Understanding PCOS: Causes, Symptoms, Treatments, & Fertility

As many as 12% of women in the United States are affected by PCOS during their reproductive years. PCOS is an endocrine disorder that mainly affects women’s hormone levels. Many women discover that they have PCOS when they struggle with fertility, as hormone imbalances can prevent the ovaries from releasing eggs. Women who don’t ovulate regularly may miss their period or skip it altogether.

Specifically, women with PCOS often produce higher levels of androgen or male hormones, which affects ovulation. PCOS is also associated with insulin resistance, meaning women with the condition often produce higher amounts of insulin than the average. These hormone imbalances mean that PCOS often results in symptoms such as the growth of unwanted facial hair and weight gain.

Additionally, PCOS is linked to other health concerns such as obesity, diabetes, and high blood pressure. Because of its many symptoms and long-term effects, PCOS is a disorder that often requires lifelong treatment. Fortunately, your lifestyle can have a big influence on your PCOS symptoms and outcomes. Proper management of the syndrome through medications can also help you achieve your best possible health.

Determining the exact causes of PCOS has challenged researchers, as many body systems may be involved. However, one main cause of PCOS may be the abnormal production of androgen hormones such as testosterone. While it’s normal for all women to produce some androgen hormones, excess production can stop eggs from being released from the ovaries during ovulation. As a result, cysts are often present in the ovaries of women with PCOS. 

Another factor that may cause PCOS is insulin resistance. As many as 75% of women with PCOS may also have insulin resistance, often resulting in weight gain. This condition also puts women at risk for diabetes. Plus, excess insulin in the blood can increase the production of androgen hormones. Yet, the link between insulin resistance and androgen hormone production isn’t clearly understood. Many factors may influence insulin resistance, including genetic and lifestyle factors.

Inflammation has also been linked to PCOS and may be considered a subtype of PCOS. Inflammation markers can be found in blood tests, helping doctors determine the leading causes of the syndrome in each patient.

Because of these factors, the causes of PCOS can vary from person to person. While the causes of PCOS for some women may be more related to lifestyle, for other women, hormonal imbalances or genetics may play a more prominent role. In order to understand the causes behind your PCOS diagnosis, your doctor will need to run blood tests, check your patient history, and take other factors, such as your weight, into account.

PCOS causes many symptoms, which can make it challenging to diagnose as it can mimic other conditions. Some of the most common symptoms associated with PCOS include:

• Irregular Menstruation. Many women with PCOS have irregular periods that either come more or less frequently than usual. Other women with PCOS may stop menstruating altogether. For some women, painful periods or abdominal pain may be associated with cysts that grow on the ovaries due to PCOS.
• Infertility. Struggling to get pregnant is often the first sign of PCOS for women. If you are under the age of 35 and haven’t been able to get pregnant after six months of trying, it may be a sign you have PCOS. Fortunately, infertility due to PCOS is highly treatable.   
• Hirsutism. Excess hair growth on the face, neck, chest, stomach, and thighs, known as hirsutism, is typical in women with PCOS. This is caused by the production of excess androgen hormones. These same hormones may also cause your hair to thin on your scalp.
• Acanthosis Nigricans. This symptom presents as darkened skin where you have folds of skin, such as your armpits, along creases in the neck, or near the groin. 
• Cysts on Ovaries. Many women with PCOS have small growths known as cysts in their ovaries. Cysts are fluid-filled sacs that were originally follicles. The follicles protect eggs that are released each month from the ovary. If an egg isn’t released or the follicle doesn’t disappear after the egg’s release, the follicle can remain in the ovary and form a cyst. This is often the case for women with PCOS, as androgen hormones prevent ovulation, leaving follicles stuck within the ovary. In many women, the cysts disappear on their own over time. 
• Acne. When they occur after puberty and adolescence, oily skin and acne may be a symptom of PCOS. 
• Weight Gain. Many women with PCOS either struggle to maintain a healthy weight or are obese. This symptom may be related to hormone imbalances, including insulin resistance. 

Do you recognize some of these symptoms? Use our helpful PCOS Symptoms Quiz to learn more about your reproductive health and whether or not PCOS may be a factor for you.

It’s natural to wonder if PCOS is associated with any risk factors. If you have any of the following risk factors of PCOS, you are more likely to develop the condition:

• Infertility 
• Type 2 Diabetes
• Gestational Diabetes
• Heart Disease
• Endometrial Cancer
• Metabolic Syndrome
• Sleep Apnea

Additionally, having PCOS can put you at risk for developing other health problems including many of the above, as well as Nonalcoholic Fatty Liver Disease (NAFLD). For this reason, treating PCOS is essential not only for your reproductive health but also for your overall wellness. This is because hormonal imbalances associated with PCOS can affect your weight and how your body processes sugar.

It’s important to remember that these risks are not a given. Catching PCOS early and treating it can help improve your long-term health outcomes, improve your fertility, and reduce your risks.

PCOS is one of the most common conditions associated with fertility struggles. Because PCOS creates hormone imbalances, it can prevent basic reproductive functions from working normally. For many women, PCOS means irregular or missed ovulation. If you’re not ovulating normally, no egg is released into the uterus so that it can be fertilized. This can make it difficult to conceive and achieve a healthy pregnancy.

Additionally, PCOS affects fertility in other ways, including during pregnancy. For example, the condition has been linked to higher rates of miscarriage, gestational diabetes, preeclampsia, and birth via C-Section. Also, because many women with PCOS are also obese or have other health conditions, it’s difficult to know for certain that fertility risks are linked to PCOS. For example, obesity is associated with many similar pregnancy complications, such as gestational diabetes and preeclampsia. That said, careful monitoring and prenatal care can help improve outcomes.

