Complications with pcos

Polycystic Ovary Syndrome (PCOS) | Johns Hopkins Medicine

Polycystic ovary syndrome (PCOS) is a condition in which the ovaries produce an abnormal amount of androgens, male sex hormones that are usually present in women in small amounts. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form in the ovaries. However, some women with this disorder do not have cysts, while some women without the disorder do develop cysts.

Ovulation occurs when a mature egg is released from an ovary. This happens so it can be fertilized by a male sperm. If the egg is not fertilized, it is sent out of the body during your period.

In some cases, a woman doesn’t make enough of the hormones needed to ovulate. When ovulation doesn’t happen, the ovaries can develop many small cysts. These cysts make hormones called androgens. Women with PCOS often have high levels of androgens. This can cause more problems with a woman’s menstrual cycle. And it can cause many of the symptoms of PCOS.

Treatment for PCOS is often done with medication. This can’t cure PCOS, but it helps reduce symptoms and prevent some health problems.

What causes PCOS?

The exact cause of PCOS is not clear. Many women with PCOS have insulin resistance. This means the body can't use insulin well. Insulin levels build up in the body and may cause higher androgen levels. Obesity can also increase insulin levels and make PCOS symptoms worse.

PCOS may also run in families. It's common for sisters or a mother and daughter to have PCOS.

What are the risks for PCOS?

You may be more likely to have PCOS if your mother or sister has it. You may also be more likely to have it if you have insulin resistance or are obese.

What are the symptoms of PCOS?

The symptoms of PCOS may include:

Missed periods, irregular periods, or very light periods
Ovaries that are large or have many cysts
Excess body hair, including the chest, stomach, and back (hirsutism)
Weight gain, especially around the belly (abdomen)
Acne or oily skin
Male-pattern baldness or thinning hair
Infertility
Small pieces of excess skin on the neck or armpits (skin tags)
Dark or thick skin patches on the back of the neck, in the armpits, and under the breasts

How is PCOS diagnosed?

Your health care provider will ask about your medical history and your symptoms. You will also have a physical exam. This will likely include a pelvic exam. This exam checks the health of your reproductive organs, both inside and outside your body.

Some of the symptoms of PCOS are like those caused by other health problems. Because of this, you may also have tests such as:

Ultrasound. This test uses sound waves and a computer to create images of blood vessels, tissues, and organs. This test is used to look at the size of the ovaries and see if they have cysts. The test can also look at the thickness of the lining of the uterus (endometrium).
Blood tests. These look for high levels of androgens and other hormones. Your health care provider may also check your blood glucose levels. And you may have your cholesterol and triglyceride levels checked.

How is PCOS treated?

Treatment for PCOS depends on a number of factors. These may include your age, how severe your symptoms are, and your overall health. The type of treatment may also depend on whether you want to become pregnant in the future.

If you do plan to become pregnant, your treatment may include:

A change in diet and activity. A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate.
Medications to cause ovulation. Medications can help the ovaries to release eggs normally. These medications also have certain risks. They can increase the chance for a multiple birth (twins or more). And they can cause ovarian hyperstimulation. This is when the ovaries release too many hormones. It can cause symptoms such as abdominal bloating and pelvic pain.

If you do not plan to become pregnant, your treatment may include:

Birth control pills. These help to control menstrual cycles, lower androgen levels, and reduce acne.
Diabetes medication. This is often used to lower insulin resistance in PCOS. It may also help reduce androgen levels, slow hair growth, and help you ovulate more regularly.
A change in diet and activity. A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate.
Medications to treat other symptoms. Some medications can help reduce hair growth or acne.

What are the complications of PCOS?

Women with PCOS are more likely to develop certain serious health problems. These include type 2 diabetes, high blood pressure, problems with the heart and blood vessels, and uterine cancer. Women with PCOS often have problems with their ability to get pregnant (fertility).

Living with PCOS

Some women struggle with the physical symptoms of PCOS, such as weight gain, hair growth, and acne. Cosmetic treatments, such as electrolysis and laser hair removal, may help you feel better about your appearance. Talk with your health care provider about the best ways to treat the symptoms that bother you.

When should I seek medical care?

If you have missed or irregular periods, excess hair growth, acne, and weight gain, call your doctor for an evaluation.

Key points

PCOS is a very common hormone problem for women of childbearing age.
Women with PCOS may not ovulate, have high levels of androgens, and have many small cysts on the ovaries.
PCOS can cause missed or irregular menstrual periods, excess hair growth, acne, infertility, and weight gain.
Women with PCOS may be at higher risk for type 2 diabetes, high blood pressure, heart problems, and endometrial cancer.
The types of treatment for PCOS may depend on whether or not a woman plans to become pregnant. Women who plan to become pregnant in the future may take different kinds of medications.

