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Signs you could have polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is one of the most common causes of infertility in the United States, affecting up to 5 million women. And the condition continues to impact women throughout their lifetimes. Yan Yu Chen, D.O., a Piedmont obstetrician and gynecologist, says PCOS is linked to a higher risk of other serious health conditions, including:

  • Gestational diabetes

  • Type 2 diabetes

  • High blood pressure

  • High LDL (“bad”) cholesterol and low HDL (“good”) cholesterol 

  • Heart disease

  • Depression

  • Anxiety 

  • Stroke

  • Sleep apnea 

What causes PCOS?

Medical experts aren’t sure exactly what causes PCOS, but treatment is largely symptom-based. An elevated level of androgens in the body may contribute to it.

PCOS risk factors

The following factors can increase your risk:

  • Obesity

  • Insulin resistance (including prediabetes and diabetes)

  • Family history (mother or sister with PCOS or type 2 diabetes) 

How is PCOS diagnosed?

Dr. Chen says most physicians use the following Rotterdam criteria to diagnose PCOS. If a person meets two of the three criteria, they likely have PCOS:

  • Irregular menstrual cycle

  • High levels of androgens (testosterone contributing to hirsutism or acne)

  • Multiple ovarian cysts seen in ultrasounds 

“PCOS is a diagnosis of exclusion, meaning we don’t have a test that definitively says you have the condition,” she says. “We have to rule out other conditions before we can settle on a PCOS diagnosis.”

She adds that having ovarian cysts doesn’t mean you have PCOS. It’s normal for women to develop cysts on their ovaries throughout their menstrual cycles. Having cysts alone is a very nonspecific finding. In addition, some women with PCOS don’t develop the typical polycystic ovaries found on ultrasound. That’s why it can be tricky to diagnose.

The difference between PCOS and ovarian cancer

“PCOS is very different from ovarian cancer, and it isn’t suggestive of ovarian cancer,” Dr. Chen says.

Cysts are fluid-filled pockets of normal cells, while ovarian cancer tumors tend to contain complex solid masses of cancer cells. Cysts aren’t usually harmful and come and go during menstrual cycles, while tumors don’t go away without treatment.

Symptoms of PCOS

Symptoms of PCOS can include:

PCOS treatment

There’s no current cure for PCOS, so physicians focus on symptom management through healthy lifestyle modifications and certain medications. Women with PCOS should also be routinely screened for cardiovascular disease to reduce the risk and complications of early onset heart disease. The following can help improve symptoms:

  • Weight loss if you are overweight or obese through regular exercise and a healthy diet 

  • Contraceptives (hormonal birth control) 

  • Insulin sensitizing agents like Metformin if you have prediabetes or type 2 diabetes 

  • Spironolactone helps lower androgen hormones indirectly

“It’s important to see your health care provider if you have these symptoms because they can negatively impact your quality of life,” Dr. Chen says. “I’m a strong proponent of annual exams with your primary care provider or gynecologist. That’s a good place to start the conversation about any symptoms you may have.”

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