At Westchester Health, some of our female patients come to us complaining of irregular or missed periods, and they want to know if this is a signal of an underlying condition that needs attention. After taking a medical history and performing tests, what we find in many cases is that these patients have polycystic ovary syndrome (PCOS), a hormonal disorder common among women of reproductive age.
When we’ve discussed polycystic ovary syndrome with these patients, many of them are unfamiliar with it. For this reason, we as endocrinologists offer the following information and treatment options for this condition so that women can make more knowledgeable decisions about their health.
Polycystic ovary syndrome: an imbalance of reproductive hormones
The reason the word “ovary” is in the name of this condition is because POCS results from an imbalance of reproductive hormones. This imbalance creates problems in the ovaries, the female reproductive organs that produce an egg that is released each month as part of a woman’s menstrual cycle (ovulation). With PCOS, the egg may not develop as it should, or it may not be released during ovulation.
The exact cause of PCOS is not known. Most experts think that several factors, including genetics, play a role but the two causes that are most frequently cited are high levels of androgens (male hormones) and high levels of and insulin.
What types of women develop POCS?
Women of all races and ethnicities can have PCOS. Your risk of PCOS may be higher if you are obese, or have a mother, sister or aunt with PCOS, according to the Office on Women’s Health. Most women find out they have PCOS in their 20s and 30s when they have problems getting pregnant, but it can happen at any age after puberty.
The way most women learn that they have POCS is by way of missed or irregular menstrual periods, which can lead to:
- Infertility. PCOS is one of the most common causes of infertility in women.
- Development of cysts (small fluid-filled sacs) in the ovaries.
Typical symptoms of PCOS include:
- Irregular menstrual cycle. Women with PCOS may miss periods or have fewer periods (less than 8 in a year). Or, their periods may come every 21 days or more often. Some women with PCOS stop having menstrual periods altogether.
- Unusual amounts of hair on the face, chin or parts of the body where men usually have hair.
- Acne on the face, chest and upper back
- Thinning hair or hair loss on the scalp (male-pattern baldness)
- Weight gain or difficulty losing weight
- Darkening of skin, particularly along neck creases, in the groin and underneath breasts
- Skin tags (small excess flaps of skin in the armpits or neck area)
Can I still get pregnant if I have PCOS?
Yes. Even though PCOS is one of the most common causes of infertility in women, this does not mean that you can’t get pregnant. PCOS interferes with the growth and release of eggs from the ovaries (ovulation), and if you don’t ovulate, you can’t get pregnant. The good news is that there are ways to help you ovulate, including determining which days in your menstrual cycle you are most likely to be fertile.
How is PCOS treated?
There is no cure for PCOS but there are a number of treatments, which in many cases are prescribed in combination. We agree with these, provided by the Office on Women’s Health:
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Lose weight
Healthy eating habits and regular physical activity can help relieve PCOS-related symptoms. Losing weight can help lower your blood glucose levels, improve the way your body uses insulin, help your hormones reach normal levels, and help your menstrual cycle become more regular, which can improve your chances of getting pregnant.
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Remove excess hair
Facial hair removal creams, laser hair removal and electrolysis are effective at removing excess hair.
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Slow your hair growth
A prescription skin treatment (eflornithine HCl cream) can help slow down the growth rate of new hair in unwanted places.
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Hormonal birth control methods
These include the pill, patch, shot, vaginal ring and hormone intrauterine device (IUD), all of which can make your menstrual cycle more regular, lower your risk of endometrial cancer, help improve acne and reduce extra hair on your face and body.
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Anti-androgen medications
These medicines block the effect of androgens and help reduce scalp hair loss, facial and body hair growth and acne, but keep in mind that they can also cause problems during pregnancy.
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Metformin
Metformin is often used to treat type 2 diabetes and may help some women with PCOS symptoms by improving insulin’s ability to lower blood sugar and insulin and androgen levels. Recent research shows that metformin may have other positive effects, including lowering body mass and improving cholesterol levels.
Helpful websites we recommend
Concerned that you may have polycystic ovary syndrome? Please come see us.
If you have polycystic ovary syndrome, or are worried that you’re at risk of developing it, please call (914) 232-1919 to make an appointment with one of our Westchester Health OB/GYNs. We’ll examine you, evaluate your symptoms, possibly perform some tests, and together with you, decide on the best course of treatment to improve your PCOS or hopefully even reverse it. Whenever, wherever you need us, we’re here for you.
By Tiffany Werbin-Silver, MD, FACOG, an OB/GYN with Westchester Health, member of Northwell Health Physician Partners