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Polycystic Ovary Syndrome (PCOS)

Reviewed by: Tal Grunwald, MD

What Is Polycystic Ovary Syndrome (PCOS)?

Polycystic (pronounced: pol-ee-SISS-tik) ovary syndrome (PCOS) is a common health problem that can affect teen girls and young women. It can cause irregular menstrual periods, make periods heavier, or even make periods stop. It can also cause a girl to have excess hair and acne.

What Causes Polycystic Ovary Syndrome (PCOS)?

Doctors can't say for sure what causes it, but PCOS seems to be related to an imbalance in a girl's .

Both girls and guys produce sex hormones, but in different amounts. In girls, the ovaries make the hormones estrogen and progesterone, and also androgens. The adrenal glands also make androgens. These small glands sit on top of each kidney. These hormones regulate a girl's menstrual cycle and  (when the egg is released).

Androgens are sometimes called "male hormones," but the female body also makes them. In girls with PCOS, the body makes a higher than normal amount of androgens. Research also suggests that the body might make too much , signaling the ovaries to release extra male hormones.

PCOS seems to run in families too, so if someone in your family has it, you might be more likely to develop it.

What Happens in Polycystic Ovary Syndrome (PCOS)?

The higher amounts of androgens that happen in PCOS can interfere with egg development and release. Instead of the eggs maturing, sometimes cysts (little sacs filled with liquid) develop. Then, instead of an egg being released during ovulation as in a normal period, the cysts build up in the ovaries. Polycystic ovaries can become enlarged. Girls with PCOS are not ovulating or releasing an egg each month, so many have irregular or missed periods.

What Problems Can Polycystic Ovary Syndrome (PCOS)Cause?

Girls with PCOS are more likely to:

  • have difficulty conceiving. This is treatable when when a woman decides she wants to become pregnant.
  • have excessive hair growth
  • get acne or have their acne get worse
  • be obese
  • develop diabetes, heart disease, or high blood pressure
  • have obstructive sleep apnea

There's no cure for PCOS, but it can be treated.

What Are the Signs & Symptoms of Polycystic Ovary Syndrome (PCOS)?

A key sign of PCOS is irregular periods or missed periods. The effects of PCOS on the ovaries can make a girl stop ovulating. But because it can take up to 2 years after a first period for any girl's menstrual cycle to become regular, it can be hard to recognize missed periods as a sign of PCOS.

Still, many girls with PCOS can get pregnant if they have sex. So if you're sexually active, use condoms every time you have sex to avoid becoming pregnant or getting a sexually transmitted disease (STD). (Of course, this is important whether you have PCOS or not.)

Imbalanced hormone levels can cause changes in a girl's entire body, not just her ovaries. So doctors also look for these other signs of PCOS:

  • weight gain, obesity, or difficulty maintaining a normal weight, especially when the extra weight is concentrated around the waist
  • a condition called hirsutism (pronounced: HER-suh-tiz-um), where a girl grows extra hair on her face, chest, abdomen, nipple area, or back (a little of this is normal for most girls, though)
  • thinning hair on the head (alopecia)
  • acne and clogged pores
  • darkened, thickened skin around the neck, armpits, or breasts (this is called acanthosis nigricans)
  • high blood pressure, high cholesterol, or diabetes mellitus (high blood sugar levels)

Girls who show signs of puberty early — such as developing underarm or pubic hair before age 8 — may be at greater risk for PCOS later on.

How Is Polycystic Ovary Syndrome (PCOS) Diagnosed?

If your doctor thinks you might have PCOS, he or she may refer you to a or an for a diagnosis.

The gynecologist or endocrinologist will ask about your concerns and symptoms, your past health, your family's health, any medicines you're taking, any allergies you have, and other issues. He or she will also ask you lots of questions specifically about your period and its regularity. This is called the .

Your doctor also will do a physical exam, which includes checking your weight, and looking for physical signs such as acne, hair growth, and darkened skin. The doctor might do a gynecologic exam to rule out other possible causes of your symptoms, but this is not always necessary for diagnosis.

Doctors sometimes order blood tests to diagnose PCOS and or to see if the symptoms are caused by other conditions, such as thyroid or other ovarian or gland problems.

Your doctor might order a pelvic ultrasound (a safe, painless test that uses sound waves to make images of the pelvis) to check your ovaries for cysts or other problems. Because cysts aren't always visible, this test isn't always done.

How Is Polycystic Ovary Syndrome (PCOS) Treated?

There's no cure for PCOS, but there are several ways to treat and manage it.

Diet and Exercise

If a girl is overweight or obese, a doctor will recommend lifestyle changes. Weight loss can be very effective in easing many of the health conditions associated with PCOS, such as high blood pressure and diabetes. Sometimes weight loss alone can get hormone levels back to normal, making many symptoms disappear or become less severe.

Your doctor or a registered dietitian can look at your food intake and your exercise and activity to create a weight-loss program for you. Exercise is very important to improve your body’s sensitivity to insulin and prevent progression to diabetes.

Medicines

Sometimes doctors prescribe medicines to treat PCOS. A doctor might first have a girl try birth control pills to help control androgen levels in her body and regulate her menstrual cycle. Birth control pills may help control acne and excessive hair growth in some girls, but they don't work for everyone. It may take up to 6 months to determine whether treatment with birth control is effective.

Antiandrogens also are sometimes used to treat PCOS. These medicines counter the effects of excess androgens on a girl's body, and can help clear up skin and hair growth problems.

A diabetes medicine, metformin, can lower insulin levels. In some girls with PCOS, it can help control ovulation and androgen levels. This can make a girl's menstrual cycles more regular.

Medicines should always be combined with the recommended lifestyle changes.

How Can I Cope With Polycystic Ovary Syndrome (PCOS)?

Having PCOS can be hard on a girl's self-esteem. Fortunately, there are things you can do to reduce the physical symptoms and take care of the emotional side of living with PCOS.

Medicines used to treat PCOS will slow down or stop excessive hair growth for many girls. Also, different types of products can help get rid of hair where it's not wanted. Depilatory creams can gently remove facial hair on the upper lip or chin. Follow the instructions carefully so you don't develop a rash or allergic reaction.

Tweezing and waxing done at home or at a salon can manage excess hair growth. A dermatologist (a doctor who specializes in skin problems) or qualified hair removal specialist can use electrolysis and laser surgery treatments for long-term removal of unwanted hair, but they're more expensive.

Treatment with birth control pills or antiandrogens might make severe acne better. If it doesn't, your doctor may refer you to a dermatologist for treatment. A dermatologist can also recommend medicines to reduce skin darkening or discoloration, and to prevent hair growth.

Some girls with PCOS may become depressed, in which case it may help to talk to a therapist or other mental health professional. Talking with other teens and women with PCOS is a great way to share information about treatment and get support. Ask your doctor or search online for a local support group.

Reviewed by: Tal Grunwald, MD
Date reviewed: July 2018