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About PCOS and Treatment Options

About PCOS

What is PCOS?
Polycystic Ovarian Syndrome (PCOS) is the most common hormonal reproductive problem in women of childbearing age. It can affect not just a women's menstrual cycle, fertility and appearance, but also her overall health and wellbeing.
How common is PCOS?
Almost 10% of reproductive-aged women (including adolescents) meet criteria for diagnosis of PCOS.
What are the signs and symptoms of PCOS?
Irregular menstrual cycles, excess facial and body hair, thinning of scalp hair, acne, excessive weight, and fertility problems are common in women with PCOS. Depressive symptoms and sleep disturbances are also commonly seen in PCOS. See Figure 1.
What causes PCOS?
PCOS is a disorder of imbalance in hormones. A relative excess of "male hormones" such as "testosterone" and of "insulin" is thought to contribute to ovarian dysfunction, which then results in irregular menses. Excess body weight is recognized to contribute to the hormonal imbalance and weight loss improves the clinical picture.
What are the health risks of PCOS?

Women with PCOS are at an increased risk for chronic health problems, including diabetes, depression, and heart disease. They are also at risk for gynecological problems including uterine polyps and even uterine and breast cancer. Pregnancy complications such as pre-eclampsia and diabetes in pregnancy are more common in women with PCOS.

For more information on PCOS and our services, click here to read our brochure.
How is PCOS diagnosed?
While there is no single test to diagnose PCOS, this disorder should be suspected in any woman experiencing the common symptoms and signs of PCOS (irregular periods, excessive facial hair and body hair, thinning of scalp hair or elevated blood levels of male hormones). A combination of clinical presentation, pertinent blood tests, and pelvic ultrasound examination are utilized for diagnosis.
Management of PCOS is a "Two-Pronged" Approach

Treatment Options

Treatment strategies that target the patient's complaint..
  • To manage irregular periods- these include hormonal and non-hormonal treatment options.
  • To manage excess hair growth, hair loss, and acne- these include hormonal and non-hormonal treatment options.
  • To manage infertility in women with PCOS.
Risk reduction strategies are critically important in any women with PCOS to help reduce her life-time risks (e.g., diabetes, heart disease, depression, and uterine cancer)
  • Lifestyle of our patients at their initial representation to our PCOS program is reflected in the following charts-excessive consumption and sedentary lifestyle dominate the clinical picture. Lifestyle modification, which includes attention to diet and regular physical activity, is a must for all women with PCOS. Excess dietary calories and carbohydrates, erratic eating profile and limited physical activity are major contributors to weight gain in women with PCOS.
  • Psychological support- Depression and anxiety are commonly seen in women with PCOS and seeking appropriate help is strongly encourages. Pregnant women with PCOS face a number of challenges before, during, and after their pregnancies. To address these concerns, Yale's infertility specialists and Maternal-Fetal Medicine specialists at the Yale PCOS Program provide on-site consultations prior to conception and throughout pregnancy for women likely at high risk for pregnancy-related complications. Our goal is to help achieve a healthy pregnancy in a health mother.
  • Uterine protection- Irregular menstrual periods and the absence of ovulation place women with PCOS at a risk for abnormalities of the uterine lining (endometrium). Polyps and hyperplasia of the endometrium cause not only heavy or irregular bleeding, but can also lead to pre-cancerous and even cancer.
  • Sleep study and sleep hygiene strategies are advised for those experiencing disturbed sleep (difficulty going to sleep or interrupted night sleep).

For more information on PCOS treatment and our services, click here to read our brochure.

Common Patient Concerns

My weight gain is because of PCOS.

While 2/3 of women diagnosed with PCOS are overweight or obese, the weight excess is not because of you, but may contribute to some of the symptoms of PCOS. Weight reduction has been shown to improve symptoms of PCOS including menstrual irregularity, acne, and hair growth.

I worry that I will never be able to achieve pregnancy because of PCOS.

Although ovulatory disturbance is common in women with PCOS, a number of treatment options are available and are effective in managing PCOS-related infertility.

I don't need to undergo an infertility workup as I already know I have an ovulation problem.

While an ovulation problem is obvious in many women with PCOS, additional factors, such as problems with a partner's sperm or blocked tubes, may co-exist and should be considered so that the most optimal treatment can be provided.

To learn more about PCOS, read our brochure...