So, you have a friend who has PCOS — or maybe you've read about it — and you're starting to wonder if you have it too. Let's walk through what PCOS actually is and what you can do about it.

What exactly is PCOS?

PCOS stands for polycystic ovarian syndrome. It's a hormonal imbalance in women that causes too many male-type hormones along with irregular or absent periods. About 10% of women will be diagnosed with PCOS, but many struggle to get an accurate diagnosis. Women with PCOS are also at increased risk of other health problems.

How is PCOS diagnosed?

PCOS can sometimes be diagnosed based on symptoms alone; other times, lab tests and/or an ultrasound of the ovaries are needed. Symptoms include:

  • Abnormal hair growth (on the face, chest, and/or abdomen)
  • Acne
  • Thinning hair on the head, especially at the crown or hairline
  • Irregular or absent periods due to not ovulating regularly — for most women periods are very irregular or absent, though some have prolonged or frequent periods

What treatment options are available?

Many treatments exist. Medications to regulate periods — such as progesterone, birth control pills, and birth control rings — are common. It isn't safe to go long stretches without a period if you're not on hormonal birth control, because that can raise the risk of cancer and precancer in the uterine lining. So if you're going long periods without a cycle, something may need to be done to protect that lining even if you'd rather not be on the pill.

There are also medications to treat the symptoms of excess male-type hormones — acne, abnormal hair growth, and hair loss. Birth control pills help with these, but sometimes additional medications that lower testosterone are needed.

Is PCOS making it harder to lose weight?

Quite possibly. Between 40% and 85% of women with PCOS are overweight or obese, and most have insulin resistance — when the body doesn't respond properly to insulin, the hormone responsible for sugar metabolism. This drives the body to make more and more insulin, which can eventually lead to prediabetes and diabetes.

Insulin resistance can cause weight gain or make it very hard to lose weight. Medications like metformin can treat insulin resistance and make weight loss easier — and metformin can also help the ovaries work better (regulating periods) and lower male-hormone levels.

What should I do now?

If you think you may have PCOS, the best next step is to see a doctor who can evaluate your symptoms, order any needed testing, and build a plan that fits you. I'm accepting patients in my virtual clinic who live in states where I'm licensed, and I'd love to help you get answers.