Straight from our fertility specialists, board-certified reproductive endocrinologists. They wrote, in understandable language, a definition of what PCOS (Polycystic Ovarian Syndrome) is and what is it not. Since we're coming up on September, which is PCOS Awareness month, it seems like a good place to start. Questions? Let us know, we'll be glad to answer.
Fertility Specialists Explain PCOS
Polycystic Ovarian Syndrome (PCOS) is a medical condition that causes infertility by preventing women from ovulating.
It is a common condition, affecting 5-10% of women of reproductive age. In terms of conceiving a baby, the hormonal imbalances created by PCOS prevent the ovary from ovulating and releasing an egg to meet with the sperm.
Polycystic Ovarian Syndrome (PCOS) Symptoms
Many women with Polycystic Ovarian Syndrome (PCOS) have ovaries that are producing excess hormones, specifically the hormone testosterone. In addition, they can have a decreased sensitivity to insulin for which their bodies compensate by over-producing insulin. The overactive ovaries and high levels of insulin may contribute to the development of hirsuitism (excessive body hair) and worsen the already present ovulation disorder. There is evidence that excess insulin plays a role in the development of PCOS; it is therefore hypothesized that reducing the circulating levels of insulin may help restore normal reproductive function. This may be accomplished by weight loss, improved nutrition, and exercise. These lifestyle changes should be the first line of therapy for any woman with PCOS.
PCOS & Metformin
Additionally, there is some evidence that insulin sensitizing agents can aid in both the medical and fertility therapy of PCOS. The best studied insulin sensitizing agent available in the United States for women with PCOS is metformin (Glucophage®). Metformin reduces circulating insulin and androgen levels and may restore normal ovulation in select women with PCOS. The most current scientific evidence shows that metformin alone does not usually restore ovulation, but in some women it may improve the ovarian response to fertility medications. Most patients with PCOS do not need metformin, and the decision to prescribe metformin is made by your physician on a case-by-case basis to ensure personalized treatment plans.
PCOS Health Issues
In addition to these infertility and reproductive problems, there are also health issues for patients with PCOS that include: irregular menstrual periods, obesity, high cholesterol, high blood pressure and a pre-disposition towards Type 2 diabetes. Some of these symptoms, if left untreated, can lead to heart disease later in life.
Diagnosing Polycystic Ovarian Syndrome
We can diagnosis women with PCOS by reviewing your symptoms: infertility, irregular menstrual periods (or skipping them entirely), severe and chronic acne and excessive body hair growth. The symptom that brings most women to see a specialist is irregular menstrual periods. If you are having fewer than 4-6 menstrual periods per year, you should have the lining of your uterus evaluated for overgrowth, a condition known as endometrial hyperplasia. You should also have a fasting sugar test to make sure you do not have a pre-diabetic condition called Insulin-Resistance that is common in patients with PCOS. Additionally, cholesterol levels and blood pressure should be checked regularly. It is also important to maintain a routine of diet and exercise. Many studies have shown an improvement in every aspect of PCOS with a sustained loss of 5-10% of your body weight, regardless of your starting weight.