Questions about Polycystic Ovary Syndrome (PCOS)

How common is polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome affects 5 to 10% of women of childbearing age, and it is a leading cause of infertility. As many as 30% of women have some characteristics of the syndrome.


What are the symptoms of PCOS?

Women with PCOS may have some of the following symptoms:

  • No menstrual period, infrequent menses and/or irregular bleeding
  • Infrequent or absent ovulation
  • Increased levels of male hormones
  • Infertility
  • Cystic ovaries
  • Enlarged ovaries
  • Chronic pelvic pain
  • Obesity or weight gain
  • Insulin resistance, overproduction of insulin and diabetes
  • Abnormal lipid levels
  • High blood pressure
  • Excess body hair
  • Baldness or thinning hair
  • Acne/oily skin/seborrhea

 

Why do some people call it polycystic ovarian disease and others call it polycystic ovary syndrome?

The terms polycystic ovary syndrome (PCOS) and polycystic ovarian disease (PCOD) are commonly used interchangeably. We prefer to use the term polycystic ovary syndrome because it more accurately reflects the complex signs, symptoms and nature of this condition, namely that of a "syndrome." Syndrome is the favored term because it alludes to the varied signs and symptoms but does not imply a precise cause of the condition - as for PCOS the exact cause has yet to be determined. This definition is in contrast to that of a "disease," which commonly implies a specific cause for the condition.


Are there other names for PCOS?

This syndrome is also known as Stein-Leventhal syndrome (not currently in use), hyperandrogenic chronic anovulation and functional ovarian hyperandrogenism.


What are the effects of PCOS?

Although PCOS can cause difficulty getting pregnant, its effects go far beyond fertility. A few good examples of these far-reaching effects include hirsutism (hair growth), insulin resistance, heart disease risk factors and even uterine cancer. This list is far from complete, but we can review these few examples here in order to give you some idea of the importance of seeking treatment for PCOS long before you desire pregnancy.

Hirsutism is the excess growth of coarse dark hair in a predominantly male pattern. Women affected by PCOS commonly experience hirsutism due to increased levels of the male hormones called androgens. The longer a women with PCOS goes untreated the more severe her hirsutism will become.

Insulin resistance is a condition common to PCOS in which the tissues of the body become less responsive to the hormone insulin. If left untreated, the body may become so unresponsive to insulin that it develops a type of diabetes. If diagnosed appropriately, there are treatments available that can prevent the progression to diabetes.

Heart disease risk factors are more common in women with PCOS. Women affected by PCOS are frequently overweight, have increased levels of androgens and may have insulin resistance, elevated cholesterol and high blood pressure. With proper attention these risk factors can be treated; however, if left untreated they can increase the woman's risk of heart disease.

One final example of the far-reaching effects of PCOS, beyond that of fertility, is the rare complication of uterine cancer. Women with PCOS can often go great lengths of time without a menstrual period. When this occurs the inside lining of their uterus, called the endometrium, is exposed to the hormone estrogen for long periods of time without a break. This can lead to a condition of disorganized cell growth within the endometrium. If left untreated this disorganized cell growth can develop into cancer of the uterus. With appropriate medical treatment this can be prevented in almost all cases. Having said this, it is very important that we stress that it is not the period itself that prevents endometrial cancer. Rather, it is exposure of the uterine lining to the hormone progesterone - which is commonly lacking in women with PCOS. Appropriate treatment to prevent uterine cancer will include a progesterone-like medication.


What causes PCOS?

The exact cause of PCOS is unknown. Some studies are looking at the possibility of a genetic link. Just as one might have a genetic predisposition to diabetes, one might also have a disposition to PCOS.


Is there a cure for PCOS?

No. PCOS is a condition that can be managed, but currently no cure exists. Treatment of the symptoms can help reduce risks of future health problems.