Polycystic Ovarian Syndrome (PCOS): What is it and what are its symptoms?

Polycystic Ovarian Syndrome (PCOS) is a condition that affects woman’s menstrual cycle, fertility and hormones. Women develop PCOS when they have high levels of androgens, sometimes called male hormones. This hormone makes ovulation rare or irregular.

Symptoms of PCOS include:

• Infrequent, irregular, or absent menstrual cycles

• Infertility due to irregular or absent ovulation

• Increased hair growth on face, neck, stomach, back, hands, and feet

• Acne or oily skin

• Dandruff

• Pelvic pain

• Weight gain

• High cholesterol

• High blood pressure

• Thinning hair

• Skin tags

• Dark or thick skin located on the neck, arms, thighs, and/or breasts

• Increased hair growth on face, stomach, back, hands or feet

• Sleep Apnea

Usually women with PCOS are likely to have a relative with PCOS as well, leading researchers to believe there may be a genetic factor. Many women with PCOS also struggle with weight issues. The main culprit is insulin -.  Excess insulin in a women’s body causes a production increase of androgen, causing irregular ovulation.

Normally a woman ovulates when an egg-containing follicle develops and releases a mature egg. Polycystic Ovarian Syndrome keeps those follicles from growing; the follicles build up in the ovaries and form small cysts that release estrogen and excess androgens. The combination of estrogen and androgens disrupts the production of other hormones that help ovulation to occur.  

The primary fertility problem with PCOS is the lack of ovulation or late ovulation. If a woman struggles with weight issues, losing weight will improve ovulation, and a low carbohydrate diet is key such as our own Dr Sharara’s app “The Infertility Diet” which will be available in the App Store on February 3rd. Prescribing insulin-sensitizing drugs such as Metformin helps many PCOS women ovulate on their own or respond better to drug treatment. Fertility drugs like Clomiphene and Gonadotropins may be prescribed to help ovulation occur if Metformin and life style changes are not enough to achieve ovulation. Multiple pregnancy remains a major concern for women using Gonadotropins.

Another fertility option for woman with PCOS is in vitro fertilization (IVF). IVF creates the best opportunity of getting pregnant during a menstrual cycle because it gives doctors better control and allows for the transfer of a single embryo.

Dr. Sharara at the Virginia Center for Reproduction Medicine will evaluate a woman’s symptoms, review their medical records and conduct a physical exam and blood test to evaluate hormone levels to assist women with PCOS get pregnant. For more information, please visit http://www.vcrmed.com/fertility-reston-va/pcos/