- Polycystic ovary syndrome (PCOS) a condition that affects women and can disrupt their cycle, cause infertility, and lead to excess amounts of facial and body hair.
- What causes PCOS is unclear but doctors think it’s a mix of genetics and exposure to toxins in the environment that play a role.
- There’s no cure for PCOS but women can improve symptoms with birth control, medication, and by losing weight if they are overweight.
- This article was medically reviewed by Julia Simon, MD, who is an assistant professor with the Department of Obstetrics and Gynecology at UChicago Medicine.
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Polycystic ovary syndrome, or PCOS, is a hormonal disorder in women that can cause irregular periods, abnormal amounts of facial and body hair, infertility, among other symptoms.
The Office on Women’s Health reports that PCOS affects 1 in 10 women of childbearing age – from 15 to 44 years old. And “as we understand it, is a lifelong disorder,” says Richard Legro, MD, Professor of Obstetrics and Gynecology and Public Health Services at the Penn State College of Medicine and Penn State Health.
Here’s what you need to know about the causes, symptoms, and symptom relief from PCOS.
What is PCOS
The name polycystic ovary syndrome is a slight misnomer because it doesn’t involve traditional ovarian cysts. Instead, people affected by PCOS often have a larger-than-average number of tiny follicles in their ovaries that look like small cysts but are not like traditional ovarian cysts. These follicles grow but never fully develop to release eggs. And if no eggs are released, you don’t ovulate.
The follicles themselves aren’t dangerous but the hormonal imbalance they cause can wreak havoc with the person’s menstrual cycle. Your body may not produce enough of the female reproductive hormone progesterone to maintain a normal menstrual cycle. As a result, PCOS is the most common cause of infertility in women, according to the Endocrine Society.
The causes of PCOS
There is also some evidence that environmental factors – including exposure to toxins in the environment like plasticizers – may contribute to the condition in rare instances.
Obesity has long been thought to be a cause of PCOS, but it may be the case that obesity only aggravates the condition, rather than causes it. That could be because PCOS causes insulin resistance in the body. Regardless of BMI, all women with PCOS have a degree of insulin resistance, but obesity seems to make the condition worse.
How to know if you have PCOS
Many of the symptoms associated with PCOS are the result of an increase in male hormones, such as testosterone.
That’s because many people with PCOS have insulin resistance in their body, which inhibits the process of sending glucose to cells. As a result, the pancreas has to produce more insulin, which causes problems for the endocrine system and leads the body to ramp up the production of androgens, aka male hormones.
Consequently, you may start having very irregular periods or even stop having periods altogether. You may also put on some extra weight – although not every woman with PCOS gains weight.
This excessive amount of androgens also tend to cause you to develop a few other symptoms, notably extra hair on your body and face. The extra hair is what Dr. Legro calls “male-patterned hair.” Meaning you’re not developing a fine layer of hair all over your body. It’s hair that appears in areas where men grow body hair, like the middle of the chest, the midline, and the back.
“Excess facial hair, hair thinning and balding: that’s not normal,” says Dr. Legro. “Get investigated.”
Treatment for PCOS
While there’s no cure for PCOS, the symptoms of the condition can be abated with various treatments. These treatments include weight loss, birth control pills, and anti-androgen medications.
- Birth control: If you’re experiencing symptoms from PCOS, and not trying to get pregnant, then you’ll likely receive a prescription for birth control pills. The hormones estrogen and progestin in the pill can help address the symptoms caused by increased androgens, like excess hair, acne, and irregular periods. Other hormonal methods of birth control could also be an option, such as the patch, vaginal ring, or a progesterone-containing IUD.
- Weight loss: Many doctors recommend that women with PCOS try to shed a few pounds, usually with exercise and diet changes, since that can sometimes help normalize your insulin resistance. Even losing as little as 5% of your body weight can lead to a significant improvement in PCOS symptoms, according to the National Health Service.
- Other medications: Sometimes, women can’t tolerate hormonal contraceptives. In that case, doctors will prescribe other meds, like anti-androgen medications to address the hair and acne issues. Or doctors might consider prescribing the insulin sensitizer metformin for women with an irregular menstrual cycle, according to clinical practice guidelines from the Endocrine Society. Women with PCOS are more likely to develop Type 2 diabetes, according to the Office on Women’s Health. So if you have both PCOS and type 2 diabetes, your doctor may also prescribe metformin to help you manage symptoms and your diabetes.
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