Polycystic Ovarian Syndrome

PCOS is a common endocrine disorder which affects about 5-10% of women. Most women with PCOS have irregular or absent menstrual cycles. They frequently also have signs of higher testosterone activity which may lead to increased face or body hair, acne, or hair loss on the scalp.

PCOS is also a metabolic disorder. Many women with PCOS will be "insulin resistant," meaning their insulin does not function as normally as it should to dispose of glucose. This frequently leads to weight gain and increased difficulty with weight loss. Although there are not good ways to measure how insulin resistant someone is, we can measure how well they handle glucose. This is done by measuring a fasting glucose, drinking a high sugar drink, and measuring the glucose again 2 hours later.

The reason many women with PCOS have irregular or absent menstrual periods is because they do not release an egg every month. This leads many women to seek help when they are interested in achieving pregnancy.

When women suspect they may have PCOS, we usually do a series of tests to confirm the diagnosis. This includes measuring other hormones to make sure it is not another endocrine disorder such as thyroid disease, and sometimes performing a vaginal ultrasound to look at the ovaries. Typical ultrasound findings include a higher number of small follicles, or "cysts." Although this typical finding may lend support to the diagnosis, it is not a requirement.

Treatment for PCOS depends on whether or not someone is attempting pregnancy. For women not attempting pregnancy, treatments may include oral contraceptive pills, insulin sensitizers, anti-androgen medications, or hair removal treatments. For women attempting pregnancy, treatments may include clomiphene citrate, insulin sensitizing agents, or injectable gonadotropins. All women with PCOS will benefit from regular exercise and a well-balanced diet.