PCOS : symptoms and management

PCOS : symptoms and management

Polycystic ovary syndrome (PCOS) is a condition that affects a woman’s hormone levels.

Women with PCOS produce higher-than-normal amounts of male hormones. This hormone imbalance causes them to skip menstrual periods and makes it harder for them to get pregnant.

The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.


PCOS is a syndrome disease defined by a group of signs (physical findings) and symptoms (patient complaints).Symptoms can vary from woman to woman. Some of the symptoms of PCOS include:

-Infertility (not able to get pregnant) – PCOS is the most common cause of female infertility. Conception may take longer than in other women, or women with PCOS may have fewer children than they had planned. In addition, the rate of miscarriage is also higher in affected women.
-Infrequent, absent, and/or irregular menstrual periods- The menstrual irregularities in PCOS usually present around the time of menarche.
-Hirsutism -increased hair growth on the face, chest, back, thumbs, or toes
-Acne, oily skin, or dandruff
-Weight gain or obesity, usually with extra weight around the waist
-Male-pattern baldness or thinning hair
-Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black
-Skin tags(excess flaps of skin in the armpits or neck area)
-Pelvic pain
-Anxiety or depression
-Sleep apnea (when breathing stops for short periods of time while asleep)
-Cysts in the ovaries


The cause of PCOS is unknown. But most experts think that several factors, including genetics, could play a role. Women with PCOS are more likely to have a mother or sister with PCOS.

A main underlying problem with PCOS is a hormonal imbalance. In women with PCOS, the ovaries make more androgens than normal. Androgens are male hormones that females also make. High levels of these hormones affect the development and release of eggs from ovary each month (process called ovulation).

Researchers also think insulin may be linked to PCOS. Insulin is a hormone that controls the change of sugar, starches, and other food into energy for the body to use or store. Many women with PCOS have too much insulin in their bodies because they have problems using it. Excess insulin appears to increase production of androgen.

High androgen levels can lead to:

Excessive hair growth
Weight gain
Problems with ovulation


Doctors typically diagnose PCOS in women who have at least two of these three symptoms .

high androgen levels
irregular menstrual cycles
cysts in the ovaries

Your doctor should also ask whether you’ve had symptoms like acne, face and body hair growth, and weight gain.

A pelvic exam can look for any problems with your ovaries or other parts of your reproductive tract. During this test, your doctor inserts gloved fingers into your vagina and checks for any growths in your ovaries or uterus.

Blood tests check for higher-than-normal levels of male hormones. You might also have blood tests to check your cholesterol, insulin, and triglyceride levels to evaluate your risk for related conditions like heart disease and diabetes.

An ultrasound uses sound waves to look for abnormal follicles and other problems with your ovaries and uterus.


PCOS treatment focuses on managing your individual concerns, such as infertility, hirsutism, acne or obesity. Specific treatment might involve lifestyle changes or medication.

Lifestyle changes

Your doctor may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Even a modest reduction in your weight — for example, losing 5 percent of your body weight — might improve your condition. Losing weight may also increase the effectiveness of medications your doctor recommends for PCOS, and can help with infertility.


To regulate your menstrual cycle, your doctor might recommend:

Combination birth control pills. Pills that contain estrogen and progestin decrease androgen production and regulate estrogen. Regulating your hormones can lower your risk of endometrial cancer and correct abnormal bleeding, excess hair growth and acne. Instead of pills, you might use a skin patch or vaginal ring that contains a combination of estrogen and progestin.

Progestin therapy. Taking progestin for 10 to 14 days every one to two months can regulate your periods and protect against endometrial cancer. Progestin therapy doesn’t improve androgen levels and won’t prevent pregnancy. The progestin-only minipill or progestin-containing intrauterine device is a better choice if you also wish to avoid pregnancy.

To help you ovulate, your doctor might recommend:

-Clomiphene (Clomid). This oral anti-estrogen medication is taken during the first part of your menstrual cycle.
-Letrozole (Femara). This breast cancer treatment can work to stimulate the ovaries.
-Metformin (Glucophage, Fortamet, others). This oral medication for type 2 diabetes improves insulin resistance and lowers insulin levels. If you don’t become pregnant using clomiphene, your doctor might recommend adding metformin. If you have prediabetes, metformin can also slow the progression to type 2 diabetes and help with weight loss.
-Gonadotropins. These hormone medications are given by injection.


PCOS cannot be prevented, but early diagnosis and treatment helps to prevent long-term complications, such as infertility, metabolic syndrome, obesity, diabetes and heart disease.

A healthy lifestyle consists of a healthy diet, regular exercise and maintaining a healthy weight is helpful in preventing various complications. Further regular checkups are recommended for early diagnosis of these complications.