The polycystic ovary syndrome (PCOS) is a metabolic syndrome that describes an interacting group of symptoms in women, including excess androgens (male hormones), irregular periods, anovulation (not ovulating), obesity, glucose intolerance/insulin insensitivity, and cardiometabolic dysfunction (diabetes, high blood pressure, risks for heart disease). Diagnosis is by symptoms (acne and hirsutism suggest high androgen effect), irregular periods (suggest lack of ovulation), signs (obesity), and labs to check androgen levels and other sources of anovulation. To complete the diagnosis, ultrasounds generally demonstrate multiple, small cysts or follicles in the ovaries (polycystic ovaries).
The overall goals of therapy of women with PCOS include:

  • Symptomatic management of hirsutism, acne, and scalp hair-loss
  • Management of metabolic abnormalities and risk factors for both type 2 diabetes and cardiovascular disease.
  • Prevention of endometrial pathology (cancerous and pre-cancerous) that results from chronic anovulation and obesity.
  • Regulation of periods
  • Contraception
  • Ovulation induction for those pursuing pregnancy

Treatment for PCOS generally involves weight loss, a low-carbohydrate lifestyle, and birth control pills to reduce androgens and regulate periods. Other helpful measures may include an insulin-sensitizer such as Glucophage, and sometimes help with ovulation induction for those women pursuing pregnancy. Progesterone IUDs help regulate bleeding and reduce uterine cancer risk in women who cannot use birth control pills.

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