PCOS causes fluid-filled sacs to form on the ovaries, interrupting ovulation and leading to complications such as infertility and increased risk of Type 2 diabetes, high cholesterol, hypertension and endometrial cancer.

Published: January 30, 2019 | Updated: March 10, 2023

If you have erratic periods and have tried — and struggled — to get pregnant, you could be living with polycystic ovary syndrome (PCOS) but not realize it, according to R. Paige Walker, M.D., an OB/GYN with Norton Women’s Specialists. Early diagnosis could significantly reduce your chances for lifelong health problems.

PCOS is a common hormonal imbalance affecting up to 12 percent of reproductive-age women in the U. S., according to the Centers for Disease Control and Prevention. A woman with PCOS ovulates very infrequently or not at all.

In PCOS, the ovaries develop immature follicles, or fluid-filled sacs containing an immature oocyte (egg), but “you don’t have that hormonal signal to develop into a mature egg that can be released during ovulation,” Dr. Walker said.

According to Dr. Walker, infertility is just one of many possible complications, which makes early detection especially important. Women with PCOS are at increased risk for developing Type 2 diabetes, high cholesterol, hypertension and endometrial cancer.

“Knowing all this is the real benefit because you can get screened regularly and make lifestyle changes like diet modifications and exercise” to mitigate your risks, Dr. Walker said.

PCOS symptoms vary among women

Most women with PCOS have enlarged ovaries and irregular periods. Higher than normal levels of male hormones like testosterone, which may cause acne and excess facial or body hair, are also PCOS symptoms.

Though breakouts and hair growth were once considered typical of PCOS, only about 50 percent of women have those outward physical symptoms, according to Dr. Walker. Teen girls are most likely to show outward signs, but they could also be normal byproducts of adolescence.

If PCOS symptoms don’t resolve after a few years or acne treatments don’t work, girls should be checked for PCOS as well as endocrine problems like thyroid disease or other conditions that cause increased testosterone.

The most common symptom for women of any childbearing age is infrequent, then prolonged menstrual periods.

“Usually, women with PCOS are skipping periods, and then having a really heavy period,” Dr. Walker said.

PCOS diagnosis and treatment

PCOS is diagnosed through a combination of lab tests and ultrasound. The where the cysts may look like a string of pearls within the ovary. The best treatment to correct PCOS for women who are not trying to conceive is usually hormonal birth control, which helps regulate cycles and correct hormonal imbalances by decreasing testosterone.

For women who are trying to have a baby, a PCOS diagnosis is far from hopeless. Women can often get pregnant by taking ovulation stimulation medications like Clomid or letrozole. They may also benefit from metformin, a diabetes medication that treats insulin resistance — which is often a complication of PCOS. Regulating insulin can stimulate ovulation.

According to Dr. Walker, women who are obese are not more likely to get PCOS, but their symptoms may be more severe. That also means losing a small amount of weight can make a big difference.

“Even losing 10 to 15 pounds can regulate menstrual cycles and stimulate the ovaries to ovulate on their own,” Dr. Walker said.

Because PCOS can affect much more than fertility, having a full continuum of care readily accessible is vital to long-term wellness, according to Dr. Walker.

“When a patient is referred to me from another one of our doctors, I can see all of their lab work and testing. I have all of that information at my fingertips,” Dr. Walker said. “It makes such a difference in someone’s care.”