Polycystic Ovary Syndrome

Anywhere between 6-12% of individuals with a uterus who are of childbearing age will develop Polycystic Ovary Syndrome, or PCOS. The symptoms associated with PCOS are caused by a hormonal imbalance–your body starts producing too much of some hormones and not enough of others. While the underlying and root cause of this imbalance is not well understood, PCOS symptoms can be successfully managed and several therapeutic approaches exist.

Polycystic Ovary Syndrome can cause complications throughout your body, including infertility and obesity. If you think you might have PCOS, you can work with your OBGYN or Midwife to develop a treatment plan and find strategies that help you successfully manage your condition.

What Are the Symptoms of PCOS?

For most menstruating individuals, Polycystic Ovary Syndrome develops around puberty. This usually occurs around the time when you have your first period.  Diagnosing PCOS can be tricky as it is not uncommon for menstrual periods to be somewhat irregular for the first 2-3 years after you have your first menarche (first period).  For others, symptoms may develop later in life, sometimes in response to weight gain. Most people don’t know they have PCOS until they visit their doctor. This usually occurs during their 20s or 30s when they have trouble becoming pregnant.

The most common symptoms of PCOS include the following:

• Weight gain: In approximately half of cases, polycystic ovary syndrome can cause obesity.  However, individuals of normal weight can also have PCOS.
• Acne: Acne may be more widespread and persistent than expected. Often resistant to treatment. 

• Hair growth: As the hormone androgen rises throughout your body, you may notice that you start growing significantly more facial and body hair on your chin, neck, back, chest, breasts or abdomen. 

• Polycystic ovaries: Sometimes the ovaries can appear to have many small follicles or cysts noted on transvaginal ultrasound.  However, this can also be a nonspecific finding and without the presence of other symptoms, may not be suggestive of PCOS.

• Your periods become irregular: As your hormone levels fluctuate, your periods may become sporadic – sometimes months without periods and sometimes periods that happen too often. It’s not unusual for those with PCOS to have only 9 periods per year, for example.

• Darkening of skin: Some people who develop PCOS may also notice a darkening of their skin called acanthosis nigricans. This may occur broadly or in patches. 

• Skin tags: Also known as acrochordons, these are small areas of excess skin that may develop and often around the area of darkening skin.

Only your doctor can diagnose polycystic ovary syndrome. But if you’re experiencing multiple symptoms as noted above, it’s worth bringing your concerns to the attention of your OBGYN or Midwife.

Can PCOS Cause Complications?

Over the long term, PCOS can cause complications in a variety of ways. Some of the most common are the following:

• Metabolic syndrome or prediabetes
• Type 2 diabetes, often linked with PCOS-caused weight gain
• Depression
• Liver inflammation
• Infertility
• Abnormal uterine bleeding
• Miscarriage
• Premature birth
• Gestational diabetes

In general, those with PCOS may experience trouble becoming pregnant. That’s because the hormone imbalance may sometimes interfere with ovulation–and if there’s no egg to become fertilized, one cannot conceive. 

Additionally, you may experience metabolic complications due to your PCOS. This could increase your overall risk of cardiovascular disease and high blood pressure.

None of these complications are inevitable. There is a great deal of variability in terms of who experiences complications and who does not. The best way to avoid complications is to work closely with your OBGYN or Midwife to manage symptoms

What are the Treatments for Polycystic Ovary Syndrome?

In general, the approach to treating PCOS is to help you manage your symptoms as well as possible. As new symptoms may (or may not) pop up, your OBGYN or Midwife will work with you to manage those as well.

As a result, PCOS may be treated in the following ways:

• Infertility and trouble conceiving: These symptoms may sometimes be addressed with fertility treatments. This will increase the rate of your ovulation–or bypass the process altogether. If you have PCOS and want to get pregnant, your provider may refer you to a fertility specialist. Your OBGYN or Midwife may also prescribe medication designed to help you ovulate.

• Menstrual irregularity: To help your monthly bleeding stay on track–and be more predictable–your OBGYN or Midwife may prescribe birth control options that are designed to regulate your menstrual cycle. This could include birth control pills, vaginal rings, and IUDs.

• Weight gain: If your weight gain begins to interfere with your health or impact you in negative ways, your OBGYN or Midwife may take a tiered approach to your treatment. First, they may recommend increasing your daily activity or decreasing your daily caloric intake (or both). In other cases, medication might be used to help regulate the way your body stores fat.

• Acne: To help improve your acne, your provider may refer you to see a dermatologist who may prescribe prescription strength face wash and other topical medications designed to help you keep your skin clear. Sometimes birth control or other prescription medications can be given to help with acne as well. 

• Excess hair: Removal of excess facial or body hair often involves cosmetic methods which may include bleaching, waxing, shaving, laser or electrolysis. 

• Diabetes and insulin related complications: Many individuals with PCOS are insulin resistant, making it challenging to address and manage diabetes that may occur. To help you control your blood pressure and avoid insulin-related complications, your OBGYN or Midwife may prescribe metformin, a diabetes drug that will lower your insulin resistance. This drug can also help regulate your ovulation and improve your weight loss prospects.

Your OBGYN or Midwife will help you manage the symptoms of your PCOS. There’s no cure for the overall condition, but with the right approach, you can still live a very full and healthy life.

Common PCOS Questions

Many people will have questions about their polycystic ovary syndrome. Among the most common are the following:

Will PCOS go away after menopause?

In some ways, your polycystic ovary syndrome will no longer impact you after menopause–in particular the aspects related to infertility and conception. However, your hormonal imbalance will still remain in place. And the life-long complications will still be with you. So, you’ll still have to work with your provider to manage any symptoms that remain.

If I become pregnant, will PCOS Impact my pregnancy?

It could. Polycystic ovary syndrome can increase your chances of gestational diabetes, hypertensive disorders in pregnancy, pregnancy loss, and preterm birth. If you know you have PCOS and you become pregnant, you will want to work closely with your OBGYN or Midwife to monitor your pregnancy.

How will my doctor diagnose my PCOS?

A diagnosis requires a multitude of factors. In general, your OBGYN or Midwife will perform a physical exam and order blood tests. A pelvic exam and pelvic sonogram (ultrasound) may also be performed. Based on the results of all of these tests, your provider may be able to determine whether you have polycystic ovary syndrome and in some cases may refer you to meet with an endocrinologist who specializes in diagnosing, treating and managing metabolic disorders including PCOS.

Talk to Your OBGYN About PCOS

Polycystic ovary syndrome impacts almost one in ten people of childbearing age. This occurs in varying degrees of severity. So, it’s important to understand that, even though there is no cure for PCOS, many people are able to successfully treat this condition on a daily basis.

If you have questions about PCOS, or think this condition may be impacting your fertility, talk to your OBGYN or Midwife today! Contact us at our Wilmette or Glenview locations to schedule an appointment.