Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS, polycystic ovaries) is a gynecological and endocrine disorder associated with impaired function of the ovaries (absent or irregular ovulation and increased production of male and female sex hormones), the pancreas (excessive insulin production), and other endocrine organs.

PCOS may lead to infertility because normal maturation and release of an egg from the ovary — ovulation — may not occur.

Symptoms of Polycystic Ovary Syndrome:

Infrequent or absent menstruation due to absent or irregular ovulation;

Elevated levels of male hormones (androgens), which may manifest as excessive hair growth, acne, and increased skin oiliness;

Excess body weight or, conversely, significant underweight.

Diagnosis

Ultrasound examination may reveal enlarged ovaries with numerous small follicles located around the periphery.

Hormonal testing may reveal an imbalance between female and male sex hormones.

Treatment

Treatment depends on whether the patient is planning a pregnancy.

If the patient is planning a pregnancy:

In cases of excess weight and hyperinsulinemia: dietary modification, including a low-carbohydrate diet, and regular physical activity;

Medical stimulation of ovulation using specific medications, followed by attempts at natural conception or intrauterine insemination (IUI);

In vitro fertilization (IVF).

If the patient is not planning a pregnancy:

Progesterone medications during the second phase of the menstrual cycle to protect the endometrium from hyperplastic changes, including endometrial polyps or endometrial hyperplasia;

Hormonal contraceptives containing components that help reduce the effects of elevated androgen levels.

*Surgical treatment is generally not recommended because it may reduce ovarian reserve.