What Is Polycystic Ovary Syndrome (PCOS)?
Leading Cause of Hormone-Related Infertility
Updated August 2023
Polycystic ovary syndrome (PCOS) is a disorder that affects 1 in 10 women* of childbearing age. “It is a combination of symptoms resulting from the inability to ovulate,” says Christina E. Boots, MD, a reproductive endocrinologist at Northwestern Medicine with a specialized polycystic ovary syndrome clinic for patients at the Northwestern Medicine Center for Fertility and Reproductive Medicine Chicago.
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.” While PCOS can be a challenging diagnosis, help is available to manage your symptoms and to grow your family.
Signs and Symptoms of PCOS
Although the exact cause is unknown, PCOS has been linked to genetics, heightened levels of sex hormones called androgens and insulin. These hormone imbalances can impact the metabolic system and result in some of the following symptoms:
- Irregular menstrual cycle. This includes infrequent periods (fewer than eight per year).
- Hair growth. Heightened levels of testosterone may result in facial hair, sideburns or whiskers.
- Acne. Acne may occur on the face.
- Alopecia. This type of hair loss results in thinning of the hair, including a widening part.
- Weight gain. The metabolic component of PCOS can cause insulin resistance, where your cells can’t take up glucose in your bloodstream, making it easy to gain weight and harder to lose weight.
Diagnostic testing may help confirm PCOS. For example, your physician may use an ultrasound to examine your ovaries. With PCOS, “ovaries are enlarged with multiple follicles, or small sacs filled with fluid, on them,” says Dr. Boots. “These follicles have an egg inside of them, but it’s like a traffic jam in the ovary.”
Your physician can order a blood test to check your hormone levels.
There is no cure for PCOS, but you can manage the symptoms. “Lifestyle is far and away the most important way to manage PCOS,” says Dr. Boots. She encourages regular physical activity and a healthy diet that is rich in vegetables and lean protein. Medication may also be used to manage symptoms in some people. “We focus on what’s important to you and your quality of life.”
Symptom management is important, as the effects of PCOS can put you at risk for complications or other long-term health problems. These can include:
- Diabetes. Those with PCOS are often insulin-resistant, which can lead to Type 2 diabetes. While you can offset Type 2 diabetes with healthy lifestyle changes, 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. There is a link between PCOS and 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
While there is not a known cause of PCOS, research continues to evolve, with a focus on the role of genetics.
“At Northwestern Medicine, we are investigating the origins of PCOS so we can better understand how our genetic code is causing these symptoms and hopefully prevent them from starting at a young age,” says Dr. Boots.
If you are experiencing PCOS, you’re not alone. The Northwestern Medicine Fertility and Reproductive Medicine team can discuss your options regarding infertility, pregnancy loss and other reproductive concerns. The team of experts can guide you through available treatment options, such as intrauterine insemination (IUI) and in vitro fertilization (IVF), as well as provide emotional support and symptom management.
*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.