Polycystic Ovary Syndrome: Irregular Periods and What a Visit Covers

What it involves

MedlinePlus explains that polycystic ovary syndrome, or PCOS, is a hormonal disorder that affects the ovaries and many other parts of the body, and its encyclopedia notes the condition is now also called polyendocrine metabolic ovarian syndrome, or PMOS. It usually involves at least two of three problems: not ovulating, higher levels of androgens, and growths on one or both ovaries.

Who this is for

• Women with irregular, missed or very heavy periods that have not been looked into
• Patients with acne that is hard to treat, oily skin, or extra hair on the face, chest or belly
• Women who gain weight easily or have trouble losing it and want to check blood sugar and cholesterol
• Women who have had trouble becoming pregnant, or whose mother or sister has PCOS

What to expect

• Questions about your periods, hair growth, skin, weight changes, sleep, mood and family history
• A check of weight and body mass index, and an exam of the skin for acne, extra hair or dark thickened patches
• Blood work that can include hormone levels, blood sugar or A1C, cholesterol and thyroid tests
• A referral for a pelvic ultrasound or a gynecologist when the findings call for it

The three features

MedlinePlus says that not ovulating means the egg may not develop or be released, so periods can be irregular or absent. High androgens, hormones women normally make in small amounts, can cause extra body or facial hair, called hirsutism. The third feature is growths in one or both ovaries, often clumps of follicles that stopped developing, which may look like small fluid-filled cysts. It is less common, but a woman can have PCOS without growths, with only symptoms, no ovulation and high androgens.

Symptoms MedlinePlus lists

PCOS often starts around the first period, though it can develop later, and some women have few or no symptoms. Listed symptoms include irregular or missed periods, too much hair on the face, chest, stomach or thighs, weight gain or trouble losing weight, severe acne, oily skin, and patches of thickened dark skin. The encyclopedia adds hair loss, fatigue and sleep apnea. The acne guide, the hair loss guide and the skin conditions guide cover individual signs.

Health problems linked to PCOS

MedlinePlus says PCOS is linked to insulin resistance, which can lead to prediabetes and type 2 diabetes; heart disease; high blood pressure; high LDL and low HDL cholesterol; a thickened uterine lining called endometrial hyperplasia; sleep apnea; and depression and anxiety. Not everyone has all of these. The prediabetes and A1C guide, the sleep apnea guide and the depression screening guide describe how a provider checks for three of them.

How it is diagnosed

The encyclopedia says a provider checks your weight and body mass index and may order blood tests for hormone levels, including estrogen, FSH, LH, testosterone and progesterone, as well as fasting glucose, A1C, cholesterol, prolactin and thyroid function. A pelvic exam or pelvic ultrasound may look at the ovaries. Serenity By A Dr. Sareen lists blood work and thyroid care among its services, and the thyroid blood tests guide and the lipid panel guide explain two of them. Imaging is arranged by referral.

Treatment based on your symptoms

MedlinePlus says treatment depends on your symptoms and any related conditions, with lifestyle changes as an important tool: a healthy diet, regular exercise and support for anxiety or depression. Losing even a small amount of weight can help how the body responds to insulin, reduce symptoms from excess male hormones and bring more regular periods. A provider may also prescribe birth control pills to regularize periods and ease hair growth and acne, or a diabetes medicine. The practice lists weight loss and the obesity and BMI guide describes how it is approached.

Pregnancy and long-term checks

MedlinePlus says PCOS is one of the most common causes of infertility but that many women with it can still get pregnant, and it lists pregnancy complications among the possible symptoms. Because the related risks can develop over time, regular checks of blood pressure, blood sugar and cholesterol are a sensible part of care. The practice lists high cholesterol management and blood pressure care among its services, and a gynecologist can be involved when pregnancy is the goal.

Sources

• MedlinePlus: Polycystic Ovary Syndrome (health topic)
• MedlinePlus: Polyendocrine metabolic ovarian syndrome (medical encyclopedia)