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Fertility 101: Treatment

Hormonal Imbalances:  Polycystic ovarian syndrome (PCOS)—Diagnosis and Treatment

What is PCOS?

Polycystic ovarian syndrome (PCOS) is common among reproductive-aged women. Women with PCOS experience irregular menstrual periods and frequently have oily skin, acne, and growth of facial hair usually involving the upper lip and chin. About half of women with PCOS are overweight. The ovaries of women with PCOS show multiple, small cysts often 20 or more on an ultrasound. In PCOS, an excess of testosterone affects the ovaries, preventing women from ovulating monthly, and also causes these cosmetic problems. Irregular periods often cause infertility in women with PCOS.

Women with PCOS may only have a few menstrual periods each year, and therefore may have trouble getting pregnant. In fact, PCOS is the most frequent cause of infertility in reproductive-aged women. Women with PCOS also may be at an increased risk for miscarriage because of hormonal imbalances.

Diagnosis

Physicians diagnose PCOS by the patient's history, and frequently use ultrasound and blood testing to confirm the diagnosis. Women with PCOS often have high insulin levels; while they are not diabetic, high insulin levels can contribute to menstrual irregularities and cosmetic problems. High insulin levels may contribute to difficulty losing weight, hirsutism and infertility.

Treatment

Weight loss may result in regular cycles, but even with stringent life style modifications, weight loss is difficult. When trying to conceive, oral ovulatory meds (Clomid, Letrozole) may be used. Complementary medications included glucophage (metformin), ACTOS and Xenical.

Learn more about PCOS (PDF File)