Polycystic ovary syndrome

Polycystic ovary syndrome
Other namesHyperandrogenic anovulation (HA),[1] Stein-Leventhal syndrome[2]
A polycystic ovary
SpecialtyGynecology, endocrinology
SymptomsIrregular menstrual periods, heavy periods, excess hair, acne, difficulty getting pregnant, patches of thick, darker, velvety skin[3]
ComplicationsType 2 diabetes, obesity, obstructive sleep apnea, heart disease, mood disorders, endometrial cancer[3]
DurationLong term[4]
CausesGenetic and environmental factors[5]
Risk factorsFamily history, obesity[6]
Diagnostic methodBased on irregular periods, high androgen levels, ovarian cysts[7]
Differential diagnosisAdrenal hyperplasia, hypothyroidism, high blood levels of prolactin[8]
ManagementHealthy lifestyle, medication[5]
MedicationBirth control pills, metformin, anti-androgens, fertility treatments such as letrozole[9][10]
Frequency5 to 18% of women of childbearing age[5]

Polycystic ovary syndrome (PCOS) is the most common hormonal disorder in women of reproductive age. The name comes from the observation of small follicles (or "cysts") that sometimes appear on the ovaries. However, not everyone with PCOS has these follicles, and they are not the cause of the condition.[5]

PCOS is diagnosed when a person has at least two of the following three features: irregular menstrual periods, high testosterone or related symptoms (like excess facial hair), or polycystic ovaries found on an ultrasound. A blood test for high levels of anti-Müllerian hormone can replace the ultrasound.[11] Other symptoms associated with PCOS are heavy periods, acne, difficulty getting pregnant, and patches of darker skin.[3][12]

The exact cause of PCOS remains uncertain.[13] There is a clear genetic component, but environmental factors are also thought to contribute. PCOS occurs in between 5% and 18% of women.[5] The disorder is associated with insulin resistance, which is made worse by obesity. Insulin resistance and related excess insulin levels are associated with various complications such as type 2 diabetes and liver disease.[14] Women with PCOS also have higher risk of endometrial cancer.[15]

Management focuses on relieving symptoms and reducing long-term risks. A healthy lifestyle and weight control are recommended for general management. In addition, management can involve hormonal contraception to regulate menstrual cycles, to reduce acne and excess hair growth. Metformin increases insulin sensitivity. For fertility, ovulation can be induced with letrozole, among other methods. In addition, women can be monitored for cardiometabolic risks, and during pregnancy.[5]

  1. ^ Kollmann M, Martins WP, Raine-Fenning N (2014). "Terms and thresholds for the ultrasound evaluation of the ovaries in women with hyperandrogenic anovulation". Human Reproduction Update. 20 (3): 463–4. doi:10.1093/humupd/dmu005. PMID 24516084.
  2. ^ Sun H, Li D, Jiao J, Liu Q, Bian J, Wang X (1 January 2022). "A Potential Link Between Polycystic Ovary Syndrome and Asthma: a Meta-Analysis". Reproductive Sciences. 29 (1): 312–319. doi:10.1007/s43032-021-00662-8. ISSN 1933-7205. PMID 34811714.
  3. ^ a b c "What are the symptoms of PCOS?". Eunice Kennedy Shriver National Institute of Child Health and Human Development. 21 August 2024. Archived from the original on 20 May 2025. Retrieved 28 June 2025.
  4. ^ Cite error: The named reference NICHD Is there a cure for PCOS? was invoked but never defined (see the help page).
  5. ^ a b c d e f Joham AE, Norman RJ, Stener-Victorin E, Legro RS, Franks S, Moran LJ, et al. (1 September 2022). "Polycystic ovary syndrome". The Lancet Diabetes & Endocrinology. 10 (9): 668–680. doi:10.1016/S2213-8587(22)00163-2. ISSN 2213-8587. PMID 35934017.
  6. ^ Goodarzi 2024, p. 16.
  7. ^ "Polycystic Ovary Syndrome (PCOS): Condition Information". National Institute of Child Health and Human Development. 21 August 2024. Archived from the original on 22 August 2025. Retrieved 7 September 2025.
  8. ^ "Polycystic ovary syndrome: What else might it be?". CKS NICE. March 2025. Retrieved 26 July 2025.
  9. ^ "What are the treatments for PCOS?". Eunice Kennedy Shriver National Institute of Child Health and Human Development. 21 August 2024. Retrieved 24 July 2025.
  10. ^ Goodarzi 2024, p. 3.
  11. ^ Cite error: The named reference :7 was invoked but never defined (see the help page).
  12. ^ CDC (15 May 2024). "Diabetes and Polycystic Ovary Syndrome (PCOS)". Diabetes and Polycystic Ovary Syndrome (PCOS). Retrieved 20 September 2024.
  13. ^ Lentscher JA, Slocum B, Torrealday S (March 2021). "Polycystic Ovarian Syndrome and Fertility". Clinical Obstetrics and Gynecology. 64 (1): 65–75. doi:10.1097/GRF.0000000000000595. PMID 33337743. S2CID 229323594.
  14. ^ Cite error: The named reference :2 was invoked but never defined (see the help page).
  15. ^ Cite error: The named reference :8 was invoked but never defined (see the help page).
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