September is PCOS Awareness Month

PCOS stands for polycystic ovarian syndrome, a disorder that affects about 7% of reproductive-aged women, though this estimate varies based on what definition you are using. September has been named PCOS Awareness Month, so let’s discuss some facts about this disorder and what it means for those who have it.

What is PCOS?

The classic 3 symptoms in PCOS are absent or irregular ovulation (leading to absent or irregular periods), high androgen levels (causing features like acne and excess facial hair), and multiple cysts on the ovaries (thanks to the uncoordinated ovulation).

What causes PCOS?

Truthfully, we aren’t sure. There isn’t a single blood test or genetic test for it. While some people think obesity leads to PCOS, it may make PCOS symptoms worse, but it is not considered the causative agent.

What does PCOS look like?

PCOS can manifest a bit differently in those who have it, but some features are pretty typical. These include absent or irregular periods, acne, hirsutism (male-patterned hair), oily skin, darkened skin patches called acanthosis nigricans, and infertility.

How do I get a diagnosis?

Your provider will take a good history and do a physical exam to look for signs of PCOS. They will also likely recommend some bloodwork to measure hormone levels, check your cholesterol (this can often be high in people with PCOS), and rule out other causes of your symptoms. A pelvic ultrasound may be done to look at your ovaries.

What happens next?

Treatment depends on your goals. If you are not trying to conceive, hormonal birth control is often recommended if you aren’t having regular periods. This isn’t to “cover up” your PCOS but rather to decrease your risk of developing uterine cancer, which can happen when you don’t have regular cycles. Weight loss may also be discussed as even a small percentage of loss can help improve cycle regularity, and drugs that help your body use insulin better can also help menstrual cycles and lowering testosterone levels.

People with PCOS are at higher risk for developing heart disease and diabetes, so in addition to lifestyle changes certain medications may also be prescribed to prevent these. Hormonal birth control can also help decrease future facial hair growth, but hair removal treatments will be needed to remove the hair currently present.

Will PCOS make it harder to get pregnant?

PCOS definitely contributes to infertility. If you are planning to try to conceive and have PCOS, having a consultation with a reproductive endocrinologist and infertility (REI) specialist can be extremely helpful to optimizing your chances. Medications are sometimes needed to help your ovaries release an egg, called ovulation induction. Some people with PCOS need treatments such as in vitro fertilization to get pregnant.

Where can I get more information?

You can get more information about PCOS from The American College of Obstetricians and Gynecologists as well as The American Society for Reproductive Medicine. Events related to PCOS Awareness Month can be found on the PCOS Awareness Month website.