PCOS (Polycystic Ovary Syndrome) is a hormonal disorder that affects one in 10 women of childbearing age, where their ovaries or adrenal glands produce more male hormones than normal. Women with PCOS have a hormonal imbalance and metabolism problems that may affect their overall health and appearance. PCOS is also a common and treatable cause of infertility.
The Newton-Wellesley OB/GYN team of physicians is very experienced in diagnosing and treating PCOS. With two locations in Newton and Walpole, Massachusetts our team is here to help you.
Symptoms of PCOS
Some of the symptoms of PCOS include:
- Infrequent and irregular periods
- Pelvic pain
- Excess hair growth on the face, chest, stomach, or thighs
- Acne on the face, chest, and upper back
- Weight gain or having trouble losing weight
- Darkening of skin along neck creases, in the groin, and underneath breasts
- Patches or thickened skin
Health Risks Associated with PCOS
Women with PCOS are at higher risk of diabetes, metabolic syndrome, heart disease, sleep apnea, mood disorders, and high blood pressure, and therefore, will need to see their doctors regularly for checkups.
Causes of PCOS
While the exact cause of PCOS is unknown, there are several factors that may play a role:
- Genetics. PCOS tends to run in families, especially if you have a mother or sister with PCOS or with symptoms like yours.
- High levels of androgens. Having high levels of androgens can prevent the ovaries from releasing an egg (ovulation) during each menstrual cycle and can cause extra hair growth and acne.
- Insulin resistance. The body’s cells do not respond normally to insulin. Many women with PCOS have insulin resistance, especially those who are overweight or obese, do not get enough physical activity, and have a family history of diabetes, usually Type 2 diabetes.
In diagnosing PCOS, your doctor is looking for three characteristic features including the absence of ovulation, high levels of androgens, and cysts on the ovaries. Having one or more of these features could lead to a diagnosis of PCOS.
During your consultation, your doctor will
- Take a full family history and ask your questions about your menstrual cycle.
- Conduct a physical exam and look for extra hair growth, acne, and other signs of high levels of the hormone androgen.
- Take blood samples to test your levels of androgens, cholesterol, and sugar in your blood.
- Conduct a pelvic exam to check your ovaries.
- Recommend an ultrasound to take a picture of your pelvic area.
Treatment for PCOS
Even though there is no cure for PCOS, the symptoms can be managed. Your doctor will work with you to develop a treatment plan that may include:
Weight loss. Losing weight will help you to lower your blood glucose levels, improve the way your body uses insulin, and help your hormones reach normal levels.
Hair removal or slowing hair growth. You can try laser hair removal or electrolysis to remove excess hair. There are even prescription skin creams that can slow down the growth rate of new hair in unwanted places.
Prescription medicines. Hormonal birth control, such as the pill, patch, shot, vaginal ring, or hormonal IUD may be prescribed to improve acne and reduce unwanted hair. Other medicines can block the effect of androgens or lower insulin and androgen levels. If you are trying to get pregnant, your doctor may prescribe Clomid to help you ovulate.
In-vitro fertilization (IVF). This is another option to help you get pregnant. Your egg is fertilized with your partner’s sperm in a laboratory and then placed in your uterus to implant and develop. IVF results in higher pregnancy rates and lowers your risk for multiple births.
Hormone Imbalance FAQs
Women who have a hormone imbalance may experience one or more of the following symptoms:
- Heavy, irregular or painful periods
- Osteoporosis (weak, brittle bones)
- Hot flashes and night sweats
- Mood swings and/or depression
- Weight gain
- Increased sensitivity to cold or heat
- Dry skin
- Puffy face
- Vaginal dryness
- Painful sex due to a lack of
- vaginal lubrication
- Decreased sex drive
- An increase in urinary tract infections (UTIs) due to a thinning of the urethra
- Breast tenderness
- Constipation and diarrhea
- Acne during or just before menstruation
There are numerous possible causes of hormone imbalance in women. Some causes are due to external factors, such as stress and hormone medications, and other causes may be due to medical conditions such as
- Polycystic Ovary Syndrome
- Androgen Excess (an overproduction of male hormones that cause menstrual irregularities, infertility, acne, and male pattern baldness)
- Hormone Replacement or Birth Control Medications
- Early Menopause
- Primary Ovarian Insufficiency
- Ovarian Cancer
- Eating Disorders
- Cancer Treatments
During your consultation, your Newton-Wellesley OB/GYN physician may order a blood test for you that checks your estrogen, progesterone, and testosterone levels, as well as your thyroxin (thyroid hormone), insulin, and cortisol levels. There may be more tests ordered based on your symptoms.
Your doctor will also conduct a pelvic exam to check for any lumps or cysts. A biopsy may be taken of any abnormally appearing tissue. If required, your doctor may order imaging tests such as an ultrasound, MRI, or thyroid scan for an accurate diagnosis.
Treatment for hormone imbalance depends on the cause. Once your doctor figures out what is causing your hormone imbalance, treatment recommendations may include:
- Hormone control or birth control regulate menstrual cycles and symptoms.
- Vaginal estrogen reduces symptoms of vaginal dryness.
- Hormone replacement medications reduce symptoms associated with menopause like hot flashes and night sweats.
- Eflornithine slows excessive facial hair growth in women.
- Anti-androgen medications help limit severe acne and excessive hair growth or loss.
- Clomiphene (Clomid) and Letrozole (Femara) help stimulate ovulation for women suffering from PCOS.
- Gonadotropin injections increase the chances of pregnancy.
- Metformin helps manage or lower blood sugar levels.
- Levothyroxine helps improve symptoms of hypothyroidism.
- In-vitro fertilization may help those with PCOS complications get pregnant.
- Lifestyle changes (e.g., losing weight, keeping a healthy diet, avoiding stress, getting enough sleep).