Dr. Shannon L. Fitzgerald, MD, MPH

Despite the name, not everyone with polycystic ovarian syndrome develops cysts on their ovaries. It is also possible to have ovarian cysts without having PCOS. The symptoms of polycystic ovarian syndrome are actually related to insulin resistance, a condition where the insulin made by the body is not effectively recognized by the cells. This causes the pancreas to release higher levels of insulin in order to keep blood sugar levels stable, and the excess insulin interferes with hormone production in the pituitary and ovaries, causing the PCOS symptoms.

The symptoms of PCOS include:

• Weight gain
• Acne
• Facial or body hair
• Thinning head hair
• Missing or irregular periods
• Infertility

PCOS is a syndrome, which means that if patients have PCOS, they might not have each and every symptom. Even a few of them might be enough to have physicians check for polycystic ovarian syndrome. A doctor might perform an exam and order blood tests to measure hormone levels.

Treatment for PCOS may include:

• Insulin sensitizers, which help the body use insulin more effectively, lowering hormone levels. The most commonly used insulin sensitizer is metformin.
• Weight loss. Being overweight does not cause PCOS, and PCOS can make losing weight difficult. Still, weight loss can improve symptoms for many women.
• Birth control pills to regulate menstruation and sometimes reduce symptoms such as acne.
• Fertility medications, especially medications to stimulate ovulation such as clomiphene.
• Anti-androgen medications, which work to treat symptoms such as acne and facial hair.
• Low-carb diets, which work similarly to insulin sensitizers to lower hormone levels and help reduce weight.
• Ovarian drilling or resectioning, surgical procedures sometimes performed if infertility is a persistent problem. These procedures open up the wall of the ovary to temporarily make ovulation more likely.

Polycystic ovarian syndrome is one of the most common endocrine disorders affecting women. Left untreated, it can increase the risk of diabetes, heart disease, and certain cancers. Fortunately there are many good treatment options available.