Polycystic Ovary Syndrome (PCOS): Symptoms and Causes
Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age.
The three main features of PCOS are:
- Irregular periods: Which means your ovaries don’t regularly release eggs (ovulation).
- Excess androgen: High levels of “male hormones” in your body, which may cause physical signs such as excess facial or body hair.
- Polycystic ovaries: Your ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function regularly.
Causes of PCOS
- Resistance to insulin: Insulin resistance means the body’s tissues are resistant to the effects of insulin. The body therefore has to produce extra insulin to compensate. High levels of insulin cause the ovaries to produce too much testosterone, which interferes with the development of the follicles (the sacs in the ovaries where eggs develop) and prevents normal ovulation. Insulin resistance can also lead to weight gain, which can make PCOS symptoms worse, because having excess fat causes the body to produce even more insulin.
- Raised levels of testosterone: A hormone often thought of as a male hormone, although all women usually produce small amounts of it.
- Raised levels of luteinising hormone (LH): This stimulates ovulation, but may have an abnormal effect on the ovaries if levels are too high.
- Low levels of sex hormone-binding globulin (SHBG): A protein in the blood, which binds to testosterone and reduces the effect of testosterone.
- Raised levels of prolactin (only in some women with PCOS): Hormone that stimulates the breast glands to produce milk in pregnancy.
- Genetics: PCOS sometimes runs in families. If any relatives, such as your mother, sister or aunt, have PCOS, then the risk of you developing it is often increased.
Symptoms of PCOS
- Irregular periods or no periods at all
- Difficulty getting pregnant as a result of irregular ovulation or failure to ovulate
- Excessive hair growth (hirsutism), usually on the face, chest, back or buttocks
- Weight gain
- Thinning hair and hair loss
- Oily skin or acne
Complications of PCOS
- Gestational diabetes or pregnancy-induced high blood pressure
- Miscarriage or premature birth
- Nonalcoholic steatohepatitis, a severe liver inflammation caused by fat accumulation in the liver
- Metabolic syndrome, a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increase your risk of cardiovascular disease
- Type 2 diabetes or prediabetes
- Sleep apnea
- Depression, anxiety and eating disorders
- Abnormal uterine bleeding
- Cancer of the uterine lining (endometrial cancer)
See your doctor if you’ve skipped periods or you have other PCOS symptoms like hair growth on your face or body.
Also see a doctor if you’ve been trying to get pregnant for 12 months or more without success.
Lifestyle interventions are the first treatments doctors recommend for PCOS, and they often work well. Weight loss can treat PCOS symptoms and improve the odds of getting pregnant. Diet and aerobic exercise are two effective ways to lose weight.
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Medicines are an option if lifestyle changes don’t work. Birth control pills and metformin can both restore more normal menstrual cycles and relieve PCOS symptoms.