Polycystic Ovarian Syndrome (PCOS)


PCOS is a very common endocrine disorder, it affects 5-12% of women.  It can cause a lot of issues as you will see below.  It can be in both  normal body mass index (BMI) weight women and in overweight women. 

Cause: Genetics and hormone regulation play a role, otherwise, etiology is unclear.

What happens?  Our ovaries produce a lot of cysts which produce a lot of “male” hormones which causes an imbalance in our system. I put male in quotes as the hormones or androgens that are elevated are in both men AND women, but predominantly more in men.  Those with PCOS continue to make estrogen which builds the lining of the uterus up, without ovulation, we do not produce progesterone, which helps to thin the lining of the uterus.  We want the uterine lining thin in non-pregnant patients.   

The most common signs/symptoms of PCOS, (click on title for more info):

    Irregular bleeding:  Due to anovulation (not ovulating) the lining of the uterus builds up and then can slough off when it loses blood supply, this is why women have irregular bleeding or do not have any at all.  When we do not ovulate, we do not produce progesterone which keeps the uterine lining thin.  Irregular or no bleeding should always be evaluated.
    Hyperandrogenism: This is elevated “male” hormones in the blood stream, which causes: acne, unwanted hair growth and/or loss of hair.  Women can grow hair on their face, around the nipple (areola), abdomen, and even on their buttocks and back.
    Difficulty losing weight: If you are eating properly and exercising but still having difficulty losing weight, it might be due to PCOS.
    Cardiovascular and diabetes risk: There may be an increased risk for obesity, diabetes, high cholesterol, and heart disease.  There may be an increase of insulin in the blood due to an insensitivity of the receptors, (insulin helps the body absorb sugar into cells), this then leads to an impaired glucose-tolerance, which causes your body not to absorb the sugar, which can increase the risk for type 2 diabetes.
    Infertility: Due to the irregular anovulatory cycles, PCOS makes it difficult to become pregnant. It does not make it impossible though, there are things that can be done to help improve your chances of becoming pregnant.
    Mood disorders: Increased risk for depression and anxiety and potentially eating disorders
    Potential increased risk for sleep apnea: Improving ones BMI is helpful to combat this.
    Increased risk for uterine cancer: This is due to lack of ovulation (regular periods) and the thickening of the lining from the lack of shedding.

Diagnosis:  It can sometimes take some time to figure this out but you need to have at least 2 of the 3 criteria for diagnosis:

  • Few periods in a year or none (not on hormonal medication)
  • Hyperandrogenism, clinically and/or seen on blood work
  • Polycystic ovaries (by ultrasound)

Some of the possible treatment options:     

  • Lifestyle Changes = healthy diet and exercise
  • Combined oral contraceptives (birth control pill) (if able to take them)
  • Alternative to combined oral contraceptives: cyclic progestin therapy, continuous progestin therapy or a progestin-releasing intrauterine device
  • Possible use of myo-inositol can help restore ovulation
  • Anti-androgen may be added (medication used to help decrease testosterone from binding to the receptors and causing hair loss and/or acne)
  • Screen for anxiety and depression, sleep apnea, cardiovascular issues; treat accordingly

If you think you have PCOS or you have irregular period concerns, sign up for Weber Medical to discuss this with Dr. Lauren Weber for your personalized treatment plan.



The information provided in this blog is for educational purposes only and is not to be used as medical advice.