PCOS, also known as Stein-Leventhal syndrome, is a hormonal imbalance that affects women. It’s characterized by the production of too many androgens, or “male” hormones.

PCOS can cause women to develop excessive hair and acne. It can also cause cysts on the ovaries and interrupt normal menstrual cycles.

It’s a tricky condition because there’s not one single test to diagnose it. Instead, doctors look at the clues of what’s going on in your body. Excessive hair growth or irregular periods might be signs. Doctors can then piece together a picture of PCOS.

PCOS often gets missed in women because of the difficulty of making a diagnosis. The symptoms can vary and occur in many different types of women.

Obesity or weight gain, for example, can be a frequent occurrence with PCOS. But it’s not a given. Many women with PCOS have lean body shapes.

Unfortunately, up to 50% of women who have PCOS never actually get diagnosed. Because of this, PCOS is sometimes called the silent killer.

Some of the more common symptoms of PCOS include:

• “String of pearl” cysts on the ovaries
• Insulin resistance
• High testosterone causing excessive hair growth, male pattern baldness, and acne
• Suppressed ovulation
• Excessive weight gain
• Weight gain on the waistline
• Dark, thick patches of skin on the neck, arms, breasts, or thighs
• Skin tags in the armpits or neck area
• Pelvic pain
• Anxiety or depression
• Sleep apnea

Options to help manage symptoms include:

• Birth control pills
• Weight loss
• Spironolactone
• Other androgen blockers

Along with other fertility drugs, metformin, which helps to control blood sugar, is commonly prescribed to help induce ovulation.

Polycystic ovarian syndrome (PCOS) is a condition that affects between 6 and 15 percent of women of childbearing age. If you’re diagnosed with PCOS, it may be more difficult to become pregnant. And if you’re able to become pregnant, you’re at risk for more complications during pregnancy, labor, and delivery.PCOS and Infertility

PCOS negatively impacts fertility because women with the condition do not ovulate, or release an egg, each month due to an overproduction of estrogen by the ovaries. Because ovulation does not occur regularly, periods become irregular and increased levels of hormones such as testosterone can affect quality of egg, inhibit ovulation, lead to insulin resistance, and increase the risk disorders such as gestational diabetes.

PCOS and Fertility Treatment

For those women trying to conceive a pregnancy, the first step in treatment of PCOS is lifestyle modification, including a healthy diet and exercise. The diets shown to be most successful in PCOS patients include those with lower carbohydrates, a reduced glycemic load. Recommended exercise in PCOS patients is at least 30 minutes of moderate exercise three times per week, with daily exercise being the ultimate goal.

Women who still have infrequent ovulation despite lifestyle modifications may require fertility medications to assist with the release of an egg from the ovary.  Typical initial therapy for patients with PCOS who do not ovulate and are trying to conceive includes administration of certain fertility medications. These agents are selective estrogen receptor modulators.

For some women with PCOS, fertility tablets do not result in ovulation or pregnancy, and they require fertility injections to release an egg. Fertility injections (Follistim®, Gonal-F®, Bravelle®, and Menopur®) contain the same hormone the brain releases to signal the ovary to produce eggs. Rather than producing one egg in a month, most women on fertility injections will produce two or more eggs. This treatment requires closer monitoring with transvaginal ultrasounds and several blood draws to determine the woman’s estradiol level, which is a hormone produced in the ovary. Fertility injections are also associated with an increased risk of multiple births.

In some instances, women with PCOS require IVF to achieve a healthy pregnancy. In this scenario, daily fertility injections are used to stimulate the ovaries to produce multiple eggs, which are harvested in a minor procedure. The eggs are fertilized in the lab and then a resulting embryo (fertilized egg) is transferred into the woman’s uterus. Additional embryos can be frozen (cryopreserved) for future use.

What are PCOS Health Risks?

As previously mentioned, insulin resistance can occur in women with PCOS. A simple blood test can determine if a person is insulin resistant. If the test indicates insulin resistance exists, women with PCOS may be treated with a medication called metformin (trade name Glucophage).

