Polycystic Ovary Syndrome

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Our specialists have advanced training and board certification in gynecology and reproductive endocrinology to provide expert care for women with hormonal disorders that can affect their reproductive health, including polycystic ovary syndrome. At UT Southwestern Medical Center, we offer the latest diagnostic and treatment options to help women achieve their best health.

Interdisciplinary Care for Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a metabolic disorder that results in abnormal levels of reproductive hormones. The hormonal imbalance prevents the ovaries from working properly to release one or more eggs during a menstrual cycle (ovulation); this irregularity can lead to infertility. It’s estimated that up to 10 percent of women of childbearing age have this disorder.

UT Southwestern gynecologists and reproductive endocrinologists provide experienced care, backed by the latest research findings, for women with PCOS. Our research to advance the standard of care for PCOS helps us deliver up-to-the-minute services and treatments to relieve symptoms and help improve the chances of successful pregnancy.

Causes of Polycystic Ovary Syndrome

Some women with PCOS have elevated levels of androgens (male hormones), but the exact cause for this hormone imbalance is unknown. Factors that might be involved include:

  • High level of insulin, the hormone produced by the pancreas that helps cells absorb glucose (blood sugar) and either use it for energy or store it as fat
  • Inherited genes or gene mutations (changes)
  • Low-grade inflammation

Symptoms of Polycystic Ovary Syndrome

PCOS can cause signs and symptoms such as:

  • Acne on the face, chest, or upper back
  • Mildly elevated androgens
  • Hirsutism, or excess hair on the face, chest, abdomen, or upper thighs
  • Infertility
  • Irregular menstrual periods, which can be missing, infrequent, too frequent, too light, or too heavy
  • Excess numbers of pea-sized asymptomatic cysts on the ovaries
  • Patches of darkened or thickened skin, especially around the neck, armpits, groin, or under the breasts

Diagnosing Polycystic Ovary Syndrome

Our expert gynecologists have extensive experience in evaluating symptoms to diagnose PCOS and rule out other conditions with similar symptoms. We begin with a thorough evaluation that includes a:

  • Review of personal and family medical history
  • Discussion of symptoms
  • Physical exam

To confirm a diagnosis, we might recommend one or more additional tests, such as:

  • Blood tests: Tests of a patient’s blood sample to check levels of male and female hormones, blood sugar, cholesterol, and thyroid hormones
  • Ultrasound: Imaging that uses sound waves to produce images inside the pelvic region to examine the ovaries and uterine lining

Treatment for Polycystic Ovary Syndrome

Although no cure exists for PCOS, treatment helps manage its symptoms. At UT Southwestern, we work closely with patients to create a treatment plan focused on their specific symptoms. Our treatment options include lifestyle recommendations and medications.

Lifestyle Recommendations

Some steps that women can take on their own include:

  • Weight loss: A body weight loss of just 10 percent can help lower blood sugar and cholesterol levels, improve insulin sensitivity, bring hormone levels to normal, and regulate menstrual cycles.
  • Hair removal: Patients can buy creams and razors over the counter or have laser hair removal or electrolysis procedures done by doctors or licensed technicians to remove unwanted hair.

Medications

Our specialists prescribe medications based on the specific PCOS symptoms that each patient has, such as:

Menstrual Cycle Problems

  • Hormonal contraceptives: A combination of birth control pills, skin patches, or vaginal rings that contain estrogen and progestin, which reduce androgen production and regulate menstrual cycles. Hormonal contraceptives reduce abnormal menstrual bleeding, hair growth, and acne.
  • Progestin therapy: The progestin-only birth control pill or progestin-releasing intrauterine device helps prevent pregnancy but doesn’t reduce androgen. Progestin taken 10 to 14 days each month helps regulate periods but does not prevent pregnancy. 

Ovulation Problems

  • Clomiphene citrate (Clomid) or letrozole (Femara): These medications stimulate the ovaries to release eggs and help improve the chance of pregnancy.
  • Metformin (Glucophage): This oral medication for borderline and Type 2 diabetes can help regulate periods and stimulate ovulation in about 25 percent of patients.
  • Gonadotropins: These injectable medications stimulate ovulation to help improve the chance of pregnancy.

Excessive Hair Growth

  • Birth control pills: Contraceptive pills reduce hair growth by decreasing androgen production.
  • Spironolactone (Aldactone): This oral medication reduces hair growth but isn’t recommended for women who are or want to become pregnant because it can cause birth defects.
  • Eflornithine (Vaniqa): This prescription cream can slow facial hair growth in women.    

Fertility Treatment for Women with PCOS

PCOS is one of the most common causes of female infertility. At UT Southwestern, our specialists in fertility and reproductive medicine offer a wide range of therapies to help women achieve successful pregnancy. Learn more about our fertility services.