Polycystic Ovarian Syndrome

Personalized PCOS diagnosis and treatment

Women’s bodies naturally make small amounts of male hormones (androgens). In PCOS, higher than normal androgen levels, often linked to insulin resistance, can cause a group of symptoms that can lead to infertility and have a major effect on your health and quality of life. There’s no cure for PCOS, but the symptoms are treatable.  

At Reid Health, our OB/GYNs and women’s health providers offer comprehensive, individualized PCOS care for women in East Central Indiana and West Central Ohio. We can help you control your symptoms and get back to feeling like you.

PCOS causes and risk factors

It’s unclear what causes PCOS. Genetic and environmental factors likely play a role. What is clear, however, is an imbalance between male and female hormones is responsible for most symptoms.

Not all PCOS symptoms stem from high androgen levels. Problems with how the body uses the hormone insulin, which carries glucose, or sugar, from the blood into cells, can lead to high blood sugar levels — a risk factor for Type 2 diabetes. Insulin resistance can occur in many women with PCOS, even those who are not overweight. It can also contribute to weight gain and skin darkening.

Certain factors can increase your chances of developing PCOS, including obesity and family history. You’re more likely to develop PCOS if your mother or sister has it.

PCOS symptoms

PCOS can cause symptoms that affect many aspects of your life, from how you look and feel to your family planning goals.  

The ovaries are two of several hormone producers in your body. Your ovaries make the main female hormone called estrogen. They also produce small amounts of male hormones called androgens.  

If you have PCOS, your ovaries might make higher levels of androgens than they should. This can cause ovulation to stop, ovarian cysts (fluid-filled sacs) to form, and other symptoms, including:

• Acne: This can appear on your face, chest, or back.
• Changes to your menstrual cycles: You might experience heavy or irregular periods, periods without ovulation, or no periods at all.
• Infertility: PCOS is a common cause of female infertility. In fact, PCOS diagnoses frequently occur when providers are trying to determine why women are having trouble getting pregnant. Fortunately, treatments can help increase your chances of becoming pregnant.
• Male-like hair growth or hair thinning: Hair might grow on the face, chest, or stomach, or you might notice thinning hair on your scalp.
• Pelvic pain: You may experience pain or discomfort in your lower abdomen.
• Problems with weight: You might gain or have trouble losing weight.
• Skin changes: Skin tags (tiny flaps of skin) might appear in your armpits or on your neck. In addition, your skin might become oily, or you might develop dark, thick patches on your neck or the under your breasts, among other areas.

Diagnosing PCOS

Your provider might order tests to get more information about what’s causing your symptoms and to make a PCOS diagnosis:

• Blood tests: These can reveal whether you have high levels of androgens or high blood sugar.  
• Pelvic exam: Your provider will feel inside your pelvis and vagina for signs of enlarged ovaries or other abnormalities.
• Pelvic ultrasound: This imaging test can reveal ovarian cysts and whether the endometrium — the tissue lining your uterus — is thick. An abnormally thick endometrium could be a sign of irregular periods, a symptom of PCOS. Not all women have ovarian cysts with PCOS, and cysts aren’t required for diagnosis.

PCOS treatments

Although PCOS has no cure, treatment can improve your quality of life and overall health. This condition is associated with several health problems, including anxiety and depression, endometrial cancer, Type 2 diabetes, high blood pressure, and more.  

Treatment options for PCOS include:

• Excess hair removal: Over the counter hair removal creams, electrolysis, and other treatments can help you get rid of unwanted hair.
• Healthy lifestyle changes: Following a healthy diet and exercising regularly can help you lose weight. This, in turn, might improve menstrual problems and boost fertility.
• Hormonal birth control: Birth control methods that use hormones can stabilize your menstrual cycles and reduce acne and excess hair.  
• Medications: Certain medicines, such as anti-androgens and the diabetes medication metformin, might improve some PCOS symptoms.  
• Fertility treatments: Your provider might prescribe medicines to help you ovulate and get pregnant. If medicines alone aren’t successful, other fertility procedures — such as intrauterine insemination (IUI) or in vitro fertilization (IVF) — may be options..
• Surgery: If other infertility treatments don’t work or aren’t right for you, your provider might recommend a procedure called ovarian drilling. During this procedure, a provider uses lasers or a heated needle to make tiny holes in the ovary to temporarily restore ovulation.

Talk with your provider about whether you’d like to address fertility problems as part of your treatment. Certain therapies may not be right for you if you’re hoping to become pregnant. Emotional support or counseling can also help manage the anxiety or depression that sometimes accompany PCOS.