Polycystic ovary syndrome (PCOS)

One of the main causes of infertility for hundreds of thousands of women around the world is polycystic ovary syndrome (PCOS)

What is PCOS?

One of the most common endocrine disorders among women of reproductive age in the world. In 1935, physicians Irving Freiler Stein and Michael Leventhal published an article entitled “Amenorrhea Associated with Polycystic Ovaries”. In this groundbreaking paper, they described their observations of seven women with amenorrhea, hirsutism, obesity, and ovarian cysts. This was one of the first descriptions of this disease, which for some time was called Stein-Leventhal syndrome. Since then, thousands of publications have been created on this topic, however, the exact causes of PCOS are still unknown.

General information

On the ovaries of women with the syndrome, many capsules with fluid about 8 mm in size are formed. These follicles with immature eggs are called cysts. The follicles are often unable to release eggs, which is why ovulation does not occur.

You may not have your period for several months. Or your period will last for two weeks. All this is accompanied by hormonal imbalance: male hormones – androgens – are secreted excessively. At the same time, the pregnancy hormone progesterone is not produced enough.

The syndrome significantly affects a woman’s reproductive health, metabolism and cardiovascular system. This condition is incurable, but it is quite possible to treat it and reduce this impact.

Polycystic ovary syndrome

Causes of PCOS

The exact causes are unknown, but certain factors indicate that PCOS is a hereditary disorder. If your mother had it, there is a high probability that you will have it too.

There are other risk factors that are associated with the development of polycystic ovary syndrome.

Insulin resistance. The hormone insulin is produced by the pancreas. It let your body process sugar – the main source of energy for the body. If the cells are resistant to its action, the sugar level rises and the pancreas starts to produce more insulin. As a result, the ovaries increase the production of androgens, which in turn complicate the process of releasing eggs.

Overweight and obesity. It can be both a consequence of insulin resistance and a separate risk factor. In addition, it also affects the production of insulin – the body produces more of it if you are overweight. There is also a reverse effect: insulin preserves and expands fat reserves – so the more it is produced, the more weight you gain. Especially if you eat lots of carbohydrate products.

Low-grade inflammation. Studies show that glucose can cause oxidative stress and inflammatory response of mononuclear cells. Women with polycystic ovary syndrome have a certain type of long-term, mild inflammation that leads to androgen production.

Too much androgen. For a woman, this means excessive hair – hirsutism, acne, and difficulties with the release of eggs from the follicles, that is, a violation of the ovulation process. And PCOS.

Plus, a study of 237 mentally healthy women found a link between emotional violence against women in childhood and the development of polycystic ovary syndrome.


The main symptom is irregular periods or their complete absence for a long time. During ultrasound, cysts on the ovaries are detected. Usually, PCOS manifests itself quite early, from the first menstruation to 20+.

At the same time, other signs signal the syndrome:

  • Inability to get pregnant;
  • Excess weight, especially around the waist;
  • Hair in unusual places and hair loss on the head;
  • Acne;
  • Pain in the lower abdomen;
  • Sudden mood changes;
  • Dark spots on the skin of the neck, under the breast, groin or armpits (this is also a symptom of insulin resistance);
  • Increased appetite.

However, some women do not have any symptoms, and in obese women they are on the contrary stronger.


It is important to remember that reproductive health is not only about the ability to have children. Your overall health depends on the balance of hormones, including female hormones. Emotional, mental, and of course physical. As well as with symptoms, being overweight affects complications, not for the better.

Women with PCOS have a higher chance of developing the following health problems:

  • Infertility. Eggs are not released, so you can’t get pregnant;
  • Premature birth or miscarriage. If you do become pregnant, PCOS increases the risk of losing the baby;
  • Type 2 diabetes. About half of women with PCOS will have type 2 diabetes by the age of 40;
  • Metabolic syndrome. This is a medical term that combines diabetes, high blood pressure (hypertension), high blood cholesterol and obesity. The consequence is a greater risk of cardiovascular diseases: coronary heart disease, stroke and other diseases that affect blood vessels;
  • Endometrial cancer – the mucous membrane that lines the uterus;
  • Depression or anxiety. Hormonal imbalance, mood changes, symptoms of PCOS – all this does not add joy to life;
  • Sleep apnea;
  • Inflammation of the liver due to the accumulation of fat in it.


I will immediately note the widespread advice from old school doctors: “have a baby and everything will pass”. This is a myth. But you do can take care of yourself, eat healthy, sleep enough, exercise, be attentive to your emotional state and get rid of bad habits, especially smoking. All this may protect you from any problems and complications of PCOS. In general, lifestyle management is the best prevention of the complications. Losing only 5% of excess weight helps to really improve the condition, namely to restore ovulation.

Since there is no cure that will help you completely get rid of the syndrome, we treat the symptoms. Control of insulin and blood pressure levels, regulation of emotional state. By the way, here you can use meditation or other tips from our article.

Therapy also depends on reproductive plans. If you are not planning pregnancy, your doctor may prescribe you combined oral contraceptives with estrogen and progesterone, which helps to reduce the level of androgens in your body. But choose this way if you need contraception! If you do not need protection from unplanned pregnancy, look for a doctor who will offer another method of correcting excess androgens in your body.

If you are planning a pregnancy, there are medications that can help solve this problem. Needless to say, they should be prescribed only by a specialist.


In addition, you may be offered a surgical intervention – drilling. This is a small operation called laparoscopic ovarian drilling. Under general anesthesia, microscopic cameras – laparoscopes – are inserted through small incisions in the lower abdomen. Then, using a laser or ultrasonic scalpel, the doctor will make tiny holes (up to 2 mm) in your ovaries. This reduces the amount of luteal tissue that produces androgens. This stimulates ovulation. However, this procedure helps only a small percentage of women.

Remember, polycystic ovary syndrome is not a sentence. Adjusting your lifestyle and a good specialist could help you to forget about this problem.

Be always healthy!

More about your health and body is in the courses: A girl becomes a womanAll about you. What it’s like to be a WomanAll about you 35+.

I’m eager to file all of these courses in English, just send me a request to dr.silinaeducation@gmail.com

You can always choose your doctor at the Lior Medical Center.

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