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Polycystic ovarian syndrome (PCOS) is the most common hormonal disorder in women of reproductive age, causing disrupted ovulation and a lack of regular menstruation. The exact cause is unknown, but it may be genetic. Symptoms vary from woman to woman, with some experiencing milder symptoms and others more severe.

Symptoms are linked to hormones, with women with PCOS having slightly higher testosterone levels, leading to facial hair growth, and insulin resistance, a condition where the body doesn’t respond to insulin, increasing glucose levels and leading to weight gain and fertility issues. Diagnosing PCOS increases the risk of developing diabetes in later life.

PCOS affects around one in every 10 women, with half of these people getting type 2 diabetes before the age of 40. Despite the prevalence of PCOS, 70% of women with the disorder are unaware of it. There is currently no cure for PCOS, but therapies to alleviate symptoms are available. Women with PCOS often complain about issues such as irregular bleeding, infertility, obesity, excessive hair growth, hair loss, and acne.

Some PCOS women ovulate infrequently or not at all, have trouble getting pregnant, and usually require therapy to boost their chances of conception. They also have an excess of the male hormones testosterone and androstenedione, resulting in elevated testosterone levels in the blood. Many women with PCOS appear to have physical or psychological signs of depression, which should be addressed by seeking emotional help from a doctor. Ultrasound diagnosis is frequently used to initiate treatment for PCOS and infertility, as the multiple tiny
cystic formations in a polycystic ovary give the ovaries a typical “polycystic” appearance on ultrasonography.

It must however be stated that ultrasound appearance is not enough for diagnosis as you need the presence of at least 2 out of 3 symptoms/signs:

  1. Absence or irregular menses (less than 8 menses in a year)
  2. Presence of hair in abnormal place in a female or balding are usual signs of excessive male hormone in a woman or blood test showing elevated male hormones.
  3. Presence of polycystic ovaries on ultrasound seen.

Losing weight may help alleviate symptoms, but there are thin women with PCOS who may also have insulin resistance, which may contribute to weight gain and difficulty shedding excess weight. Most PCOS patients can see their usual obstetrician, but those with significant insulin resistance, diabetes, or high blood pressure should consult a high-risk obstetrician. Fertility testing may be beneficial
for both the patient and their partner, revealing any other variables causing problems, such as male infertility.

With fertility medications, the chances of getting pregnant with PCOS are quite favorable. Although there is currently no cure for PCOS, some women’s periods do normalize after birth, and those with fertility issues may find it easier to conceive again. IVF is an excellent choice, but its effectiveness depends on individual factors such as age, length of infertility, and weight. Many women with PCOS suffer from physical or psychological manifestations of depression, which should be sought by a doctor who is willing to listen to concerns and not dismiss this potential side effect of PCOS.

Treatment for PCOS and infertility often begins with an ultrasound diagnosis, which helps determine the necessary tests. Physical examinations, including height, weight, facial or body hair growth, acne, and discoloration of the skin under the arms, breasts, and groin, can help make the diagnosis. Insulin resistance, common to PCOS, may play a role in weight gain and the difficulty of losing any extra weight.

It is worth repeating that PCOS has no cure but a healthy lifestyle is probably the defense against PCOS worsening the prime reproductive years.

To sum it up, PCOS is a common and treatable cause of infertility that can lead to missed or irregular menstrual periods. Irregular periods can lead to infertility, PCOS can also cause the development of cysts in the ovaries. Between 5 percent and 10 percent of women aged 15 to 44, or during the years they can have children, have PCOS.

Most women discover it in their 20s and 30s when they have problems getting pregnant and see their doctor. However, PCOS can occur at any age after puberty.

Women of all races and ethnicities are at risk, with a higher risk associated with obesity or having a mother, sister, or aunt with PCOS.

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