Polycystic ovary syndrome (PCOS) is a disorder that occurs when levels of certain hormones are abnormal. Women with PCOS may have irregular or no menstrual periods, infertility, and excess hair growth.

Signs and Symptoms
Women with PCOS have a history of irregular menstrual bleeding and often have difficulty getting pregnant. They also may have unwanted hair growth in places such as on the face (mainly on the upper lip and chin), between their breasts, in the lower part of the abdomen, and on the inner thighs. In severe cases, PCOS can lead to balding, lowering of the voice, and bigger muscles.

Many women with PCOS produce too much insulin or the insulin they produce does not work as it should. This is one reason why women with PCOS tend to gain weight or have a hard time losing weight.

Causes
Each month an egg matures in a woman’s ovary. The egg is surrounded by a sac called a follicle. The cells of the follicle first produce the hormone estrogen. The egg is then released (ovulation), and the follicle cells begin to produce progesterone as well as estrogen.

Women with PCOS produce an excess amount of male sex hormones called androgens. All women produce a certain amount of these hormones. When too much is produced, it can prevent ovulation. This can result in infertility. Too much androgen also can result in excess hair growth and irregular bleeding.

Diagnosis
Women who are not ovulating and have signs of androgen excess are considered to have PCOS. The diagnosis is based on a medical history, physical exam, and lab tests.

An ultrasound exam may be done to look for small cysts on the ovary. These cysts often occur with PCOS.

Treatment
PCOS is a lifelong condition, but it can be treated in a number of ways. Treatment depends on the symptoms and whether a woman wants to become pregnant. Long-term treatment may be needed to help prevent endometrial cancer, diabetes, and heart disease.

Lifestyle Changes
Daily exercise improves the body’s use of insulin and can help relieve symptoms of PCOS. Many of the symptoms of PCOS may be improved by daily exercise for at least 30 minutes a day.

In some women with PCOS, weight loss will lower insulin levels enough to allow ovulation to begin. It also may help slow new hair growth.

Medication
Your doctor may prescribe progesterone (or other hormones) or birth control pills to bring on regular menstrual bleeding. Women who wish to become pregnant may be given medications to help them ovulate. Some women with PCOS will be prescribed medication to lower their insulin levels.

Your doctor also may prescribe birth control pills and other medications to help slow the growth of new body hair.

Finally...
With proper treatment, PCOS can be managed and your symptoms can be relieved. You should have long-term health care to look for disorders that may arise.

This excerpt from ACOG's Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.