Affecting 6% to 12% (as many as 5 million) of U.S. women of reproductive age, polycystic ovarian syndrome is one of the most common hormonal endocrine disorders.
But it’s also still somewhat of a mystery since the exact causes of PCOS are unknown. What is known is that factors such as excess weight, insulin resistance, low-grade inflammation and family history can contribute to the risk. Women whose mother or sister has PCOS or type 2 diabetes are more likely to develop PCOS.
Although most PCOS case are of women in child-bearing years, it can cause lifelong complications, according to Tonya Callender, a nurse practitioner in the Department of Obstetrics and Gynecology at UTMB.
“PCOS is a very common disorder that we see in women,” said Callender, who practices out of UTMB’s Women's Comprehensive Care Clinic on the Clear Lake Hospital Campus. “It can affect women of all ages, but mainly it’s associated with menstrual irregularities, as well as excess androgens in women.”
Androgens are male hormones that females also have. Too many of them in a woman can hinder ovulation and cause irregular periods, acne, thinning scalp hair and excess hair growth on the face and body.
Chief among the potential complications from PCOS are diabetes, gestational diabetes, heart disease, high blood pressure, high LDL (“bad) cholesterol and low HDL (“good) cholesterol, sleep apnea, depression and increased risk of stroke, Callender said.
“One thing in particular is infertility,” she explained. “So, for women who are trying to get pregnant, it can be more difficult because they're not ovulating regularly and not having regular cycles. So that is one thing.
“But the other thing is they’re not having a period every month,” she added. “Even though girls might think that’s a great bonus, it’s really not healthy. You don't have to have a period every month as long as you’re controlling it hormonally. But if you're going six, eight months without having a period, we worry about developing abnormal cells—something we call endometrial hyperplasia.”
In endometrial hyperplasia, the lining of the uterus becomes too thick, which can lead to endometrial cancer.
After the diagnosis
PCOS cannot be cured, but the symptoms can be managed. Regulating the menstrual cycle is an important first step in care once a woman is diagnosed.
“One thing that's very important is that we regulate your cycles,” Callender said. “The best treatment for polycystic ovarian syndrome is birth control pills. That helps you to have regular periods as well as protect that lining of the uterus.
“Then the other things that go along with that … we will try and help you with things such as hair growth,” she said. “Birth control pills don't stop hair growth, but they can reduce the amount of hair growth. If there's obesity, we would like to try and help address that issue if we can. And screening for things like Type 2 diabetes. Those would be things that we would be interested in.”
Learn more and find other resources on PCOS and other gynecologic issues.