Polycystic ovary syndrome (PCOS) is recognized as the most common hormonal and reproductive disorder among women of childbearing age in the United States, affecting up to 5 million women. PCOS often leads to difficulties with pregnancy, but its impact extends beyond fertility issues.
Dr. Jerry Lucas, an OB/GYN with St. Joseph’s/Candler Physician Network, explains that PCOS is characterized by irregular ovulation. While a typical menstrual cycle involves monthly ovulation, women with PCOS may only ovulate every few months or less frequently. “In most cases, a young female should have regular menstrual cycles by the age of 16. Females with erratic, irregular periods – skipping months at a time, heavy bleeding, spotting – may have PCOS,” Dr. Lucas says.
Diagnosis typically involves taking a medical history and performing an ultrasound examination. According to Dr. Lucas, on an ultrasound, “Women with PCOS have little cysts that line the outer rim of the ovary, similar looking to a string of pearls.” This finding combined with menstrual history helps confirm the diagnosis.
However, not all irregular cycles are due to PCOS. Dr. Lucas notes that if an older teenager or young adult suddenly develops irregular periods—possibly due to weight gain or stress—it does not necessarily indicate PCOS unless irregularity has been present from early on.
The cause of PCOS remains unclear but appears to have a hereditary component; it can run in families but inheritance is not guaranteed. Dr. Lucas advises: “But it does mean you may have to pay attention, particularly as you start to menstruate, what is the regularity of it?”
Symptoms go beyond menstrual changes and can include weight gain, excess hair growth, and acne—all linked to hormone imbalances caused by infrequent ovulation.
Insulin resistance is another concern for those with PCOS. Dr. Lucas explains: “What that means is their body has to produce more insulin to utilize the sugars that are in their bloodstream… Insulin resistance may seem like you’re diabetic, but you’re not quite diabetic.” Women diagnosed with PCOS are monitored for this condition because over half develop type 2 diabetes by age 40 according to data from the Centers for Disease Control & Prevention (https://www.cdc.gov/diabetes/basics/pcos.html). There are also increased risks for hypertension and thyroid disease associated with PCOS.
Dr. Lucas points out that most cases do not increase cancer risk nor should they be physically painful; however mental health challenges such as anxiety or stress related to symptoms like weight gain can occur.
Infertility remains one of the major side effects: “If you have polycystic ovary syndrome, you may only ovulate three times a year whereas somebody without PCOS ovulates 12 times a year,” says Dr. Lucas. He adds: “But…if all the stars align, you can get pregnant…it’s just far more difficult.”
Treatment focuses on managing symptoms since there is no cure for PCOS. Options include medications such as birth control pills for regulating cycles and drugs targeting acne or excess hair growth. For those struggling with infertility due to PCOS, medications exist that help induce ovulation; specialist care may be needed if these fail.
Lifestyle modifications—improving diet and exercise habits—can help reduce risks for type 2 diabetes and other complications associated with PCOS.
Reflecting on advances in understanding and treatment options available today compared to previous generations who were told they could not conceive due to unexplained infertility symptoms now attributed to PCOS, Dr. Lucas says: “I don’t think polycystic ovary syndrome is anything new; we just didn’t know what to call it… Now we have options.”
Dr. Lucas currently accepts new patients seeking OB/GYN care in Savannah.
