PCOS Frequently Asked Questions
How common is PCOS?
Polycystic Ovary Syndrome affects an estimated 5-10 percent of women of childbearing
age and it is a leading cause of infertility. It is the most common endocrinopathy
among reproductive age women. As many as 30 percent of women have some characteristics
of the syndrome.
What are the symptoms of PCOS?
Women with PCOS may have some of the following symptoms:
Amenorrhea (no menstrual period), infrequent menses, and/or oligomenorrhea (irregular
bleeding) Cycles are often greater than six weeks in length, with eight or fewer
periods in a year. Irregular bleeding may include lengthy bleeding episodes, scant or
heavy periods, or frequent spotting.
Oligo or anovulation (infrequent or absent ovulation) While women with PCOS produce
follicles which are fluid-filled sacs on the ovary that contain an egg the follicles
often do not mature and release as needed for ovulation. It is these immature follicles
that create the cysts.
Hyperandrogenism Increased serum levels of male hormones. Specifically, testosterone,
androstenedione, and dehydroepiandrosterone sulfate (DHEAS).
Infertility Infertility is the inability to get pregnant within six to 12 months of
unprotected intercourse, depending on age. With PCOS, infertility is usually due to
ovulatory dysfunction.
Cystic ovaries Classic PCOS ovaries have a "string of pearls" or "pearl necklace"
appearance with many cysts (fluid-filled sacs). It is difficult to diagnose PCOS without
the presence of some cysts or ovarian enlargement, but sometimes more subtle
alterations may not have been recorded, or are not recognized as abnormal, by the
ultrasonographer.
Enlarged ovaries Polycystic ovaries are usually 1.5 to 3 times larger than normal.
Chronic pelvic pain The exact cause of this pain isn't known, but it may be due to
enlarged ovaries leading to pelvic crowding. It is considered chronic when it has been
noted for greater than six months.
Obesity or weight gain Commonly a woman with PCOS will have what is called an apple
figure where excess weight is concentrated heavily in the abdomen, similar to the way
men often gain weight, with comparatively narrower arms and legs. The hip:waist ratio
is smaller than on a pear-shaped woman meaning there is less difference between hip
and waist measurements. It should be noted that most, but not all, women with PCOS are
overweight.
Insulin resistance, hyperinsulinemia, and diabetes Insulin resistance is a condition
where the body's use of insulin is inefficient. It is usually accompanied by
compensatory hyperinsulinemia an over-production of insulin. Both conditions often
occur with normal glucose levels, and may be a precursor to diabetes, in which glucose
intolerance is further decreased and blood glucose levels may also be elevated.
Dyslipidemia (lipid abnormalities) Some women with PCOS have elevated LDL and reduced
HDL cholesterol levels, as well as high triglycerides.
Hypertension (high blood pressure) Blood pressure readings over 140/90.
Hirsutism (excess hair) Excess hair growth such as on the face, chest, abdomen,
thumbs, or toes.
Alopecia (male-pattern baldness or thinning hair) The balding is more common on the
top of the head than at the temples.
Acne/Oily Skin/Seborrhea Oil production is stimulated by overproduction of androgens.
Seborrhea is dandruff flaking skin on the scalp caused by excess oil.
Acanthosis nigricans (dark patches of skin, tan to dark brown/black) Most commonly on
the back of the neck, but also but also in skin creases under arms, breasts, and
between thighs, occasionally on the hands, elbows and knees. The darkened skin is
usually velvety or rough to the touch.
Acrochordons (skin tags) Tiny flaps (tags) of skin that usually cause no symptoms
unless irritated by rubbing.
Is PCOS a Syndrome or a Disease?
PCOS is generally considered a syndrome rather than a disease (though it is sometimes
called Polycystic Ovary Disease) because it manifests itself through a group of signs
and symptoms that can occur in any combination, rather than having one known cause or
presentation.
Are there are other names for PCOS?
Other names for Polycystic Ovary Syndrome are Stein-Leventhal Syndrome, hyperandrogenic
chronic anovulation, functional ovarian hyperandrogenism, and Polycystic Ovary Disease.
What causes PCOS?
The exact cause of PCOS is unknown. There are studies being conducted to see if there
may be a genetic link that PCOS is passed along in families. Just as one might have a
genetic predisposition to diabetes, one might also have a disposition to PCOS.
The above analogy to diabetes seems appropriate as many current studies into PCOS are
focusing on the body's ability to process insulin. A growing collection of data suggests
that elevated insulin levels are unhealthy and contribute to increased androgen
production, worsening PCOS symptoms from cosmetic issues to infertility, and eventually
increasing the risk of certain cancers, diabetes and heart disease.
It is also possible that PCOS may be caused or worsened by valproate, a medication used
to treat seizures, but it is hard to say if it is the epilepsy per se or the agent used
to treat it that brings about the PCOS symptoms in some women. The condition may be
improved by switching to another medication.
Is there a cure for PCOS?
No, it is a condition that is managed, rather than cured. Treatment of the symptoms of
PCOS can help reduce risks of future health problems.
