Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome, often abbreviated as PCOS, is the most common endocrinological disorder for reproductive aged women.  There are several similar but slightly different diagnostic criteria for PCOS.  Most reproductive endocrinologist and obstetrician-gynecologists use the  Rotterdam Criteria which states patients need 2 out of 3 clinicalsymptoms or findings:

• Many small cysts on the ovary (12 or more) or increased ovarian size.
• Irregular and fewer than normal menstrual cycles (usually less than 9)
• Evidence of an overproduction of male hormones

Common symptoms of PCOS are:

Infertility

For reasons not completely understood PCOS patients often ovulate infrequently or not at all which explains why they can have abnormal menstrual cycles.  When ovulation does not occur, an egg is not available causing infertility.

Irregular menstrual periods

Without ovulation, progesterone is not produced by the ovary; this often leads to irregular, infrequent vaginal bleeding.  Importantly, women need to menstruate regularly if they are not pregnant, or using birth control pills or progesterone to prevent endometrial hyperplasia (pre-cancer) and endometrial cancer.

Hirsutism or excessive “hairiness” and acne

Because about 75% of women have an excess of functional androgens (for example, testosterone) they often have more coarse (thick and dark) hair in places such as above the lip, chin, sideburns, back, belly button, and breasts.  Androgens also contribute to acne.