Polycystic ovaries; Polycystic ovary disease; Stein-Leventhal syndrome; Polyfollicular ovarian disease; PCOS
Polycystic ovary syndrome (PCOS) is a condition in which a woman has an imbalance of female sex hormones. This may lead to changes in the menstrual cycle, cysts in the ovaries, trouble getting pregnant, and other health problems.
PCOS is linked to changes in hormone levels that make it harder for the ovaries to release fully-grown (mature) eggs. The reasons for these changes are unclear. The hormones affected are:
Normally, one or more eggs are released during a woman's cycle. This is known as ovulation. In most cases, this release of eggs occurs about 2 weeks after the start of a menstrual period.
In PCOS, mature eggs are not released. Instead, they stay in the ovaries with a small amount of fluid around them. There can be many of these. However, not all women with the condition will have ovaries with this appearance.
These problems with the release of eggs can contribute to infertility. The other symptoms of this disorder are due to the hormone imbalances.
Most of the time, PCOS is diagnosed in women in their 20s or 30s. However, it may also affect teenage girls. The symptoms often begin when a girl's periods start. Women with this disorder often have a mother or sister who has similar symptoms.
Symptoms of PCOS include changes in the menstrual cycle, such as:
Other symptoms of PCOS include:
The development of male characteristics is not typical of PCOS and may indicate another problem. The following changes may indicate another problem apart from PCOS:
Your doctor or nurse will perform a physical exam. This will include a pelvic exam. The exam may show:
The following health conditions are common in women with PCOS:
Your doctor or nurse will check your weight and body mass index (BMI) and measure your belly size.
Blood tests can be done to check hormone levels. These tests may include:
Other blood tests that may be done include:
Your doctor may also order the following imaging test or surgeries to look at your ovaries:
Weight gain and obesity are common in women with PCOS. Losing weight, even a small amount of weight, can help treat the hormone changes and health conditions such as diabetes, high blood pressure, or high cholesterol.
Your doctor may recommend birth control pills to make your periods more regular. These medicines may also help reduce abnormal hair growth and acne after you take them for several months.
A diabetes medicine called Glucophage (metformin) may also be recommended to:
Other medicines that may be prescribed to help make your periods regular and help you get pregnant are:
These medicines work better if your body mass index (BMI) is 30 or less (below the obese range).
Your doctor or nurse may also suggest other treatments for abnormal hair growth. Some are:
Permanent hair removal options include electrolysis and laser hair removal. However, many treatments may be needed, and treatments are expensive.
A pelvic laparoscopy may be done to remove or alter an ovary to treat infertility. The effects are temporary.
With treatment, women with PCOS are very often able to get pregnant. There is an increased risk of miscarriage, high blood pressure, and gestational diabetes during pregnancy.
Women with PCOS are more likely to develop:
Call your health care provider if you have symptoms of this disorder.
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Rebar RW, Catherino WH. Reproductive endocrinology and infertility. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 236.
Rosenfield RL, Barnes RB, Ehrmann DA. Hyperandrogenism, hirsuitism, and polycystic ovary syndrome. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 133.
Last reviewed on: 4/5/2016
Reviewed by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.