If you are struggling to get pregnant, have painful and irregular periods, notice an increasing amount of facial hair or experience acne breakouts like never before, you may be dealing with polycystic ovarian syndrome (PCOS).

The causes

PCOS is a common health issue caused by an imbalance of reproductive hormones. Women’s bodies create the female hormones estrogen and progesterone and replicate small amounts of androgen—a male hormone, like testosterone. When the body produces too much androgen, the hormone deviation between female and male hormones creates a problem within the ovaries. The out-of-balance hormone levels can cause ovaries to multiply in size and harbor cysts.


Between 5% and 10% of women in their reproductive years have PCOS. Affecting close to 5 million women in the United States alone, it is usually diagnosed when women are in their 20s and 30s. Although this issue can occur at any age after puberty, most women are diagnosed after seeing their physician when struggling to become pregnant. PCOS affects women of all backgrounds and ethnicities, yet the risks are higher when overweight or if a hereditary thread among immediate family members exists.

The symptoms

Although PCOS has multiple causes and a variety of symptoms. Some of the signs to look for include:


  • Irregular cycle. Yes, everyone’s periods are different. If your cycle is unpredictable, or you do not have one for several months in a row, consider those signals to see your doctor.
  • Heavy bleeding. Periods that are extremely heavy happen when the lining of the uterus builds up over a longer amount of time and can be an indicator of PCOS.
  • Adult acne. Just when you thought you left breakouts behind in high school, right? When hormones are out of balance, your skin may be telling part of the story. If you are in your 20s or 30s and experiencing bouts of acne that are not cleared up with a dedicated cleansing routine or simple skin treatment, PCOS may be the cause.
  • Weight gain. If you have unexplainably gained weight or can’t seem to keep weight at even levels despite a healthy lifestyle, it may be an indicator of PCOS. It is not clear whether the weight change is related to the hormone disorder, or the hormone disorder is triggered by weight gain.
  • Changes in hair growth. From alopecia to excess hair growth, these changes may hint that PCOS is the cause. If noticeable differences accompany one or more other symptoms, a diagnosis may be easier to pinpoint.
  • Darkened skin or skin tags. If you notice unusual dark patches of skin in the creases of your neck, under your breasts or in your groin area, or the formation of skin tags (small, excess pieces of skin), these may be indicators of PCOS.
  • Headaches. Along with the hormone shift, some women experience headaches and migraines. Chart how often they happen and how long they last to provide your doctor with as much information as possible.
  • Struggling to conceive. PCOS prevents the ovaries from either releasing a viable egg or ovulation altogether. It is also the most common cause of infertility, so if a year has passed and you have been unsuccessful in becoming pregnant, this diagnosis is one to investigate.

The treatment

Part of determining whether you have PCOS includes scheduling an appointment with your doctor. Before providing a diagnosis, your physician will gather information to construct a picture of what may be going on medically. When visiting your physician, you may encounter:


  • A run-through of your medical history
  • Weight, blood pressure and BMI checks
  • A physical and gynecological exam
  • Blood work and hormone level tests
  • A glucose level check to monitor insulin levels for diabetic concerns
  • An ultrasound to detect ovarian cysts


Once your doctor reviews those results, it’s time to discuss if you need a PCOS treatment plan. Although there is no simple solution, there are measures you can take to reduce your risk of further health challenges, increase the likelihood of getting pregnant for those wanting a child and you’ll be in better health overall. Some of the doctor-recommended treatments include:


  • Weight loss. The American College of Obstetricians and Gynecologists have noted that four out of five women who have been diagnosed with PCOS are overweight and can ease symptoms through increasing activity and healthier eating habits. By moving more often and adding more good-for-you foods into your diet, monthly cycles are likely to get back on track and have you feeling better.
  • Medication. Birth control pills are one of the most prescribed medications to level a woman’s hormones. They contain controlled amounts of estrogen and progesterone, which, once in the bloodstream, stop the ovaries from producing hormones. If diabetes is determined to be the cause of your diagnosis, there are medications that treat type 2 diabetes and PCOS at the same time. If you are trying to conceive and have PCOS, research and ask if fertility drugs are an option for you.
  • Hair growth. Whether you want to stop hair growth or encourage it, treatments are available.
  • Surgery. When fertility treatment options for those with PCOS have been exhausted, surgery may help increase your chances. An ovarian drilling procedure—tiny holes made in the ovary with a heated needle or laser—can help you return to regular ovulation cycles, helping your odds of conceiving.


PCOS has no cure, yet you can partner with your doctor to make a plan that works best for you. Leaving PCOS untreated can lead to other health challenges, such as anxiety, depression, sleep apnea, heart disease and endometrial cancer (cancer of the uterine lining). Women who do not seek treatment at the onset may have problems becoming pregnant later. Remember, regular checkups with your healthcare provider are the best way to stay one step ahead when it comes to your overall health.

Sources: Franciscan Health, Office on Women’s Health, Johns Hopkins, Centers for Disease Control and Medline

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