Polycystic Ovarian Syndrome (PCOS) by Mark H. Amols, MD

Polycystic Ovarian Syndrome (PCOS), what is it? When you hear this term what do you think? Have you heard of this before? If you have heard of PCOS then you a probably thinking about infertility, unwanted hair growth, and the association of obesity. However, the term PCOS can encompass a spectrum of disorders and a wide range in severity from anovulation and infertility to Type II diabetes. 

PCOS is primarily associated with infertility however there are real medical problems and health risks that are associated with it.

PCOS is a syndrome. A syndrome is the association of several clinical signs (observed by a physician), symptoms (patient reported), and characteristics that occur together.  It is the most common hormonal disorder among reproductive age women in the United States. It is often marked by unwanted hair growth, irregular menstrual periods, and ultrasound evidence of multiple little ovarian cysts (polycystic ovaries). Its cause is not absolutely known but it appears it occurs when the ovaries overproduce androgens (male hormones). It can be associated with obesity 50% of the time.

Does this mean I can’t have a baby? Women with PCOS do have an increased risk of infertility. There are medical treatments that can help you achieve a healthy pregnancy. These treatments are as simple as a daily pill to as complicated as in-vitro fertilization.  A reproductive endocrinologist (a fertility doctor) can work with you to determine the type of plan that will give you the best outcome and that fits within your personal desires.

Can I treat the symptoms or cure myself of PCOS? There are several treatments that treat the unwanted hair (hirsutism) and acne associated with PCOS. Diet and exercise are first line treatment. It has been shown that women who are obese with PCOS can resolve the symptoms of PCOS with weight loss. As little as 5-10% weight loss can lead to return of the women’s menstrual periods and allow pregnancy without need for medical intervention.  

What are the medical risks? Women with PCOS tend not to ovulate regularly (release an egg every month). This is the main reason for infertility but can also lead to an overgrowth of the lining of the uterus predisposing these women to endometrial cancer.   Ovulation is needed to cause a menstrual period, which is shedding of the lining of the uterus.  Women with PCOS may need to take a medication to help them shed this lining to prevent overgrowth (hyperplasia) which can lead to endometrial cancer. Other major lifetime risks associated with PCOS include: insulin resistance, type 2 diabetes, cardiovascular disease, high blood pressure, and dysfunctional lipid metabolism (cholesterol issues).

Who should I see if I have PCOS or think I have PCOS? There are several practitioners that can address the problems associated with PCOS: Family Physicians, Gynecologists, Endocrinologists, and Reproductive Endocrinologists. However, a Reproductive Endocrinologist has the background and experience to treat both your medical and infertility problems giving you better comprehensive care. Dr. Ketan Patel and Dr. Mark Amols from Arizona Associates for Reproductive Health specialize in diagnosing, treating, and managing PCOS.  If you do believe you have PCOS or were diagnosed with PCOS you should seek out a reproductive endocrinologist who can direct your care to treat the symptoms and prevent the health risks associated with PCOS.