Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian syndrome is the most common endocrine (hormone) problem affecting women. PCOS affects 5-11% of women and is responsible for 70% of cases in which women have irregular cycles. PCOS is diagnosed when a woman has two of the following three medical findings: Infrequent menstrual cycles occurring less than once every 35 days or missed cycles, hair growth in unexpected areas (hirsutism) including the face, chin, chest or abdomen or high testosterone levels, and evidence of 12 or more follicles in at least one ovary on ultrasound. Your doctor must also confirm that these findings are not caused by other medical conditions such as high cortisol levels. The cause of PCOS is not completely understood, but patients that have PCOS produce higher than normal levels, for a woman, of testosterone which interferes with the release of an egg from the ovary (ovulation). Woman with PCOS also experience insulin resistance which increases their risk for developing hyperglycemia (high sugar levels), diabetes, weight gain and darkening of skin color around the neck (acanthosis nigricans). PCOS is often managed with a healthy, low-glycemic index (low carbohydrate & sugar) diet, exercise and medications including metformin. In patients who have infrequent cycles and are not trying to get pregnant, they may take oral contraceptives to reduce some of the symptoms associated with PCOS.

In patients who are trying to get pregnant, Polycystic Ovarian Syndrome can prolong the amount of time it takes to get pregnant or prevent a woman from getting pregnant. This is due to the higher levels of testosterone which interfere with the release of the egg from the ovary (ovulation). Failure to release an egg from the ovary (anovulation) for patients who want to get pregnant can be treated with various combinations of medications including clomiphene, letrozole, metformin, dexamethasone, gonal F, Follistim, Menopur, Repronex, Ovidrel or Novarel depending on your treatment plan. Women with PCOS typically require more fertility medication to respond and at the same time are at higher risk for overresponding to fertility medication (Ovarian Hyperstimulation Syndrome, or OHSS).