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OB Gyn Associates of Iowa City and Coralville

Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) affects up to 1 in 10 women of childbearing age and is the most common cause of infertility. But what causes it? Who gets it? And how is it treated? Let’s talk about it.

What causes PCOS?

PCOS is caused by an imbalance of reproductive hormones, which creates problems in the ovaries. With PCOS, the egg may not develop correctly or it may not be released during ovulation as it should be. This can cause missed or irregular menstrual periods, which can lead to infertility and development of cysts in the ovaries. 

Doctors don’t know exactly what causes PCOS, but they believe that high levels of male hormones (androgens) prevent the ovaries from making eggs normally. Genes, insulin resistance, and inflammation have all been linked to excess androgen production.

Who gets PCOS?

Many women have PCOS but don’t know it. Most women find out they have PCOS when they have problems getting pregnant. But PCOS can happen at any age after puberty. In one study, up to 70 percent of women with PCOS hadn’t been diagnosed.

Women of all races and ethnicities can get PCOS. Your risk of PCOS may be higher if you have obesity or if you have a close relative with PCOS.

What are the symptoms of PCOS?

  • Irregular menstrual cycle–missed periods, fewer periods (fewer than 8 per year), frequent periods (every 21 days or more often), or no periods at all
  • Excess hair on the face or body
  • Acne on the face, chest, and upper back
  • Thinning hair or hair loss; male-pattern baldness
  • Weight gain
  • Darkening of skin, particularly along neck creases, in the groin, and underneath breasts
  • Skin tags–small excess flaps of skin in the armpits or neck area

How is PCOS treated?

Treatment for PCOS usually starts with lifestyle changes like weight loss, diet, and exercise. Medicines such as birth control pills can help regulate your menstrual cycle and treat some symptoms like hair growth and acne.

Can I get pregnant if I have PCOS?

If you’re hoping to get pregnant, regulating your ovulation is the key. If you don't ovulate, you can't get pregnant. However, women with PCOS can get pregnant using fertility treatments that improve ovulation. You can also use an ovulation calculator to help you track the most fertile days of your cycle. 

PCOS can also increase the risk for some pregnancy complications, such as premature delivery, miscarriage, gestational diabetes, and high blood pressure. Losing weight and lowering blood sugar levels can improve your odds of having a healthy pregnancy. 

When should I see my doctor?

See your doctor if:

  • You have symptoms of PCOS
  • You’ve been trying unsuccessfully to get pregnant for more than 12 months
  • You have symptoms of diabetes, such as excess thirst or hunger, blurred vision, or unexplained weight loss

If you have PCOS, you’ll need tests to check for diabetes, high blood pressure, and other possible complications. Regular visits with your primary care doctor are important to manage your health and feel good in your body.