Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.
The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.
Polycystic ovary syndrome is a disorder involving infrequent, irregular or prolonged menstrual periods, and often excess male hormone (androgen) levels. The ovaries develop numerous small collections of fluid — called follicles — and may fail to regularly release eggs.
Signs and symptoms of PCOS often develop around the time of the first menstrual period during puberty. Sometimes PCOS develops later, for example, in response to substantial weight gain.
Signs and symptoms of PCOS vary. A diagnosis of PCOS is made when you experience at least two of these signs:
PCOS signs and symptoms are typically more severe if you're obese.
See your doctor if you have concerns about your menstrual periods, if you're experiencing infertility or if you have signs of excess androgen such as worsening hirsutism, acne and male-pattern baldness.
The exact cause of PCOS isn't known. Factors that might play a role include:
Complications of PCOS can include:
Obesity is associated with PCOS and can worsen complications of the disorder.
There's no test to definitively diagnose PCOS. Your doctor is likely to start with a discussion of your medical history, including your menstrual periods and weight changes. A physical exam will include checking for signs of excess hair growth, insulin resistance and acne.
Your doctor might then recommend:
If you have a diagnosis of PCOS, your doctor might recommend additional tests for complications. Those tests can include:
During a pelvic exam, your doctor inserts two gloved fingers inside your vagina. While simultaneously pressing down on your abdomen, he or she can evaluate your uterus, ovaries and other pelvic organs.
During a transvaginal ultrasound, your doctor or a medical technician inserts a wandlike device (transducer) into your vagina while you lie on your back on an exam table. The transducer emits sound waves that generate images of your pelvic organs, including your ovaries. On an ultrasound image (inset), a polycystic ovary shows many follicles. Each dark circle on the ultrasound image represents a fluid-filled follicle in the ovary. Your doctor may suspect PCOS if you have 20 or more follicles in each ovary.
PCOS treatment focuses on managing your individual concerns, such as infertility, hirsutism, acne or obesity. Specific treatment might involve lifestyle changes or medication.
Your doctor may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Even a modest reduction in your weight — for example, losing 5 percent of your body weight — might improve your condition. Losing weight may also increase the effectiveness of medications your doctor recommends for PCOS, and can help with infertility.
To regulate your menstrual cycle, your doctor might recommend:
To help you ovulate, your doctor might recommend:
To reduce excessive hair growth, your doctor might recommend:
To help decrease the effects of PCOS, try to:
You may be referred to a specialist in female reproductive medicine (gynecologist), a specialist in hormone disorders (endocrinologist) or an infertility specialist (reproductive endocrinologist).
Here's some information to help you get ready for your appointment.
For PCOS, some basic questions to ask your doctor include:
During your appointment, don't hesitate to ask other questions as they occur to you.
Your doctor is likely to ask you a number of questions, including: