Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects women during their childbearing years. It disrupts the normal balance of reproductive hormones, which can lead to irregular menstrual cycles, problems with ovulation, and symptoms such as acknew, excess facial or body hair (hirsutism), and thinning hair on the scalp.
PCOS is also the most common cause of infertility due to absent or irregular ovulation.
In many cases, women with PCOS have multiple small cysts called immature ovarian follicles that can be seen with medical imaging. These follicles fail to mature and release egg and instead accumulate in the ovaries. Irregular or infrequent menstruation may also increase the risk of endometrial cancer, or cancer in the uterine lining.
PCOS can affect many aspects of a woman’s health. Many women with the condition are overweight or obese and are at increased risk of a fatty liver. Additionally, many women with the condition have elevated insulin that increases their risk of prediabetes and type 2 diabetes. In addition, many women with PCOS are at an increased risk of metabolic syndrome, sleep apnea, and mood disorders such as depression.
Causes and Risk Factors
PCOS is a complex condition that likely results from a combination of genetic, lifestyle, and environmental factors.
Genetic factors
Certain genetic variations (polymorphisms) have been linked to PCOS, particularly those that affect:
- Androgen production
- Hormones involved in ovulation, such as luteinizing hormone and anti-Müllerian hormone
- Insulin regulation and energy metabolism
- Inflammatory and immune system responses
Although no single gene causes PCOS, women with a family history of the condition are more likely to develop it. An estimated 20% to 40% of women with PCOS have a mother or sister who is also affected.
Health and lifestyle factors
- Insulin resistance and obesity: Many women with PCOS have elevated insulin levels, which can increase androgen production and worsen symptoms.
- Sedentary lifestyle: Physical inactivity can contribute to weight gain and insulin resistance, increasing the risk of PCOS.
- Other health conditions: Type 2 diabetes, high blood pressure, high cholesterol, and fatty liver disease often occur alongside PCOS and may share common pathways.
While the exact interplay of these factors is still being studied, it’s clear that both inherited and modifiable risks contribute to a woman’s likelihood of developing PCOS.
Symptoms of PCOS
PCOS symptoms may vary, but common signs include:
- Irregular or absent menstrual periods
- Excess facial or body hair (hirsutism)
- Acne or oily skin
- Thinning hair or hair loss (male-pattern baldness)
- Weight gain or difficulty losing weight
- Darkening of skin, especially along neck creases, groin, and underneath breasts
- Skin tags in the armpits or neck area
- Difficulty becoming pregnant
- Mood changes or depression
Diagnosis
Diagnosing PCOS may involve:
- Reviewing your medical history and symptoms
- Physical exam
- Blood tests to check hormone levels
- Ultrasound to look at your ovaries and uterine lining
Treatment for PCOS
There is no cure for PCOS, but symptoms can be managed based on your goals (such as managing menstrual irregularities, reducing excess hair growth, or improving fertility).
Treatment options may include:
- Lifestyle changes such as diet and exercise
- Hormonal birth control to regulate periods
- Anti-androgen medications
- Medications to help with insulin resistance (such as metformin)
- Fertility treatments if pregnancy is desired
Possible PCOS Complications
Untreated or poorly managed PCOS may increase the risk of:
- Infertility
- Type 2 diabetes
- High blood pressure and heart disease
- Sleep apnea
- Endometrial cancer
- Depression or anxiety
Why Choose Cooper to Diagnose and Treat PCOS
Cooper University Health Care offers expert, compassionate care for women with PCOS. When you choose Cooper, you can expect:
- Personalized treatment from board-certified endocrinologists and OB/GYNs who specialize in managing complex hormonal conditions
- Access to advanced diagnostic tools and imaging
- Coordinated care across specialties, including fertility, cardiology, weight management, and mental health
- Academic excellence from our physicians, who are faculty at Cooper Medical School of Rowan University and are actively engaged in clinical research and education
Schedule an Appointment
To schedule an appointment with a Cooper expert in PCOS, please call 800.8.COOPER (800.826.6737).