PCOS: More than irregular periods

It’s common to miss a period occasionally, but consistently irregular periods (usually defined as greater than 35 days between periods) and other symptoms such as acne, weight gain, facial hair, and coarse body hair could be signs of polycystic ovary syndrome, also known as PCOS.

These symptoms can significantly affect your overall health and well-being. Fortunately, early diagnosis and a personalized treatment plan from your doctor can go a long way in managing symptoms and improving your quality of life.

What is PCOS?

PCOS is a hormonal imbalance that affects 6 to 12% of women of reproductive age, according to the American Medical Association.

Ovulation (release of an egg by the ovaries) and menstrual cycles are typically controlled by hormones such as estrogen, progesterone, follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

In PCOS, the ovaries produce higher levels of androgens (hormones responsible for male characteristics such as testosterone). The ovaries then do not get the proper hormonal signals to ovulate , which can make it difficult to get pregnant. PCOS is one of the most common causes of infertility in women. PCOS gets its name because the ovaries can appear to have many small fluid-filled sacs because they cannot ovulate normally.

PCOS symptoms

The most common sign of polycystic ovary syndrome (PCOS) is irregular periods, but you may also experience:

• Acne
• Excess facial or body hair
• Absent periods
• Male-pattern baldness
• Weight gain or obesity
• Infertility (12 months or more of unprotected intercourse without pregnancy)

Symptoms can vary widely from person to person, ranging from mild to severe, and sometimes fluctuate over time. Many women don’t notice any symptoms — or connect them to PCOS — until they’re trying to get pregnant. If you suspect you have PCOS or are having difficulty conceiving, it’s important to speak with your physician.

Early diagnosis and treatment are key, as PCOS may increase your risk for serious health conditions, including:

• Cardiovascular disease
• Endometrial (uterine) cancer
• Hypertension (high blood pressure)
• High cholesterol
• Infertility
• Mood disorders
• Sleep apnea
• Type 2 diabetes or gestational diabetes

You don’t have to live with PCOS symptoms. Schedule an appointment with a gynecologist today to learn about options to manage it.  

What causes PCOS?

While the exact cause of PCOS is unknown, some newer research suggest it may have a genetic link. PCOS often runs in families. Obesity has also been strongly associated with this condition.

PCOS is also linked with high androgen levels, insulin resistance and high insulin levels, and chronic inflammation. 

How is PCOS diagnosed?

You may receive a diagnosis of PCOS if your doctor finds you have at least two of the following key indicators:

• High levels of androgens diagnosed based on symptoms (such as facial hair, acne, and male-pattern baldness) or lab work
• Irregular or absent periods attributed to missed ovulation
• Polycystic or enlarged ovaries with immature follicles

Despite its name, you don’t need to have ovarian cysts to be diagnosed with PCOS.

There is no definitive test to diagnose PCOS, but, based on your symptoms, your doctor may recommend:

• Blood tests to check for abnormal hormone levels and other medical conditions such as diabetes
• Pelvic exam to see if there are any structural reasons for your symptoms
• Pelvic ultrasound to look at your uterus and ovaries

PCOS treatment

“Treatment for PCOS focuses on managing symptoms. For some women, lifestyle changes, such as increasing physical activity and maintaining a healthy weight, are enough to improve or even alleviate symptoms,” says Dr. Rachel Astles, an OB‑GYN with HCA Florida Healthcare.

Metformin, a diabetes medication, is often used because it decreases insulin resistance and may help address one of the underlying drivers of PCOS. Other medications can target specific symptoms, including hormonal options like birth control pills or progestin therapy for irregular periods. Your care team may also recommend oral or topical medications or noninvasive procedures to help manage acne, excess hair growth, or other concerns.

Many women don’t realize they have PCOS until they’re trying to get pregnant. Fertility treatments for PCOS focus on supporting ovulation and may include clomiphene, letrozole or metformin. Your care team will guide you toward the safest and most effective options for your situation.

Supportive care that meets you where you are

PCOS is common, but it doesn’t have to define your future. At HCA Florida Healthcare, we offer evidence-based, personalized care to help you manage symptoms and reduce long-term health risks.

Schedule an appointment with a gynecologist today to learn about treatment options.