Polycystic Ovary Syndrome (PCOS) – Diagnosis and Treatment
Diagnosis
Doctors usually spot polycystic ovary syndrome (PCOS) by looking at symptoms, running physical exams, checking lab tests, and sometimes using imaging. You can’t confirm PCOS with just one test.
First, health professionals ask about missed or irregular periods, unwanted hair growth, acne, or weight changes. They’ll also look at your family’s health history to see if genetics might play a role.
A typical doctor’s visit for PCOS includes a few steps:
| Test/Tool | What It Checks |
|---|---|
| Pelvic Exam | Ovarian swelling, growths |
| Blood Tests | Hormone, glucose, cholesterol levels |
| Ultrasound | Ovarian cysts, endometrial thickness |
- Physical Examination: The doctor checks for extra hair (hirsutism), acne, skin changes, and signs of insulin resistance like dark patches.
- Pelvic Exam: The provider checks for swollen ovaries or unusual growths.
- Hormone Blood Tests: These tests measure androgen, estrogen, progesterone, prolactin, and more. They help rule out other conditions, like congenital adrenal hyperplasia.
- Other Blood Tests: Doctors check cholesterol, triglycerides, and glucose to spot risks for heart disease or diabetes.
- Imaging: A pelvic ultrasound shows if there are cysts on the ovaries or if the uterine lining is thick. This helps confirm polycystic ovaries.
To diagnose PCOS, doctors look for signs of high androgen levels, irregular periods, and changes in the ovaries. They also check for disorders that look similar, like thyroid problems.
Sometimes, they’ll check for complications like endometrial hyperplasia or sleep apnea.
Treatment
Healthy Habits and Daily Choices
Tweaking your daily habits can really help manage polycystic ovary syndrome. Eating a balanced, lower-calorie diet and moving more can lower your weight and improve health.
Losing just 5% of your weight might improve symptoms, help with fertility, and make other treatments work better.
Most folks with PCOS have insulin resistance, so their bodies don’t use insulin well. More physical activity and better eating habits can make your body more sensitive to insulin.
This lowers your risk for type 2 diabetes, prediabetes, and metabolic syndrome. It also suggests teaming up with healthcare providers and dietitians to build a plan that fits you.
Benefits of Regular Exercise for PCOS:
| Benefit | Description |
|---|---|
| Improves insulin sensitivity | Helps cells use glucose better |
| Aids in weight management | Lowers risk for type 2 diabetes and heart issues |
| Supports better hormone balance | Can help reduce excess androgens |
| May improve fertility | Restores regular cycles in some women |
Medicines Used in PCOS Management
Doctors use several medicines to treat PCOS symptoms or related health issues. The right choice depends on what’s most urgent—maybe it’s irregular periods, fertility, extra hair, or acne.
To Help with Irregular Periods and Hormones:
- Combined Hormonal Pills: These pills (with both estrogen and progestin) help regulate periods, lower androgens like testosterone, and improve acne and unwanted hair.
- Progestin-Only Therapy: Taking progestin for part of the month protects the uterine lining and keeps periods regular. This option suits people who don’t want estrogen or aren’t planning pregnancy.
To Improve Fertility or Treat Ovulatory Problems:
- Ovulation Stimulant: Usually the first medicine doctors try for ovulation. It encourages egg release.
- Aromatase Inhibitor: Though first made for breast cancer, aromatase inhibitors sometimes help with ovulation in PCOS.
- Insulin-Sensitizing Agent: This diabetes medicine helps your body use insulin better, lowers insulin levels, and can boost ovulation chances. It’s also helpful for those with prediabetes.
- Hormone Injections: These hormone shots come into play if other fertility medicines don’t work.
To Treat Excess Hair and Acne:
- Combined Birth Control Pills: Besides helping cycles, these lower androgens, which can tame acne and extra hair growth.
- Anti-Androgen: This medicine blocks androgens on the skin. It’s good for acne and hair growth, but doctors don’t recommend it during pregnancy.
- Facial Hair Growth Inhibitor: A prescription cream that slows facial hair growth.
- Hair Removal Techniques: Laser hair removal, electrolysis, waxing, or shaving can all help. Laser and electrolysis might last longer but often need repeat sessions.
For Acne:
- You’ll find plenty of creams, gels, and pills to treat PCOS-related acne. It’s best to talk to your provider to find what works for you.
Important Note: Some PCOS meds, like those for diabetes or hormones, can cause side effects or might not be safe if you’re pregnant. Regular check-ins with your healthcare provider matter—they’ll track how things are going and tweak your treatment if needed.
Health Habits and Home Strategies
Shifting your daily habits can help control PCOS symptoms and lower your risks. Keeping a healthy weight cuts down on issues like high blood pressure, cholesterol, and diabetes.
Even losing a little weight can help balance hormones and support regular periods.
Choosing foods with complex carbs—think veggies, fruits, and whole grains—helps keep blood sugar steady. Cutting back on refined sugars and unhealthy fats may also help with acne, excess hair, and skin changes like acanthosis nigricans.
Regular exercise really matters. Being active lowers insulin resistance and can help protect your heart, liver, and uterus. Exercise is also a boost for mental health, easing depression and anxiety.
Examples of beneficial habits:
| Habit | Influence |
|---|---|
| Balanced eating | Controls weight and helps hormone levels |
| Physical activity | Improves heart health and reduces anxiety |
| Consistent sleep | Supports overall well-being |
Getting Ready for Your Visit
Getting ready for a gynecologist, endocrinologist, or reproductive specialist visit makes the appointment smoother. Write down your symptoms, when they started, and how long they last. This helps your provider get the full picture.
Track your period details—how often, how heavy, and how long. List all your medications, vitamins, supplements, and herbs, including dosages.
Jot down any other health problems or big changes in your life or stress levels. Bring a list of questions you want to ask, like:
- Which tests will help confirm PCOS?
- Will PCOS affect my chances of pregnancy?
- Are there treatment options for my symptoms or fertility?
- What lifestyle changes are useful?
- How could PCOS affect my health later on?
- How can I manage multiple health conditions?
A simple table or checklist can help you keep this info organized:
| Item | Example |
|---|---|
| Symptoms | Irregular periods, excess hair growth |
| Cycle details | Period every 45 days, lasting 7 days |
| Current medicines | Metformin 500mg, daily multivitamin |
| Health conditions | Thyroid disorder, recent weight gain |
Questions Your Provider May Ask
During your visit, your provider will likely ask about your main symptoms and when they started.
They might ask:
- How bad are the symptoms, and do they change over time?
- When was your last period?
- Has your weight changed since your periods first started, and by how much?
- Do any treatments or activities make symptoms better or worse?
- Are you trying for pregnancy, or planning children in the future?
- Does anyone in your family have PCOS?
Being open and honest helps your doctor give you the best care possible.
