Polycystic Ovary Syndrome
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Polycystic Ovary Syndrome (PCOS)

What is polycycstic ovary syndrome?
Polycycstic ovary syndrome is a condition in which a woman’s ovaries and, in some
cases the adrenal glands, produce more androgens (a type of hormone) than normal.  
High levels of these hormones interfere with the development and release of eggs as part
of ovulation.  As a result, fluid-filled sacs or cysts can develop on the ovaries.

Because women with polycycstic ovary syndrome do not release eggs during ovulation,
polycycstic ovary syndrome is the most common cause of female infertility.

How does polycycstic ovary syndrome affect fertility?
A woman's ovaries have follicles, which are tiny, fluid-filled sacs that hold the eggs. When
an egg is mature, the follicle breaks open to release the egg so it can travel to the uterus
for fertilization.

In women with polycycstic ovary syndrome, immature follicles bunch together to form large
cysts or lumps. The eggs mature within the bunched follicles, but the follicles don't break
open to release them.

As a result, women with polycycstic ovary syndrome often have menstrual irregularities,
such as amenorrhea (they don’t get menstrual periods) or oligomenorrhea (they only have
periods now and then). Because the eggs are not released, most women with polycycstic
ovary syndrome have trouble getting pregnant.

What are the symptoms of polycycstic ovary syndrome?
In addition to infertility, women with polycycstic ovary syndrome may also have:

* Pelvic pain
* Hirsutism, or excess hair growth on the face, chest, stomach, thumbs, or toes
* Male-pattern baldness or thinning hair
* Acne, oily skin, or dandruff
* Patches of thickened and dark brown or black skin

Also, women who are obese are more likely to have polycycstic ovary syndrome.

Although it is hard for women with polycycstic ovary syndrome to get pregnant, some do
get pregnant, naturally or using assistive reproductive technology.  Women with PCOS are
at higher risk for miscarriage if they do become pregnant.

Women with polycycstic ovary syndrome are also at higher risk for associated conditions,
such as:

* Diabetes
* Metabolic syndrome—sometimes called a precursor to diabetes, this syndrome
indicates that the body has trouble regulating its insulin
* Cardiovascular disease—including heart disease and high blood pressure

What is the treatment for polycycstic ovary syndrome?
There is no cure for polycycstic ovary syndrome, but many of the symptoms can often be
managed. It is important to have polycycstic ovary syndrome diagnosed and treated early
to help prevent associated problems.

There are medications that can help control the symptoms, such as birth control pills to
regulate menstruation, reduce androgen levels, and clear acne. Other medications can
reduce cosmetic problems, such as hair growth, and control blood pressure and
cholesterol.

Lifestyle changes such as regular exercise can aid weight loss and help reduce blood
sugar levels and regulate insulin levels more effectively.  Weight loss can help lessen
many of the health conditions associated with polycycstic ovary syndrome and can make
symptoms be less severe or even disappear.

Surgical treatment may also be an option, but it is not recommended as the first course of
treatment.

NICHD-funded research has also examined the effects of the anti-diabetes drug
metformin on fertility in women with polycycstic ovary syndrome.  To learn more about this
research, check out the news releases about polycycstic ovary syndrome.

How is polycycstic ovary syndrome diagnosed?
Your health care provider will take a medical history and do a pelvic exam to feel for cysts
on your ovaries.  He or she may also do a vaginal ultrasound and recommend blood tests
to measure hormone levels.

Other tests may include measuring levels of insulin, glucose, cholesterol, and triglycerides.

Recent Research Findings
[1] Impaired Glucose Metabolism
was found significantly more frequently only in
overweight/obese polycystic ovary syndrome subjects in comparison with healthy controls
in a study of type 2 diabetes mellitus in lean and overweight/obese women. [1]

[2] Adolescents with polycystic ovary syndrome are at risk of developing metabolic
abnormalities. Polycystic ovaries were not a consistent finding. The most commonly
prescribed treatment was the oral contraceptive pill. [2]

Reference
[1] Vrbikova J, Fanta M, Cibula D, Vondra K, Bendlova B. Impaired Glucose Metabolism
in Women with Polycystic Ovary Syndrome. Gynecol Obstet Invest. 2009 Aug 7;68(3):186-
190 [2] Orsino A, Van Eyk N, Hamilton J. Clinical features, investigations and
management of adolescents with polycystic ovary syndrome. Paediatr Child Health. 2005
Dec;10(10):602-8.

SOURCE NIH 2009