What Is Polycystic Ovary Syndrome (PCOS)?

Signs and Symptoms of PCOS

• Irregular periods (menstrual cycles). This includes infrequent periods, which means fewer than eight per year. People who have regular periods typically get 12 per year.
• Excess facial and body hair growth. High levels of testosterone may cause facial hair, sideburns or whiskers.
• Acne. Pimples may occur on the face.
• Alopecia. This type of hair loss results in thinning of the hair, including a widening part.
• Weight gain. Your hormones play a role in your metabolism, or the process of converting the food you eat into energy for your body. Because polycystic ovary syndrome impacts your hormones, it also can impact your metabolism. Many people with PCOS have insulin resistance, a condition in which your body’s cells can’t take up glucose (blood sugar) in your bloodstream, making it easy to gain weight and harder to lose weight. This can also increase your risk for Type 2 diabetes and your risk of developing high blood pressure and heart disease.
• Infertility. Because people with PCOS are not able to ovulate regularly, it is the leading cause of hormone-related infertility. “If there’s no egg released, there’s no chance of getting pregnant,” explains Dr. Boots. “It’s hard to get the timing just right for egg fertilization.”

How PCOS Is Diagnosed

Your ovaries hold your eggs. When it’s time for you to release an egg, follicles, or small sacs filled with fluid and an egg, form on your ovaries. When eggs are released from the follicles, they should travel through your fallopian tubes and into the uterus for fertilization.

PCOS causes something like a traffic jam in the ovary, according to Dr. Boots. In people with PCOS, typically too many follicles form, which can cause a backup in your ovaries. This can stop any egg from getting into your fallopian tubes and traveling down into your uterus. To identify PCOS, your clinician may use an ultrasound to examine your ovaries for extra follicles.

Although the exact cause is unknown, PCOS has been linked to genetics and high levels of insulin and sex hormones called androgens. Many people think of androgen as being a male hormone, but androgens are a group of hormones responsible for sexual function in people of all sexes. Hyperandrogenism is defined as having high levels of androgen hormones. To help diagnose PCOS, your physician can order a blood test to check your hormone levels.

Managing PCOS

PCOS can be a challenging diagnosis. There is no cure for PCOS, but help is available to manage your symptoms and to grow your family.

“Lifestyle is far and away the most important way to manage PCOS,” says Dr. Boots.

Dr. Boots encourages people with PCOS to:

• Regularly exercise (150 minutes of moderate activity every week)
• Eat a healthy diet that is rich in vegetables and lean protein (protein that is low in fat and calories, like chicken).
• Maintain a healthy weight, which can improve fertility as well

Medication may also be used to manage symptoms in some people, including:

• Hormonal birth control
• Metformin, which can help reduce insulin resistance
• Spironolactone, which is an anti-androgen medication that can help with unwanted hair growth

Symptom management is important, as the effects of PCOS can put you at risk for complications or long-term health problems. These can include:

• Diabetes. Those with PCOS are often resistant to insulin, which can lead to Type 2 diabetes. While healthy lifestyle changes can help control Type 2 diabetes, PCOS can complicate diabetes management. If you have PCOS and diabetes, your physician will work with you to develop an appropriate care plan.
• Heart disease. PCOS has been linked to an increased risk for cardiovascular disease. This is likely related to the links between PCOS, diabetes, sleep apnea and having excess weight.
• Depression or anxiety. Mental health concerns can result from hormonal imbalances that occur with PCOS, and research suggests a higher risk of mood disorders. “There is a whole interplay with self-confidence and body image, and some of that has to do with hormone dysfunction,” adds Dr. Boots.
• Cancer of the uterine lining. Unmanaged symptoms can lead to endometrial cancer.
• Infertility. Your physician can talk with you about options to raise your chance of getting pregnant.

What the Future Holds for People With PCOS

If you have PCOS, you’re not alone. Work with your physician to manage your symptoms. If fertility is a concern, intrauterine insemination (IUI) and in vitro fertilization (IVF) may be options to pursue.

Learn more about the Northwestern Medicine Fertility and Reproductive Medicine team.

*Scientists do not always collect information from participants about gender identity. To avoid misrepresenting the results of this research, we use the same terminology as the study authors.