Next steps

Tips to help you get the most from a visit to your health care provider:

Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your provider if you have questions.

Complications and challenges associated with polycystic ovary syndrome: current perspectives

Review

. 2015 Jul 31;7:745-63.

doi: 10. 2147/IJWH.S70314. eCollection 2015.

Stefano Palomba¹, Susanna Santagni¹, Angela Falbo¹, Giovanni Battista La Sala²

Affiliations

¹ Unit of Obstetrics and Gynecology, Arcispedale Santa Maria Nuova-Scientific Institute of Treatment and Care (IRCCS), Reggio Emilia, Modena, Italy.
² Unit of Obstetrics and Gynecology, Arcispedale Santa Maria Nuova-Scientific Institute of Treatment and Care (IRCCS), Reggio Emilia, Modena, Italy ; Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Modena, Italy.

PMID: 26261426
PMCID: PMC4527566
DOI: 10. 2147/IJWH.S70314

Free PMC article

Review

Stefano Palomba et al. Int J Womens Health. 2015.

Free PMC article

. 2015 Jul 31;7:745-63.

doi: 10.2147/IJWH.S70314. eCollection 2015.

Authors

Stefano Palomba¹, Susanna Santagni¹, Angela Falbo¹, Giovanni Battista La Sala²

Affiliations

¹ Unit of Obstetrics and Gynecology, Arcispedale Santa Maria Nuova-Scientific Institute of Treatment and Care (IRCCS), Reggio Emilia, Modena, Italy.
² Unit of Obstetrics and Gynecology, Arcispedale Santa Maria Nuova-Scientific Institute of Treatment and Care (IRCCS), Reggio Emilia, Modena, Italy ; Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Modena, Italy.

PMID: 26261426
PMCID: PMC4527566
DOI: 10.2147/IJWH.S70314

Abstract

Polycystic ovary syndrome (PCOS) represents the most common endocrine dysfunction in fertile women and it is considered a heterogeneous and multifaceted disorder, with multiple reproductive and metabolic phenotypes which differently affect the early- and long-term syndrome's risks. Women with PCOS present an adverse reproductive profile, including a high risk of pregnancy-induced hypertension, preeclampsia, and gestational diabetes mellitus. Patients with PCOS present not only a higher prevalence of classic cardiovascular risk factors, such as hypertension, dyslipidemia, and type-2 diabetes mellitus, but also of nonclassic cardiovascular risk factors, including mood disorders, such as depression and anxiety. Moreover, at the moment, clinical data on cardiovascular morbidity and mortality in women with PCOS are controversial. Finally, women with PCOS show an increased risk of endometrial cancer compared to non-PCOS healthy women, particularly during premenopausal period. Currently, we are unable to clarify if the increased PCOS early- and long-term risks are totally due to PCOS per se or mostly due to obesity, in particular visceral obesity, that characterized the majority of PCOS patients. In any case, the main endocrine and gynecological scientific societies agree to consider women with PCOS at increased risk of obstetric, cardiometabolic, oncology, and psychological complications throughout life, and it is recommended that these women be accurately assessed with periodic follow-up.

Keywords: PCOS; cardiovascular disease; infertility; polycystic ovary syndrome; pregnancy.

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Subramanian A, Lee SI, Phillips K, Toulis KA, Kempegowda P, O'Reilly MW, Adderley NJ, Thangaratinam S, Arlt W, Nirantharakumar K. Subramanian A, et al. BMC Med. 2022 Aug 30;20(1):298. doi: 10.1186/s12916-022-02473-3. BMC Med. 2022. PMID: 36038914 Free PMC article.

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References

1. Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab. 2004;89(6):2745–2749. - PubMed
1. Kauffman RP, Baker TE, Baker VM, DiMarino P, Castracane D. Endocrine and metabolic differences among phenotypic expressions of polycystic ovary syndrome according to the 2003 Rotterdam consensus criteria. Am J Obstet Gynecol. 2008;198(6):670.e1–670.e10. - PubMed
1. Diamanti-Kandarakis E, Kouli CR, Bergiele AT, et al. A survey of the polycystic ovary syndrome in the Greek island of Lesbos: hormonal and metabolic profile. J Clin Endocrinol Metab. 1999;84(11):4006–4011. - PubMed
1. Asuncion M, Calvo RM, San Millan JL, Sancho J, Avila S, Escobar-Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab. 2000;85(7):2434–2438. - PubMed
1. March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod. 2010;25(2):544–551. - PubMed

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- Oocyte donation nine0006
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- PRP therapy for the uterus and ovaries
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