Polycystic ovary syndrome (PCOS) is a pathology in which women have very high levels of hormones called androgens, which can lead to various health problems.

PCOS causes – mainly – menstrual irregularities, infertility, skin problems such as acne and increased hair, and an increase in the number of small cysts on the ovaries.

PCOS is linked to changes in hormone levels, although the reasons are not yet clear. The hormones affected are, on the one hand, estrogens and progesterone (female hormones that help in the release of eggs), and on the other hand, androgens (a male hormone normally found in small amounts in women).

In PCOS, a significant percentage of patients have irregular cycles, which translates into anovulatory cycles, in which ovulation does not occur, making it difficult in these cases to achieve pregnancy. This problem may contribute to possible infertility in women

Since weight gain and obesity are common in women with PCOS, losing weight (even in small amounts) can help treat hormonal changes, as well as other related health problems.

On the other hand, there are also certain medications that can help alleviate symptoms. Birth control pills, especially, can be very helpful, as they help menstrual periods to be more regular, reduce abnormal hair growth, and improve acne if taken for a few months.

At PSFC, we will be happy to help you if you think you may be suffering from PCOS.

Ovarian cysts are very common and associated with your normal menstrual cycle; usually they will resolve on their own. If there are any concerns your physician will discuss with you.

PCOS is a condition that can have serious effects on your ability to achieve a pregnancy, but it is something that can be controlled in a variety of ways. Once again it is recommended that you have a new patient consultation and a series of investigative testing to determine the best way to proceed with treatment.

Can I get pregnant with irregular cycles or no periods?

There are ways that we can monitor you to try and determine the reason behind your irregularity and/or lack of menstruation.  There are many ways that we can overcome a lot of issues, but more information from a full work up is needed before we can predict your chances of success.

There are a few conditions that can cause unwanted hair growth in women (hirsuitism). Polycystic Ovarian Syndrome (PCOS) is the most common, affecting 8-10% of women. Hair growth in the midline of the body (such as the upper lip, chin, lower stomach, or your back) can be due to PCOS. Weight gain can make PCOS symptoms worse. We diagnose PCOS with blood tests and a sonogram, and treatments can reduce the hair growth. Other conditions that can cause unwanted hair growth include adrenal gland disorders.

If you’re trying to conceive see a Reproductive Endocrinology and Infertility (REI) specialist for testing, and treatment options. We can also see women with PCOS issues who are not trying to conceive. PCOS is diagnosed with 2 out of 3 of: 1. Irregular periods 2. Clinical signs like acne, unwanted hair growth and/or blood tests showing too much male-type hormones (androgens) 3. Ultrasound appearance of polycystic ovaries: high ovarian volumes or antral follicle counts. We also rule out other causes of PCOS-like symptoms such as thyroid, prolactin, or adrenal gland issues. Treatment is different depending on whether or not you’re trying to conceive.

What are some strategies for managing weight when diagnosed with Polycystic ovary syndrome POCS?

Many women with PCOS gain weight or find it hard to lose. Moderately low carb diets (South Beach or Weight Watchers), and complex carbs instead of simple cards are good: brown rice, whole wheat bread/pasta, less sugars, and more protein. Portion control is also important, paying attention to serving sizes. Exercise is recommended: do weights and cardio at least three times a week: weights increase muscle mass, which burns more calories. Some women lose weight on metformin treatment, too.

Most women with PCOS don’t ovulate (release an egg) regularly, with infrequent periods like cycles over 35-40 days or skipping whole months, or even no periods at all. Not ovulating can also cause frequent irregular bleeding as the lining of the uterus can become thick and bleed unpredictably. You should be checked for thick lining, fibroids or polyps inside your uterus; very thick lining needs an endometrial biopsy test to rule out precancerous changes.

Polycystic ovaries (PCO) refers to one or both ovaries being bigger than normal and/or having a high number of small egg-containing ‘antral follicles. This is determined with an ultrasound scan of the ovaries. PCOS or polycystic ovarian syndrome needs 2 out of 3 of: 1. Irregular cycles 2. Clinical or blood test signs of too much male hormones – acne, unwanted hair growth or oily skin and 3. PCO. Up to 20% of women have PCO, about 8-10% have PCOS.

Yes, some women with polycystic ovarian syndrome  (PCOS) get pregnant easily without any help, some need only insulin-sensitizing medications like metformin. Others need tablets like Clomid or letrozole to induce ovulation, rarely fertility shots or IVF (In Vitro Fertilization). About 8-10% of women have PCOS. Your age also affects your chances. See a Reproductive Endocrinology and Infertility (REI) specialist if trying to conceive for an individualized treatment plan

A Reproductive Endocrinology and Infertility (REI) specialist confirms the diagnosis of PCOS and checks for hormone problems or low egg supply. Semen analysis and a Hysterosalpingogram (HSG) to check for blocked tubes are good tests to do as well. Treatment may start with metformin (insulin sensitizers) with or without ovulation inducing tablets like Clomid or letrozole. Some women need IVF (In Vitro Fertilization) if simpler treatments aren’t working, or rarely low-dose shots to induce ovulation.

With PCOS the ovaries produce excess male-type hormones (androgens) like testosterone, which cause unwanted hair growth (especially in the midline of the body like the face or lower stomach) and sometimes male-pattern hair loss. If not trying to conceive birth control pills are often used to lower androgens, sometimes with anti-androgens like spironolactone as well to decrease hair growth more than birth control pills alone. Vaniqa cream may help for excess hair growth on the face only.

It depends on if you’re trying to conceive or not? If not trying to conceive birth control pills are often used, sometimes with anti-androgens like spironolactone as well to decrease acne/hair growth more than birth control pills alone. If trying to conceive we use insulin sensitizers like metformin, plus ovulation-inducing tablets – most commonly Clomid or letrozole. Sometimes low-dose shots or IVF (In Vitro Fertilization) is needed. Surgery for PCOS is no longer a good option.

Most women with PCOS have one or more of: irregular periods or no cycles, acne, oily skin, unwanted hair growth especially on the face or lower stomach, infertility or subfertility (difficulty getting pregnant). Some women with PCOS have little or no symptoms – we look at symptoms, blood tests and an ultrasound of the ovaries to make the diagnosis. Not all women with PCOS have fertility issues.

PCOS has a genetic component; we don’t know all the genes yet – and is influenced by environmental factors and lifestyle including obesity and activity levels. Insulin resistance / ‘pre-diabetes’ may be the first thing that ‘goes wrong’ in PCOS. The closest we have to treating the cause is losing weight, with a moderately low-carbohydrate diet (Weight Watchers and South Beach are good) plus regular exercise (cardio and weights) and using insulin-sensitizing drugs like metformin. Surgery is no longer a recommended option.