What is PCOS and how does it affect pregnancy?

Polycystic ovary syndrome (PCOS) is a condition that affects 12-21 percent of all women, depending on the definition used and the population being examined. It can be present when a woman has two main issues: irregular or absent periods, and signs of extra “male” hormones (also known as hyperandrogenism). Since PCOS can lead to trouble conceiving as well as a host of other medical issues, it’s important to understand what exactly PCOS is and how it can be treated.

PCOS can be officially diagnosed when two or more of the following criteria are present:

• Infrequent or absent periods
• Signs of increased levels of male hormones (such as increased facial hair, male-patterned baldness, or abnormal lab tests)
• Ovaries with multiple cysts seen on ultrasound

A woman or her doctor may suspect she has PCOS if she has some of the above symptoms. Other symptoms that may signal PCOS include anxiety, depression, sexual dysfunction, obesity, diabetes or pre-diabetes, high cholesterol levels, or trouble getting pregnant.

Once a diagnosis of PCOS is made, it is important to manage the condition for multiple reasons: to avoid long-term health issues, to increase a woman’s chance of conceiving if she desires, and to avoid the negative emotional issues that may surface with this diagnosis.

If a woman with PCOS is obese, this is the first intervention that can make a huge difference. The goal should be to adopt a healthy lifestyle via an improved diet and increased exercise to get to a healthy weight. However, even small changes make a difference: studies have shown that even just a 5 percent weight loss can help women with PCOS resume normal menstrual cycles, thus increasing their chances of conceiving.

Treatments such as birth control pills can also help abnormal menstrual cycles improve and also prevent the new growth of unwanted facial hair. For facial or body hair that is already present, however, women with PCOS often undergo electrolysis to remove this hair, as we currently have no medical treatments to decrease its appearance.

Additional medications may be used to treat abnormal testosterone levels, high cholesterol, or the insulin resistance that often gives women with PCOS issues with pre-diabetes. One of these medications in particular, metformin may not only help prevent the development of diabetes but may also help with infertility issues.

Women with PCOS are much more likely to have trouble with depression, anxiety, and body image. These are even more likely if a woman is trying to conceive and is unable. In these women, frequent screening for and treatment of mental health disorders is key.

If you think that you may have PCOS, be sure to talk with your primary care doctor or OB/GYN about your concerns. Early diagnosis and treatment can help you avoid many of the long-term health issues that can accompany this diagnosis.