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Polycystic ovarian Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a condition in which an excess number of multiple small cysts form on both ovaries. Women with this condition don’t ovulate on a regular basis.

Polycystic ovary syndrome is a common hormone disorder that affects 5%-10% of women.  Not all women with PCOS have all the same symptoms. To be diagnosed with PCOS, a woman must have 2 of 3 possible issues: chronic lack of ovulation (anovulation), chronic high testosterone (hormone) levels (hyperandrogenism), and ovaries that have multiple small cysts containing eggs (polycystic).

How is PCOS diagnosed?

Because this condition is diagnosed by identifying several different problems, PCOS is diagnosed using a combination of physical exam and history, ultrasound (sonogram), and blood tests.

What risks do women have with PCOS?

Some of the risks are related to a woman not ovulating regularly. When ovulation doesn’t happen, it interrupts the usual hormone cycle and causes levels of estrogen making the lining of the uterus to thick and causing abnormal bleeding. Over time, it can lead to pre-cancerous changes or uterine cancer. This lack of regular ovulation can also make it difficult to get pregnant.

Metabolic syndrome is common in women with PCOS. Symptoms include extra weight around the middle, high cholesterol, high blood pressure, and insulin resistance/diabetes. Each of these symptoms raises the risk of heart disease. Obesity is common in women with PCOS.

How is infertility in women with PCOS treated?

One way to treat infertility is to cause ovulation using medicine.Clomid is taken by mouth and has usually been tried first. Letrozole is another oral medicine that can be used and can be particularly helpful in patients with PCOS and is often tried first. If this is unsuccessful, injected fertility medicines called gonadotropins (FSH)  may be given to stimulate the growth of an egg.

If a woman is overweight, losing weight can help improve ovulation patterns and fertility.

In vitro fertilization (IVF) may help women with PCOS get pregnant if other treatments do not work.