When to See a Doctor About PCOS

Polycystic ovarian syndrome (PCOS) is a very real problem for five to six million women of childbearing age in the U.S. Not only does PCOS complicate fertility, it can also increase the risk for developing many other chronic, life-threatening conditions including diabetes, heart disease, high blood pressure and uterine cancer.

PCOS is essentially an imbalance of hormones caused by an overproduction of male hormones, or androgens. Androgens throw off your body’s response to female reproductive hormones, causing both incomplete ovulation and your ovaries to develop cysts. Imbalanced hormones cause other complications as well.

How to Tell If You Have PCOS

PCOS is one of the most common hormonal conditions affecting women during their reproductive years, but the risks and effects of this condition may be lifelong, especially if left untreated. PCOS usually presents the following symptoms after puberty begins:

• Irregular periods, light periods or no period at all
• Excess body hair in places not normally grown on females; the chest, abdomen. Face and back (hirsutism)
• Excess belly fat and weight gain in the midsection
• Severe acne
• Oily skin
• Male pattern baldness
• Thinning hair
• Skin tags, especially on neck and armpits
• Discolored, dark patches of skin on neck, armpits and under the breasts
• Enlarged ovaries or ovaries containing many cysts (polycystic)
• Fertility complications

If you have any of the above symptoms, contact your doctor. These symptoms alone are not enough to make a PCOS diagnosis, but they will prompt your doctor to test you. Once you do have a diagnosis, you and your doctor can move forward with treatment.

How Your Doctor Diagnoses PCOS

For suspected PCOS, your doctor will review your symptoms, medical history and assess the condition of your reproductive organs. PCOS can also be genetic, so your doctor will also ask about your close female relatives (mother, sister, aunt, grandmother). And because PCOS symptoms are also associated with other conditions, your doctor will run a few tests before a final diagnosis.

• Ultrasound: An ultrasound is a non-invasive way for your doctor to look at your blood vessels, organs and other tissues and, in this case, your ovaries and whether or not they have cysts. Because PCOS can affect the lining of your uterus, an ultrasound will look at your uterus for the thickness of the endometrium (uterine lining).
  
  
• Blood Tests: A blood test will measure your androgen, hormone and blood sugar (glucose) levels since PCOS affects your blood sugar response to insulin. They will also likely perform a cholesterol test on your blood because it’s common for those with PCOS to have elevated cholesterol and/or triglyceride levels.

Based on these test results, your doctor can make a diagnosis and begin discussing treatment. Because infertility is a common PCOS symptom, many women don’t see a doctor until they’re trying to conceive. Remember, the earlier your diagnosis, the earlier you’re able to control your PCOS symptoms–including infertility.

Treatment for PCOS

PCOS treatment depends on a number of things: age, overall health and how advanced your PCOS is, if there are underlying conditions and whether or not you want to become pregnant in the future. For those who plan to become pregnant, treatment may include:

• Lifestyle Changes: Your doctor may prescribe a diet and exercise regimen to help you lose weight and reduce your PCOS symptoms. A specific diet targeted toward controlling the symptoms of PCOS will bring your blood sugar levels down by helping your body use your insulin more effectively. This, in turn, may help with ovulation.
  
  
• Ovulation Medication: There are specific medications your doctor may prescribe that will cause your ovaries to mature and release eggs naturally. These ovary stimulating medications may be used alone to encourage natural conception or with an IVF cycle. There are some risks with these medications, such as ovarian hyperstimulation, a painful swelling of the ovaries, or the risk for multiple babies. Your doctor will go over these risks with you.

Depending on when you want to have children, your doctor may first prescribe birth control pills to help lower androgen levels and regulate your periods. Birth control pills also help with acne.

Diabetes medications are also a way to control the symptoms of PCOS, especially insulin resistance. These medications can slow hair growth, bring down your androgen levels and may prompt regular ovulation. Your doctor may prescribe both diabetes medication and lifestyle changes.

Pregnancy and PCOS

Because PCOS causes fertility complications, many women seek medical intervention. In some cases you can conceive naturally with certain treatments. In other cases you may opt for IVF. Because of the potential complications (see below), it’s essential to your health and your potential child’s health that you work closely with your doctor to determine the best plan for you.

• Early miscarriage
• Gestational diabetes (diabetes during pregnancy)
• Preeclampsia (pregnancy-related high blood pressure)

We Can Help with PCOS

If you have symptoms of PCOS or are having trouble conceiving, contact Reproductive Health and Wellness today. We’ll get to the root of your infertility and work with you to realize your dream of having a child.