Polycystic Ovary Syndrome: Causes, Diagnosis and Treatment

• Irregular periods: This can range from infrequent periods to missed periods altogether, often leading to fertility challenges. 
• Excess androgens: These male hormones can lead to acne, unwanted hair growth, and thinning hair. 
• Polycystic ovaries: This refers to the presence of many small follicles in the ovaries that don’t develop or release eggs properly, contributing to fertility issues.
• Weight gain: Obesity is also common in women with PCOS. Up to 50-60% of women with PCOS are living with obesity. 
• Increased risk of health conditions: Given obesity is common in PCOS, often exacerbated by hormonal imbalances and insulin resistance, the risk for type 2 diabetes is also increased, as well as heart disease, and sleep apnea.

• Lifestyle changes: A healthy diet, regular exercise, and weight management can significantly improve symptoms.
• Medications: Medications can play a significant role in managing PCOS symptoms. Hormonal birth control can help regulate menstrual cycles, reduce acne and unwanted hair growth, and lower androgen levels. For women with insulin resistance, insulin-sensitizing drugs like metformin can improve insulin sensitivity and help manage blood sugar levels. Other GLP-1 agonists, like Ozempic, have also been shown to help. Additionally, anti-androgens like spironolactone can help block the effects of excess male hormones and reduce symptoms like acne and unwanted hair growth. The best medication for you will depend on your specific symptoms and goals. Your healthcare provider can help you determine the most appropriate treatment plan.
• Fertility treatments: If family-building is your goal, the aforementioned medications won’t be an option for helping manage your PCOS symptoms. If you find yourself struggling to conceive with PCOS, options like clomiphene citrate or in vitro fertilization (IVF) may be considered. Clomiphene citrate (clomid) has been shown to promote regular ovulation; about 80% of women with PCOS who take the medication will ovulate in response and 30-40% will become pregnant. About half of women will ovulate when taking one pill a day (50 mg) on cycle days five through nine. The other 50% of women do not ovulate on this dose of clomid and may need a higher dose or another medication. Using clomid increases your chances of having a multiple pregnancy to 8-13%, with twins being the most common. If pregnancy does not occur after six cycles of clomid use, further evaluation or a change in therapy is recommended. But it’s important to remember that every person and case is different. It’s crucial to work with a fertility provider who considers your situation holistically and works with you to establish a care plan best suited for you—that’s where WIN can help. 

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