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Polycystic ovary syndrome, otherwise known as PCOS, is caused by a hormone imbalance that interferes with normal ovulation. Hirsutism is a condition of unwanted hair growth typically on the face, chest and back.
Most women with PCOS will have numerous small cysts (less than the size of a pea) on their ovaries at some time. Each small cyst represents a follicle, which contains a single egg that is attempting to develop to a stage where it will be ready to be released from the ovary (a process known as ovulation). However, because of the complex biochemical situation that exists in ovaries with PCOS, the development of these follicles stops too soon, resulting in a collection of small follicles and the lack of ovulation. This lack of ovulation is the reason why women with PCOS commonly have difficulty becoming pregnant.
PCOS may increase your risk of developing other conditions or diseases over time, such as diabetes, high cholesterol, heart disease and endometrial hyperplasia.
PCOS symptoms vary widely and are similar to symptoms for other conditions. Therefore, women with these symptoms do not necessarily have PCOS.
- Excess hair growth (hirsutism), acne or balding
- Irregular ovulation and abnormal menstrual periods
- Obesity and insulin resistance
- Polycystic ovaries
PCOS has such a wide range of symptoms that no single test can be used to diagnose the syndrome. Several exams and tests to diagnose PCOS may be done, depending on your symptoms.
- Blood tests
- Insulin level tests
- Medical history
- Pelvic exam
- Thyroid level tests
- Transvaginal ultrasound
If you have been diagnosed with PCOS, you will need yearly tests to determine your insulin, glucose, cholesterol and triglyceride levels. Regular testing will help reduce the risk of any long-term complications.
In order to determine the cause of hirsutism, your doctor will obtain blood tests for different hormone levels. Your doctor may also order a pelvic ultrasound or X-rays to make certain you do not have an ovarian or adrenal tumor. The adrenal gland may also be checked by performing an adrenal stimulation test.
Since there is no specific cure for PCOS, treatment focuses on managing PCOS symptoms and preventing long-term complications.
- Drug therapy may include birth control pills to correct irregular menstrual cycles, insulin-sensitizing medications, fertility medications, weight loss pills and acne medications.
- Cosmetic therapy can include treatments for hair removal and for clearing up acne.
- Hormone replacement therapy may be prescribed to correct the hormone imbalance associated with PCOS.
- Nutritional counseling is available to treat obesity and help alleviate insulin resistance.
- Surgery to remove the ovaries or uterus (bilateral salpingo-oophorectomy or hysterectomy) is an option for women with severely symptomatic PCOS who do not want future pregnancies.
To stop the progression of hirsutism, most women should first be treated with hormones, typically with common birth control pills. Once the hormone treatment has taken full effect, electrolysis can be used to permanently remove any remaining hairs. Facial creams, waxing and shaving are also helpful in reducing unwanted hair.