients with PCOS if they have at least two of the following conditions:

Irregular menstruation
Signs of high levels of androgens
Enlarged ovaries or ovarian cysts

What are treatment options for PCOS?

Unfortunately, there is no singular cure for PCOS, but medication and lifestyle changes can manage PCOS symptoms. Some examples of treatments include:

Birth control: restores average hormone balance, regulates menstrual cycle, and treats PCOS symptoms associated with high androgen levels like acne and unwanted hair growth.
Hair removal options: laser hair removal and electrolysis can remove excess body hair. Prescription drugs may also be effective treatments. Oral birth control treats unwanted hair and hair loss; the cream Eflornithine (Vaniqa) slows hair growth, and anti-androgen medications like spironolactone can also treat unwanted hair growth.
Metformin: lowers insulin and blood sugar levels in women with PCOS. The drug can also improve fertility by stimulating ovulation.
Clomiphene: improves fertility by stimulating ovulation.
IVF and surgery: if medications do not work, in vitro fertilization treatment and surgery can be alternative options to improve fertility.

What are lifestyle changes to treat PCOS?

There are also non-medical treatment options for PCOS. The following are lifestyle changes that can treat the syndrome.

Manage your weight: If you have PCOS, managing your weight can lower your levels of insulin and androgen, which may help regulate ovulation and other PCOS symptoms. Create weight goals that you can achieve. Even a modest weight-loss plan—like losing 5 percent of your body weight—can make a positive difference.
Change your diet: One way to lower your insulin levels is by cutting down on sugars, carbohydrates, and straightforward carbs like white bread, breakfast cereals, and pasta. Look for complex carbohydrates, which raise blood sugar levels slower than simple carbohydrates. Examples of complex carbohydrates include fruits, vegetables, and whole grains.
Increase moderate exercise daily: Another way to lower your insulin levels is through exercise. If you have PCOS, try taking a 20-30 minute walk after a meal, doing HITT training, or practicing yoga, Pilates, or tai chi to manage your symptoms.

At Ms. Medicine, we believe our patients deserve to be healthy and whole. If you have PCOS, we will work to develop the right treatment plan to make sure you feel this way. Find a provider near you today!