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Polycystic Ovary Syndrome (PCOS)

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What is Polycystic Ovary Syndrome (PCOS)?

PCOS is a kind of hormone imbalance. Women with PCOS can have:

  • Irregular periods or no periods at all
  • Severe acne
  • Unwanted coarse hair on face or body
  • Weight gain, or trouble losing weight
  • Areas of darkened, velvety skin on the neck, under the arms, in the groin and other skin creases (Acanthosis Nigricans)
  • Ovaries that are normal, or slightly enlarged, or contain many small follicles (round groups of cells in the ovaries that make hormones, and have the ability to release an egg during ovulation). Women with PCOS do not have ovaries filled with cysts.

Definitions

  • Hormones: Chemical messengers in the body. They ‘tell’ different body parts to do certain things.
  • Insulin: A hormone made by the pancreas. Insulin helps the body use sugars from food. 

What causes PCOS?

The causes of PCOS aren’t clear. For most women, PCOS is probably caused by a few things, including the genes they are born with. Most women with PCOS are resistant to insulin. This means that the body’s cells do not respond normally to insulin. This leads to high insulin levels in the blood. High insulin levels cause the ovaries and adrenal glands to make extra androgens (“male hormones” like testosterone). Girls normally make small amounts of androgens during puberty. Androgens give girls underarm and pubic hair, but higher levels may cause severe acne, unwanted body hair and irregular periods. 

  • Insulin resistance: Body cells are not responding normally to insulin. 
  • High insulin levels in blood 
  • Ovaries and adrenal glands make extra androgens
  • Acne, unwanted body hair, irregular periods.

Can women with PCOS have other health problems?

Women with untreated PCOS are more likely to have other problems over time, like:

  • Type 2 diabetes
  • Heart disease
  • Difficulty becoming pregnant
  • Cancer of the lining of the uterus
  • Depression
  • Obstructive sleep apnea (short periods where you stop breathing while you sleep)

Can PCOS be cured?

There is no cure for PCOS. But many treatments can help control symptoms and decrease the chance of problems in the future.

How is PCOS diagnosed?

Before doctors diagnose PCOS, they must first rule out other problems that can cause similar symptoms. The first step is a check up with the doctor, followed by some blood tests (hormone levels, blood sugar and cholesterol). Some girls may need an abdominal-pelvic ultrasound.

How is PCOS managed?

To treat PCOS, we try to lower insulin resistance and decrease androgens (male hormones).

A healthy lifestyle, along with medications, have a role here. Your doctor may choose one or more treatments. This will depend on the symptoms of PCOS that bother you the most. Be open and honest with your doctor. Your feelings are very important!

Insulin resistance and symptoms of PCOS can be improved by making changes to:

  • Diet
    Changes in eating and drinking can improve symptoms of PCOS and insulin resistance. Aim for a balanced diet with lots of whole grains, fruit and vegetables. Limit processed foods. Drink lots of water.
  • Sleep
    Try to get enough quality sleep (8-10 hours each night) 
  • Physical Activity
    Increasing physical activity makes muscle cells more sensitive to insulin. This will decrease insulin resistance, helping to decrease androgen levels and regulate your periods. It can also help you to manage stress.
  • Manage stress
    Try yoga, mindfulness or relaxation exercises to cope with stress.

Medications

(for more detailed information about medications, please see our Medications for PCOS fact sheet) Depending on your needs, there are several medications your doctor may prescribe:

  • Oral contraceptives (the birth control pill, contains female hormones, estrogen and progesterone, or other forms of estrogen and progesterone)
  • Progesterone treatments
  • Anti-androgens, like spironolactone or Cyproterone acetate (Androcur®)
  • Insulin Sensitizers (Metformin)

Hair removal

Your doctor may suggest ways to hide unwanted hair, like: 

  • Shaving
  • Waxing
  • Bleaching
  • Using hair removal creams
  • Having electrolysis
  • Laser treatments

Taking care of yourself as you get older

Girls and women with PCOS have a greater risk some health problems. It will be important for you to see your family doctor regularly to:

  • Get blood tests for cholesterol and blood sugar every year
  • Check for depression and sleep apnea.
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