Important COVID-19 Updates: Office Guidelines | Vaccine and Pregnant Women

Wednesday, July 5, 2023

The ABCs of PCOS: Polycystic Ovary Syndrome

By Dr. Robert Wool

Polycystic Ovary Syndrome (PCOS), a condition that affects up to 15% of women, is the result of an overproduction of androgens by the ovaries. All women produce these hormones, but excess levels can result in irregular periods, infertility, enlarged ovaries, acne, abnormal hair growth and other symptoms. While there is no cure for PCOS, it’s a condition we can help you successfully manage.


Common Signs

Not all PCOS sufferers have obvious symptoms, and many don’t realize they have the condition until they have difficulty getting pregnant. In fact, it’s the most common cause of infertility in the U.S., according to the Centers for Disease Control (CDC). While it is possible to become pregnant with PCOS, it is often more challenging since ovulation is infrequent and hard to predict.


Having at least two of the following three signs is a strong indication of PCOS:

1.       Irregular menstrual cycle: going more than 40 days between periods or missing them completely. Periods may be very heavy when they do occur.

2.       Evidence of excess androgens (so-called “male” hormones): acne on your back, chest and face, and excess hair growth on your face, torso and arms).

3.       Enlarged or polycystic ovaries as seen on ultrasound. The higher levels of androgens prevent the ovaries from releasing eggs and may cause small, fluid-filled sacs (cysts) to form.


Other common signs of PCOS include:

·         Dark patches on the skin, especially around the armpits, groin, neck and under the breasts

·         Being overweight or obese

·         Skin tags

·         Hair loss or thinning



While we don’t know what causes the condition, factors that appear to play a role in PCOS include genetics, insulin resistance that causes the ovaries to produce more androgens, and low-grade inflammation.


A PCOS diagnosis typically includes your women’s health provider taking a medical history, discussing your symptoms and performing a medical examination that includes a pelvic exam. Your provider will also order a pelvic ultrasound and blood tests to check your levels of androgen hormones, glucose (to determine insulin resistance), C-reactive protein and white blood cells (to detect inflammation).


Treatment and Management

If you are diagnosed with PCOS, you and your provider will talk about the best ways to treat your condition based on its severity, symptoms and your goals. For instance, if you want to become pregnant, options can include medications to induce ovulation or procedures like in vitro fertilization (IVF). If you don’t want to become pregnant, hormonal birth control or medications to block androgens or address insulin resistance can be helpful. For those who are overweight or obese, losing weight can have an impact on symptoms and their severity.


While most women who have the condition and get pregnant have successful pregnancies, there is an increased risk of gestational diabetes, preeclampsia, high blood pressure, preterm birth and Cesarean section (C-section).


PCOS can also increase your risk of other health conditions, so diagnosis and management are important regardless of your desire to become pregnant. Research indicates that PCOS can also increase your risk of diabetes, high blood pressure, cardiovascular disease, endometrial cancer, endometrial hyperplasia (precancerous thickening of the uterine lining), sleep disorders, depression and anxiety.


We have expertise in helping our patients successfully manage this common condition.  If you are having trouble getting pregnant or if you’re experiencing any of the symptoms of PCOS, contact us to schedule an appointment.