Polycystic ovary syndrome (PCOS)

What is Polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome is a hormonal disorder that affects up to 10% of women during their reproductive years. The condition causes an imbalance in reproductive hormones, leading to irregular periods and other symptoms. The name comes from small fluid-filled sacs that can develop on the ovaries, though not all women with PCOS have these cysts.

PCOS disrupts the normal release of eggs from the ovaries, a process called ovulation. This happens because the body produces higher levels of androgens, which are hormones typically found in smaller amounts in women. The condition also affects how your body processes insulin, the hormone that controls blood sugar. Many women with PCOS develop insulin resistance, meaning their cells don't respond well to insulin.

This hormonal imbalance can affect fertility, metabolism, and appearance. Early diagnosis helps prevent long-term complications like type 2 diabetes and heart disease. With proper lifestyle changes and treatment, most women with PCOS can manage their symptoms and live healthy lives.

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Symptoms

Irregular or missed periods, often fewer than 9 per year
Heavy menstrual bleeding when periods do occur
Excess facial and body hair growth, called hirsutism
Severe acne or oily skin
Male-pattern baldness or thinning hair
Weight gain, especially around the abdomen
Darkened skin patches in body creases and folds
Skin tags in the armpits or neck area
Difficulty getting pregnant or infertility

Some women have mild symptoms and may not realize they have PCOS until they struggle to conceive. Others experience more severe symptoms that significantly impact daily life. Symptoms often become noticeable during the late teens or early 20s, but PCOS can develop at any age after puberty.

Causes and risk factors

The exact cause of PCOS remains unknown, but several factors contribute to its development. Insulin resistance plays a major role, with up to 70% of women with PCOS having this condition. When cells don't respond properly to insulin, the pancreas makes more insulin to compensate. Excess insulin triggers the ovaries to produce more androgens, disrupting ovulation. Genetics also matter, as PCOS tends to run in families. If your mother or sister has PCOS, your risk increases.

Low-grade inflammation is common in women with PCOS. This chronic inflammatory state stimulates the ovaries to produce excess androgens. Being overweight worsens insulin resistance and inflammation, though lean women can also develop PCOS. Other risk factors include sedentary lifestyle, high stress levels, and exposure to endocrine-disrupting chemicals. Women with PCOS often have lower levels of adiponectin, a protein hormone that helps regulate metabolism and insulin sensitivity.

How it's diagnosed

Doctors diagnose PCOS using a combination of medical history, physical examination, and blood tests. There is no single test for PCOS, so your doctor will look for at least two of three criteria: irregular periods, elevated androgen levels, or polycystic ovaries on ultrasound. Blood tests measure hormone levels including total testosterone, estrone, and estradiol. Women with PCOS typically show elevated testosterone and sometimes higher estrone levels. Your doctor may also check adiponectin levels, which are often low in PCOS and linked to insulin resistance.

Rite Aid offers hormone testing that can help identify PCOS-related imbalances. Our add-on hormone panel measures key markers including testosterone, estradiol, and estrone. Additional tests may check insulin levels, glucose tolerance, and cholesterol. An ultrasound of the ovaries can reveal the presence of multiple small cysts. Your doctor will rule out other conditions that cause similar symptoms, such as thyroid disorders or high prolactin levels.

Treatment options

Weight loss of just 5 to 10% of body weight can improve symptoms and hormone balance
Regular exercise, especially strength training and high-intensity intervals, improves insulin sensitivity
Low-glycemic diet focusing on whole foods, lean proteins, and healthy fats
Stress reduction through meditation, yoga, or other relaxation techniques
Birth control pills to regulate periods and reduce androgen levels
Metformin to improve insulin resistance and lower blood sugar
Anti-androgen medications like spironolactone to reduce excess hair growth and acne
Fertility medications like clomiphene or letrozole if trying to conceive
Inositol supplements to support insulin function and egg quality
Regular monitoring of blood sugar, cholesterol, and blood pressure

Frequently asked questions

PCOS has no single cause but results from a combination of genetic and lifestyle factors. Insulin resistance and excess insulin production trigger the ovaries to make too many androgens. This hormonal imbalance disrupts normal ovulation and causes many PCOS symptoms.

Yes, many women with PCOS can get pregnant with proper treatment. PCOS is one of the most treatable causes of infertility. Weight loss, fertility medications, and lifestyle changes often help restore ovulation. Some women may need assisted reproductive technologies like IVF.

Blood tests for PCOS measure hormone levels including total testosterone, estradiol, and estrone. Doctors also check insulin, glucose, and sometimes adiponectin levels. Elevated testosterone and low adiponectin are common in PCOS. These tests help rule out other conditions with similar symptoms.

PCOS does not completely go away, but weight loss significantly improves symptoms and hormone balance. Losing just 5 to 10% of body weight can restore regular periods and ovulation. Weight loss also reduces insulin resistance and lowers the risk of diabetes and heart disease.

Limit refined carbohydrates like white bread, pasta, and sugary foods that spike blood sugar. Avoid processed foods high in trans fats and inflammatory oils. Reduce dairy intake if it worsens acne. Focus on whole foods, lean proteins, healthy fats, and low-glycemic vegetables instead.

PCOS is a chronic condition that requires ongoing management but is very treatable. Without treatment, it increases the risk of type 2 diabetes, heart disease, and endometrial cancer. Early diagnosis and lifestyle changes prevent most long-term complications. Most women with PCOS live full, healthy lives with proper care.

Birth control pills do not cure PCOS but effectively manage symptoms. They regulate periods, reduce androgen levels, and improve acne and excess hair growth. Birth control works by providing steady hormone levels that suppress androgen production. It does not address the underlying insulin resistance or metabolic issues.

Get hormone levels checked at diagnosis and then annually or when symptoms change. Test blood sugar and insulin at least yearly to monitor for diabetes risk. Check cholesterol and blood pressure regularly. Your doctor may test more frequently when adjusting medications or trying to conceive.

A combination of strength training and high-intensity interval training works best for PCOS. These exercises improve insulin sensitivity more effectively than steady cardio alone. Aim for at least 150 minutes of moderate activity per week. Even short 10-minute walks after meals help control blood sugar.

Yes, chronic stress worsens PCOS symptoms by raising cortisol levels and increasing insulin resistance. High stress disrupts hormone balance and can trigger weight gain and irregular periods. Stress management through meditation, adequate sleep, and relaxation techniques helps improve PCOS outcomes.