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Patient education: Polycystic ovary syndrome (The Basics)

Patient education: Polycystic ovary syndrome (The Basics)

What is polycystic ovary syndrome? — Polycystic ovary syndrome ("PCOS") is a condition that can cause irregular periods, acne, extra facial hair, or hair loss from the head. It is very common. About 5 to 8 percent of all women have PCOS. Most, but not all, people with PCOS have excess weight or obesity.

What causes PCOS? — In PCOS, the ovaries do not work normally and they produce too much testosterone. Testosterone is called a "male hormone," but all people have some testosterone. Normally, the ovaries produce very small amounts. But in PCOS, they make more.

About once a month, the ovaries are supposed to make a structure called a "follicle" (figure 1). As the follicle grows, it makes hormones. Then, it releases an egg. This is called "ovulation." But in people with PCOS, the ovary makes many small follicles instead of 1 big one. Hormone levels can get out of balance. And ovulation doesn't happen every month the way that it is supposed to. Doctors aren't sure why this happens in some cases.

What are the symptoms of PCOS? — Symptoms can include:

Having fewer than 8 periods a year

Growing thick, dark hair on the upper lip, chin, sideburn area, chest, or belly

Acne (oily skin and pimples on their face)

Hair loss from the head

Trouble getting pregnant without medical help

Weight gain and obesity

Should I see a doctor or nurse, even if my symptoms are mild? — Yes. PCOS increases your risk of other health problems, including:

Diabetes (high blood sugar)

High cholesterol levels

Sleep apnea, which is a sleep disorder that causes people to briefly stop breathing while they sleep

Depression or anxiety

Eating disorders, such as binge eating or bulimia

Less interest in sex

Should I have tests? — Your doctor or nurse will decide which tests you should have based on your age, symptoms, and individual situation. Possible tests include:

Blood tests to measure levels of hormones, blood sugar, and cholesterol

A pregnancy test if you have missed any periods

Pelvic ultrasound – This test uses sound waves to make a picture of your uterus and ovaries. Doctors sometimes use this test to help figure out if you have polycystic ovaries.

How is PCOS treated? — The most common treatment is to take birth control pills. But there are other treatments than can help with symptoms, too.

Birth control pills – This is the main treatment for PCOS. The pills don't cure the condition. But they can improve many of its symptoms, like irregular periods, acne, and facial hair. Birth control pills also lower your risk of cancer of the uterus.

Anti-androgens – These medicines block hormones that cause some PCOS symptoms like acne and facial hair growth. Spironolactone (brand name: Aldactone) is the most commonly used one.

Progestin – This hormone can make your periods regular, but only if you take it regularly. It also lowers the risk of cancer of the uterus. Most doctors use medroxyprogesterone (brand name: Provera) or natural progesterone (brand name: Prometrium).

Metformin (brand name: Glucophage) – This medicine can help make your periods more regular. But it works only in about half of the people who try it. In people with diabetes, this medicine helps to lower blood sugar levels.

Medicated skin lotion or antibiotics to treat acne

Laser therapy or electrolysis to remove extra hair

Is there anything I can do on my own? — Yes. If you have excess weight or obesity, losing weight can improve many of your symptoms. Losing just 5 percent of your body weight can help a lot. As an example, for a person who weighs 200 pounds, this would mean losing 10 pounds.

What if I want to get pregnant? — Most people with PCOS are able to get pregnant, but it is usually easier for those who are not overweight. If you are overweight, losing weight can help make your periods more regular and improve your chances of getting pregnant. If you lose weight but your periods are still irregular, your doctor can give you medicines to help you ovulate and improve your chances of getting pregnant.

What will my life be like? — It is possible to live a full and normal life with PCOS. But it is important to see a doctor. Treatments will help your symptoms and protect you from other diseases.

Talk to your doctor or nurse if you feel depressed or anxious, think that you might have an eating disorder, or have problems with sex. There are treatments that can help with these problems, too.

More on this topic

Patient education: Female infertility (The Basics)
Patient education: Absent or irregular periods (The Basics)
Patient education: Hirsutism (excess hair growth in women) (The Basics)
Patient education: Depression in adults (The Basics)
Patient education: Generalized anxiety disorder (The Basics)
Patient education: Bulimia nervosa (The Basics)
Patient education: Sex problems in females (The Basics)

Patient education: Polycystic ovary syndrome (PCOS) (Beyond the Basics)
Patient education: Losing weight (Beyond the Basics)
Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics)
Patient education: Type 2 diabetes: Overview (Beyond the Basics)
Patient education: Depression in adults (Beyond the Basics)

This topic retrieved from UpToDate on: Feb 02, 2024.
Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms. 2024© UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
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