Every month, in women of childbearing age, tiny fluid-filled cysts known as follicles develop on the surface of the ovary. Female sex hormones, including estrogen, cause one of the follicles to produce a mature egg. The ovary then releases this egg, and it breaks out of the follicle.
In women who have polycystic ovary syndrome, or PCOS, there is an imbalance in female sex hormones. The imbalance may prevent the development and release of mature eggs. Without a mature egg, neither ovulation or pregnancy can occur.
The hormone imbalance may also include an abnormal increase in testosterone, which is primarily a male sex hormone. Women also produce testosterone, although it is usually in small amounts.
The United States’ Office on Women’s Health (OWH) note that PCOS affects 5–10 percent of women aged 15–44 years. They describe PCOS as a “common and treatable cause of infertility.”
Causes
Experts do not know exactly what causes PCOS, but it may involve genetic factors. If a woman’s mother or sister has the condition, she has a higher chance than others of developing it.
Along with a genetic link, excess insulin in the body also increases a woman’s risk of developing PCOS. Insulin is a hormone that the pancreas produces, and the body uses to convert sugar in food into energy.
Women with PCOS often have insulin resistance. Insulin resistance involves the body’s inability to lower blood sugar levels correctly. Blood sugar levels can become too high, which causes yet more insulin production.
Too much insulin also increases testosterone production, which leads to some of the symptoms of PCOS.
Symptoms
Symptoms can occur at any age or time during a person’s reproductive years. Symptoms can also change over time.
Some of the most common symptoms of PCOS include the following:
- abnormal hair growth on the face, chest, or back
- acne or a darkening of the skin
- weight gain
- thinning hair on the head
- infertility
- irregular periods
- ovarian cysts
- depression
- increased skin tags
Not everyone with PCOS will have the same signs or symptoms.
Effects on fertility
PCOS can affect a person’s fertility in different ways.
Ovulation problems are usually the primary cause of infertility in women with PCOS. Ovulation may not occur due to an increase in testosterone production or because follicles on the ovaries do not mature.
Even if ovulation occurs, an imbalance in hormones may prevent the lining of the uterus from developing properly to allow for implantation of the mature egg.
Due to unbalanced hormones, ovulation and menstruation can be irregular. Unpredictable menstrual cycles can also make it difficult to get pregnant.
Treatment
Currently, there is no cure for PCOS. However, treatment can increase the chances of conceiving in those who wish to become pregnant. It can also help people to manage their symptoms.
Symptoms vary between individuals, and so treatment is not always the same. Options also depend on whether or not a person wishes to become pregnant.
Treatment for PCOs symptoms may include:
- Birth control pills to help correct hormonal imbalances.
- Insulin-sensitizing drugs to improve the body’s use of insulin and so testosterone production, too.
- In the case of diabetes, medication to control blood sugar levels.
- Exercise and healthful eating to help boost overall wellbeing and control weight.
Maintaining a healthy weight can help reduce insulin and testosterone levels and improve symptoms.
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