What Is PCOS?

PCOS, or polycystic ovarian syndrome, is a hormonal endocrine disorder. A PCOS diagnosis is commonly given to women with irregular periods.

If you “Google” PCOS you will likely find images or descriptions of overweight women with acne who have excessive/abnormal hair growth. The truth is that not all women diagnosed with PCOS have the stereotypical characteristics, most tend to fall somewhere along the spectrum of symptoms.

Symptoms include:

  • Weight gain
  • Fatigue
  • Unwanted hair growth
  • Thinning hair
  • Infertility
  • Acne
  • Mood changes
  • Pelvic pain
  • Headaches
  • Trouble sleeping

How is PCOS diagnosed?

PCOS is a diagnosis of exclusion. That means your doctor needs to rule out all other reasons why your periods may be irregular before suspecting PCOS. In addition, women must have two of the following to be diagnosed with PCOS:

  1. Irregular periods
  2. Evidence of elevated androgens – either physically (i.e. male pattern hair growth) or based on blood work
  3. Polycycstic-appearing ovaries on ultrasound

Technically, if a woman meets two of the above criteria, and there is no other explanation for her irregular periods, she has PCOS. All women with PCOS need to be treated the same way, even those who do not “appear” to have it. Testing for associated conditions like impaired glycemic control is important. Irregular hormone levels and metabolic conditions can affect egg quality, which of course then impacts fertility, miscarriage and pregnancy complications.

Managing PCOS

PCOS management depends on a woman’s reproductive goals. When a woman with PCOS is not interested in getting pregnant the treatment may be as simple as going on a birth control pill. When pregnancy is desired, then fertility treatment may be required.

PCOS & Pregnancy

The irregular periods associated with PCOS are due to delayed and irregular ovulation. Any woman with PCOS will tell you that it is difficult to time intercourse in hopes of conceiving because she never knows when she is going to ovulate. Apps and home ovulation predictor kits are often unreliable for women with PCOS.

Achieving a pregnancy may be as simple as using an oral medication like Clomid to induce ovulation, but it may require more advanced treatment like intrauterine insemination (IUI) or in vitro fertilization (IVF). The choice of treatment is not only dependent on a woman’s PCOS diagnosis, but should also consider her age, additional history and the results of her partner’s fertility testing.