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Polycystic Ovary Syndrome

(PCOS; Stein Leventhal Syndrome; Polyfollicular Ovarian Appearance; Hyperandrogenic Anovulation; Polycystic Ovarian Disease; PCO; PCOD)

Definition

Polycystic ovary syndrome (PCOS) is a hormone condition in women. It causes changes in the ovaries, like the growth of small fluid-filled sacs (cysts).
Ovary and Fallopian Tube
Ovarian Cyst
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Causes

The cause is not known. Insulin resistance seems to play a role. It creates high levels of insulin. This causes the ovaries to make too much of a hormone called androgen. This can result in hair growth on the face, acne, and hair loss. It can stop ovulation from happening. It can lead to large ovaries with many cysts.

Risk Factors

Things that may raise the risk of PCOS are:
  • Other family members with PCOS
  • Obesity

Symptoms

Some women do not have symptoms. Others may have:
  • Problems getting pregnant
  • Irregular or no menstrual periods
  • Obesity
  • Unwanted hair growth
  • Hair loss from the scalp

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. Tests may include:
  • An ultrasound to view the ovaries
  • Blood tests to measure glucose, cholesterol, and hormone levels
  • Urine tests to check for pregnancy

Treatment

PCOS cannot be cured but treatment may help manage effects. Healthy diet choices and regular exercise can play an important role. It may help to:
  • Improve overall health and wellness
  • Maintain or reach healthy weight
  • May help hormone balance or minimize negative hormone effects
A healthy diet includes plenty of vegetables, fruit, and whole grains. A dietitian or doctor can help to develop a personalized plan.
Medicine can help to manage some symptoms. Choices may include:
  • Birth control pills—to help manage menstrual cycles
  • Medication to manage menstrual cycle that will not block pregnancy
  • Medicine to control unwanted hair growth or acne (if cosmetic efforts are not enough)
A treatment plan can also be made for those who are having trouble getting pregnant. It will include weight loss if needed, then medication to stimulate ovulation, if needed.

Prevention

There are no guidelines to prevent this health problem.

RESOURCES

The American Congress of Obstetricians and Gynecologists
http://www.acog.org
Polycystic Ovarian Syndrome Association
http://www.pcosupport.org

CANADIAN RESOURCES

The Society of Obstetricians and Gynaecologists of Canada (SOGC)
http://sogc.org
Women's Health Matters
http://www.womenshealthmatters.ca

References

American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin No. 194: Polycystic Ovary Syndrome. Obstet Gynecol. 2018 Jun;131(6):e157-e171
McCartney CR, Marshall JC. Clinical Practice. Polycystic Ovary Syndrome. N Engl J Med. 2016 Jul 7;375(1):54-64.
Polycystic ovary syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/polycystic-ovary-syndrome. Accessed October 19, 2020.
Polycystic ovary syndrome. Family Doctor–American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/polycystic-ovary-syndrome.html. Accessed September 23, 2020.

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