Hyperlipidemia, or elevated cholesterol and/or triglycerides, can occur in PCOS women, as well. Women can be screened for this condition with a fasting blood sample. Screening for hyperlipidemia is very important since this condition can lead to cardiovascular disease later in life.

Women with PCOS appear to be at increased risk for endometrial (uterine) cancer later in life due to persistently higher levels of circulating estrogens. Since menstrual periods do not occur regularly, overgrowth of the uterine lining can occur and in some cases can lead to a malignancy.

Complications During Pregnancy:

Women with PCOS are three times more likely to have a miscarriage, as compared to women who don’t have PCOS. They are also more likely to develop preeclampsia, gestational diabetes, and have a larger baby and premature delivery. This could lead to difficulty during delivery or a cesarean delivery.

Women with PCOS have an increased risk of developing several medical complications throughout life, including:

• Insulin resistance
• Type 2 diabetes
• High cholesterol
• High blood pressure
• Heart disease
• Stroke
• Sleep apnea
• Possibly an increased risk of endometrial cancer

For pregnant women, PCOS brings an increased risk of complications. This includes preeclampsia, a dangerous condition for both mother and baby-to-be. The recommended treatment to resolve symptoms is delivery of the baby and placenta. Your doctor will discuss the risks and benefits regarding timing of delivery based on the severity of your symptoms and your baby’s gestational age. If you develop preeclampsia during your pregnancy, you will have to be monitored extremely closely. Other concerns include pregnancy-induced hypertension (high blood pressure) and gestational diabetes.

Having gestational diabetes could lead to you having a larger-than-average baby. This could lead to problems during delivery. For example, larger babies are more at risk for shoulder dystocia (when the baby’s shoulder gets stuck during labor).

Most PCOS symptoms during pregnancy can be treated with careful monitoring. If you develop gestational diabetes, insulin may be required to keep your blood sugar levels stable.

Management of PCOD-

Some women may not realize they have PCOS until they try to conceive. PCOS often goes unnoticed. But if you’ve been trying to conceive naturally for over a year, you should speak to your doctor about getting tested.

Your doctor can help you develop a plan for getting pregnant. Some strategies, such as losing weight, healthy eating, and in certain cases, medications, can increase your chances for getting pregnant.

Anyone who is concerned that they are unable to become pregnant or who has symptoms that may indicate PCOS should see a doctor. Even if a woman does not wish to become pregnant, getting an early diagnosis of PCOS can help to prevent complications.

Maintain a Healthy Weight

Maintaining a healthy weight can help decrease insulin resistance, regulate your period, and reduce your risk of conditions associated with PCOS.

If you’re overweight, some Trusted Source studies suggest gradual weight loss through a low-calorie diet as a promising first-line treatment for PCOS.

Balance Your Exercise

Exercise is important for maintaining a healthy weight. But too much exercise can disrupt your hormones, so talk with your doctor about a healthy balance.

Gentle, low-impact exercises like yoga or Pilates can be practiced for longer durations. Swimming and light aerobics are also recommended. High-intensity interval training and long-distance running may also Trusted Source help improve symptoms of PCOS.

Talk with your doctor about the type of workout that would benefit you most.

Practice Good Sleep Hygiene

Sleep affects your stress levels and helps regulate cortisol to balance your hormones. But sleep disturbances are twice as common for women with PCOS. To up your sleep hygiene:

• Aim for eight to ten hours of sleep per night.
• Establish a regular bedtime routine.
• Avoid stimulants and rich, fatty foods before bedtime.

Reduce Stress

Reducing stress can regulate cortisol. Many of the strategies mentioned above, such as yoga, getting enough sleep, and cutting caffeine, can contribute to lower stress levels.

Taking walks outside and creating space in your life for relaxation can also reduce how stressed you feel.

Limit or Avoid Endocrine Disruptors

Endocrine disruptors are chemicals or ingredients that interfere with or block your body’s natural hormonal reactions.

Some endocrine disruptors mimic female and male sex hormones, causing confusion in your reproductive system. This can increase your risk of PCOS symptoms.

They are found in canned foods, soaps, and makeup. Common endocrine disruptors include:

• Dioxins
• Phthalates
• Pesticides
• BPA
• Glycol ethers