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Polycystic ovary syndrome
Polycystic ovary syndrome is a condition in which a woman has an imbalance of a female sex hormones. This may lead to menstrual cycle changes, cysts in the ovaries, trouble getting pregnant, and other health changes.
Polycystic ovaries; Polycystic ovary disease; Stein-Leventhal syndrome; Polyfollicular ovarian disease
Causes, incidence, and risk factors
PCOS is linked to changes in the level of certain hormones:
It is not completely understood why or how the changes in the hormone levels occur. The changes make it harder for a woman's ovaries to release fully grown (mature) eggs. Normally, one or more eggs are released during a woman's period. This is called ovulation. In PCOS, mature eggs are not released from the ovaries. Instead, they can form very small cysts in the ovary.
These changes can contribute to infertility. The other symptoms of this disorder are due to the hormone imbalances.
Most of the time, PCOS is diagnosed in women in their 20s or 30s. However, it may also affect teenage girls. The symptoms often begin when a girl's periods start. Women with this disorder often have a mother or sister who has symptoms similar to those of polycystic ovary syndrome.
Symptoms of PCOS include changes in your period (menstrual cycle). Some changes are:
PCOS can cause you to develop male-like characteristics. This is called virilization. Symptoms include:
You may also have skin changes:
Signs and tests
Your doctor or nurse will perform a physical exam. This will include a pelvic exam. This may reveal:
The following health conditions are common in women with PCOS:
Your doctor or nurse will check your weight and body mass index (BMI) and measure your belly size.
Blood tests can be done to check hormone levels. These tests may include:
Other blood tests that may be done include:
Your doctor may also order the following imaging test or surgeries to look at your ovaries:
Weight gain and obesity is common in women with PCOS. Losing weight can help treat the hormone changes and health conditions such as diabetes, high blood pressure, or high cholesterol.
Losing just 5% of your body weight can help your hormone imbalance and may make it easier to get pregnant. For a 160-pound woman, that's just 8 pounds!
Your doctor may recommend birth control pills to make your periods more regular. Such medicines may also help reduce abnormal hair growth after you take them for a few months.
A diabetes medicine called glucophage (metformin) may also be recommended to:
Other medicines that may be prescribed to help make your periods regular and help you get pregnant are:
Your doctor or nurse may also suggest other treatments for abnormal hair growth. Some are:
Permanent hair removal options include:
Treatments can be expensive and multiple treatments may be needed.
A pelvic laparoscopy may be done to remove or alter an ovary to treat infertility. The effects are temporary.
With treatment, women with PCOS are usually able to get pregnant. There is an increased risk of high blood pressure and gestational diabetes during pregnancy.
Women with PCOS are more likely to develop:
Calling your health care provider
Call for an appointment with your health care provider if you have symptoms of this disorder.
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Radosh L. Drug treatments for polycystic ovary syndrome. Am Fam Physician. 2009;79:671-676.
Lobo RA. Hyperandrogenism: Physiology, etiology, differential diagnosis, management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 40.
Reviewed by:Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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