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5 Things you should know about PCOS

A blog by Kara Nguyen, MD, MPH, RMA of Central Pennsylvania at PinnacleHealth, November 18, 2015

Your doctor may have diagnosed you with Polycystic Ovarian Syndrome, or PCOS. There are many misconceptions about this condition which can lead to unwarranted fears or different ideas of what PCOS means for your health. Here are 5 things you should know about PCOS:

  1. PCOS doesn’t necessarily mean that you have ovarian cysts.
  2. Many women think that having PCOS means that they have cysts on their ovaries. PCOS is a misnomer and does not mean that there are ovarian cysts and it does not mean that surgery is required to treat cysts if they do form. “Polycystic ovaries” is the ultrasound appearance of many small follicles in the early stages of egg development. These follicles give the ultrasound appearance of a black “string of pearls”. Many of these early follicles do not grow, mature, or ovulate. For that reason, most women with PCOS do not have regular menstrual cycles and may have difficulty getting pregnant without medication.

  3. PCOS has variable signs and presentations.
  4. Not all patients with PCOS have the same symptoms or findings which can make the diagnosis tricky. A very common sign is irregular menstrual cycles or even no menstrual bleeding. It is important to remember that many things other than PCOS can cause menstrual irregularity so it is important to evaluate for alternative conditions in order to confirm the diagnosis of PCOS. Some patients with PCOS have elevated testosterone levels in their blood while others may have increased unwarranted hair growth or persistent acne. Patients can be thin or obese. The ovaries may have the classic “string of pearls” appearance or not. Your fertility doctor is trained to determine whether your individual signs and symptoms are consistent with the diagnosis of PCOS.

  5. PCOS can increase your risk of uterine cancer.
  6. When there is no regular menstrual bleeding because of lack of ovulation, the lining of the uterus does not get a chance to shed and start over. In PCOS, the lining continues to thicken over weeks or months. This can increase the risk of uterine cancer. It is recommended that patients with PCOS, when not attempting to become pregnant, receive medical therapy which can ensure a thin endometrial lining and minimize the risk of cancer.

  7. With PCOS, there is an increased risk of metabolic syndrome.
  8. Metabolic syndrome involves elevated blood pressure, low HDL (good cholesterol), high triglycerides (increases risk of heart disease), obesity, and diabetes. Because patients with PCOS have a higher risk of developing this condition, the American College of OBGYN and the American Society for Reproductive Medicine recommend that patients with PCOS have annual screening for these conditions. Earlier detection means more effective treatment and a long and healthy life.

  9. PCOS doesn’t mean that you can’t get pregnant.
  10. It is true that many patients with PCOS have difficulty getting pregnant on their own. Unlike women who ovulate and have a period every month, women with PCOS don’t ovulate in a predictable fashion (or at all) and therefore may have fewer opportunities to become pregnant each year. However, there are very effective medications and treatments for PCOS that ensure ovulation each cycle. In fact, of all conditions known to contribute to infertility, PCOS is one of the easiest to fix!


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