Just because PCOS affects fertility doesn’t mean you should lose hope. This condition is highly responsive to treatment. Once your doctor knows more about your health, you can make a plan to achieve your fertility goals. Treatment before and during pregnancy can help you build the family you’ve always dreamed of.

The short answer is yes, you can get pregnant with PCOS. In many cases, failure to ovulate is what prevents women from getting pregnant with PCOS. Changes to your lifestyle and medication can often help your body begin to ovulate, meaning that you may be able to get pregnant naturally without further fertility treatments. In other cases, low complexity therapies such as intrauterine insemination (IUI) can help people with PCOS get pregnant. More complex therapies, including In Vitro Fertilization (IVF), can also be used to help achieve a pregnancy.

Many factors play into getting pregnant, including your age, weight, and whether or not you have PCOS. That said, with treatment, many women with PCOS can achieve pregnancy. Some strategies, such as weight loss, may be up to 100% effective in restoring your ability to ovulate. For many women, making lifestyle changes may be all that is necessary to get pregnant.

Keep in mind that each person is unique. Your doctor will need to assess your unique situation to determine the best course of action for you to achieve pregnancy with PCOS.

There are many favorable treatment options for PCOS, ranging from simple treatments to more invasive fertility procedures. The right PCOS treatment options for you will depend a lot on your goals, unique symptoms, and the type of PCOS you have.

For many women, lifestyle changes, including weight loss, can help improve PCOS symptoms. In fact, losing as little as 5% of your body weight can sometimes restore reproductive functions like ovulation. 

Your doctor may ask you to make some lifestyle changes before trying other treatments. Here are some lifestyle changes you can make to lessen the effects of PCOS:

• Eat a healthy diet. Focus on a diet with plenty of fiber, protein, and healthy fats. Make sure you eat mostly whole grains, lean meats and legumes, and plenty of vegetables. Replace sugary drinks and alcohol with water or unsweetened coffee or tea.
• Exercise. Getting regular exercise can help you lose weight and also reduce insulin resistance. Even short walks, especially after meals, can help manage blood sugar levels. Light weight lifting, swimming, or biking are also great exercise options. Exercising several days a week can make a big difference in your overall health and your blood sugar levels. By reducing insulin resistance, you can reduce your body’s production of androgen hormones.

The great news about lifestyle changes is that the changes will help you become healthier overall. Being healthy can also improve your pregnancy and birth experience if fertility is one of your goals.

Sometimes, PCOS requires the use of medications as a part of the treatment plan. There are many different PCOS medications your doctor may choose from depending on your symptoms and blood test results.

Here are some medications your doctor may discuss with you:

• Insulin sensitizing agents. Drugs commonly used to treat diabetes, such as Metformin, can help some women with PCOS. This PCOS treatment can help your body be more sensitive to insulin, which regulates your blood sugar levels. This, in turn, can stop your body from producing excess androgen hormones that prevent ovulation and cause other symptoms, such as the growth of facial hair.
• Ovarian stimulation medications. Modern medications can help your ovaries produce and release eggs. One common medication is clomiphene citrate (known by the brand names Clomid and Serophene). Other options include gonadotropins, human menopausal gonadotropin, and human chorionic gonadotropin.
• Birth Control. Another popular PCOS treatment is birth control pills. These medications can help your body produce regular periods by regulating your hormones. Birth control pills can reduce many unwanted symptoms of PCOS, such as hair growth and acne, and the risk of endometrial cancer. For women who wish to become pregnant, using birth control pills for several months can help regulate hormones before beginning other fertility treatments.

Another PCOS treatment is Intrauterine Insemination. This treatment involves a combination of medications to induce ovulation and artificially planting a high concentration of active sperm into your uterus. By timing the procedure correctly and checking the quality of the sperm ahead of time, this procedure increases your chances of getting pregnant with PCOS.

For some women with PCOS, the best way to achieve a pregnancy is with IVF. This advanced fertility treatment means that eggs will be harvested from your ovaries. Then, they are fertilized in the lab with a sperm sample from your partner or a donor. Finally, when the embryo is ready, it is implanted into your uterus. IVF can significantly increase your chances of achieving a healthy pregnancy.

For women who struggle with symptoms such as unwanted hair growth and acne, additional PCOS treatment options are available. Oral medications and creams may be used to treat these symptoms. 

Ultimately, PCOS treatments must address symptoms and also take long-term health effects into account. Many PCOS treatments focus on lessening the effects of symptoms and achieving pregnancy. However, due to the long-term health concerns associated with PCOS, it’s important to continue to monitor related health conditions, including diabetes, high blood pressure, metabolic syndrome, and others.

If you suspect that you have PCOS, you may feel overwhelmed and worried about your fertility and health overall. Know that you’re not alone. This condition affects many women across the country, and there are many effective PCOS treatments available.

At Kofinas Fertility, we have successfully treated many PCOS patients and helped them achieve their dreams of starting a family. As experts in PCOS treatment, we start by understanding your unique situation, symptoms, and goals. We offer a wide range of treatment options starting with low-complexity therapies. We also have the capabilities and expertise to offer cutting-edge PCOS treatments for fertility and symptom management including IVF and laparoscopic surgeries. Thanks to our state-of-the-art facilities, we are able to offer many of our services and testing in-house. 

Rest assured that if you suspect that you have PCOS, you will receive empathetic, expert care at Kofinas Fertility. From managing symptoms to planning your future family or achieving a pregnancy right away, we are prepared to help you with effective PCOS treatments and caring doctors. Request an appointment today to learn more about PCOS and the symptoms you’re experiencing.