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Polycystic ovary syndrome (PCOS) affects one in 10 women of childbearing age.


Women with PCOS have a hormonal imbalance and metabolism problems that may affect their overall health and appearance.


Q: What are the symptoms of PCOS?

A: Some of the symptoms of PCOS include:

• Irregular menstrual cycle.

  • Infertility 

• Too much hair on the face, chin, or parts of the body where men usually have hair. This is called “hirsutism.”

• Acne on the face, chest, and upper back.

• Thinning hair or hair loss on the scalp; male-pattern baldness.

• Weight gain or difficulty losing weight.

• Darkening of skin, particularly along neck creases, in the groin, and underneath breasts.

• Skin tags, which are small flaps of excess skin in the armpits or neck area.


Q: What causes PCOS?

A: The exact cause of PCOS is not known. Most experts think that several factors, including genetics, play a role.

• High levels of androgens. Higher than normal androgen levels in women can prevent the ovaries from releasing an egg (ovulation) during each menstrual cycle, and can cause extra hair growth and acne.

• High levels of insulin. Insulin is a hormone that controls how the food you eat is changed into energy. Insulin resistance is when the body’s cells do not respond normally to insulin. As a result, your insulin blood levels become higher than normal. Many women with PCOS have insulin resistance, especially those who are overweight or obese, have unhealthy eating habits, do not get enough physical activity, and have a family history of diabetes (usually type 2 diabetes). Over time, insulin resistance can lead to type 2 diabetes.

Q: How do you test for PCOS?

A: Diagnostic lab studies include thyroid-stimulating hormone, prolactin, and 17-hydroxy-progesterone. These are tests done to exclude other disorders.

We also check for increased ovarian androgens can be assessed with elevated levels of free and total testosterone. Elevations in adrenal androgens can be found by evaluating DHEAS. 

Anti-Mullerian hormone (AMH) is often elevated in women with PCOS. This compound is made by the multitude of small follicles in the ovary.


Diabetes can be a part of PCOS. To exclude diabetes, a Hemoglobin A1c will provide information on long-term sugar control.

Serum lipids should be carefully monitored, including a fasting cholesterol level.

A sonogram of the pelvis will help with the diagnosis, looking for multiple cysts on both ovaries. 


Q: How is PCOS treated?

A: There is no cure for PCOS, but you can manage the symptoms of PCOS. Many women will need a combination of treatments, including:

• Weight loss. Losing weight may help to lower your blood glucose levels, improve the way your body uses insulin, and help your hormones reach normal levels. Even a 10 percent loss in body weight (for example, a 150-pound woman losing 15 pounds) can help make your menstrual cycle more regular and improve your chances of getting pregnant.

• Hair removal or slowing hair growth. You can try facial hair removal creams, laser hair removal, or electrolysis to remove excess hair. A prescription skin treatment (eflornithine HCl cream) can slow down the growth rate of new hair in unwanted places.

• Prescription medicines.

1. Hormonal birth control, such as the pill, patch, shot, vaginal ring, or hormonal intrauterine device (IUD), to improve acne and reduce unwanted hair. Birth control works by binding and removing the extra testosterone in your system.

2. If you are trying to get pregnant, certain medicines can help you ovulate, such as Letrozole or clomiphene (Clomid). 

3. Insulin-sensitizing agents, such as Metformin, result in lower insulin levels, lower oxidative stress and lower androgen production.

4. Anti-androgens such as Spironolactone act primarily by blocking the ability of testosterone to bind to androgen receptors in the skin. 

5. Seed cycling may relieve some of your symptoms if a hormonal imbalance is present. Seed cycling is not really new but it is newly trendy treatment for PCOS.

6. Several studies have found myo-inositol to be an effective treatment in PCOS, due to its ability to improve insulin sensitivity, restore hormonal balance, improve menstrual regularity, reduce hyperandrogenism, and influence ovarian function. Popular brands include Ovasitol,  Wholesome Story, Intimate Rose and Pregnitude (for those trying to conceive). 

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