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Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a problem in women where the hormones are out of balance.

Hormones are messengers that communicate with different organs and other hormones to help the body to function properly. Sometimes, for reasons that are not totally clear, the hormones get out of balance and cause malfunctions to occur. With PCOS the ovarian hormones get out of balance and trigger other abnormalities, like the ability to regulate sugar properly. There may be multiple tiny cysts on the ovaries that are not dangerous, but contribute to the unbalanced hormones. Some women may not make an egg every month and may have slight increases in testosterone that causes increase in hair growth and acne.

Symptoms usually are mild at first and may increase over time if not treated. It may start in the teens or twenties.

Incidence: 5-10% of reproductive age women

Symptoms may include:

  • Irregular or no periods
  • Acne
  • Increased hair on face and body
  • Darker, thicker hair on face and body
  • Weight gain or difficulty losing weight
  • Darkened, velvety skin in underarm, below breasts
  • Infertility

Health concerns: increased risk for diabetes and heart disease, if left untreated

What to expect at medical consultation: After deciding that a woman may possibly have PCO, the doctor will want to do an evaluation. Weight, height and Body Mass Index will be measured.

An internal examination may be done to see if the ovaries are enlarged.Evaluation may include an ultrasound to look at the ovaries for presence of multiple tiny cysts. This exam also allows for examination of the lining of the uterus, called the endometrium. In women who are not having periods this may become too thick and the tissue may become abnormal. Blood tests are done to check for hormone imbalances and for sugar.


One way to treat this is with diet and exercise. If a woman is overweight or obese she can often reverse the abnormality by achieving normal weight. Maintaining a healthy weight is always recommended for any person, even without PCOS.

Birth control pills may be selected for treatment of someone who does not want pregnancy. The birth control pill decreases the amount of testosterone being made and increases a protein called Sex Hormone Binding Globulin (SHBG) that holds onto the testosterone that is present to keep some of it inactive. Some women may have problems with Diabetes or Pre diabetes.

Metformin, a drug to treat Diabetes may be used. After a few months, a woman may lose weight with this and some of the hormone imbalances, especially Insulin levels, may be improved. Often a woman may start ovulating with this and be able to get pregnant and have regular periods.

A dietary supplement containing Inositol is showing promise in research.

If you think you may have this, it is important to be seen by a doctor for evaluation and treatment.

Some other resources:

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