PCOS: A complex diagnosis for women
It's a medical mystery for some women. Symptoms
like irregular menstrual cycles, hair loss, weight gain,
insulin resistance, acne and excessive hair growth
can bring many questions and worries. But, the
mystery can be solved.
What is PCOS?
"Polycystic ovarian syndrome, or PCOS, is a metabolic
syndrome disorder that causes hormonal
imbalances in women," says David Goldstein, MD
Virtua obstetrician/gynecologist. "Those imbalances
can affect fertility, the body's response to insulin, and
may cause cardiovascular complications, weight gain
and diabetes if untreated."
In a woman without PCOS, the body's hormones
stimulate ovaries to release an egg. This is ovulation
and, without pregnancy, the cycle ends in menstruation.
But if a woman has PCOS, her ovaries
have tiny cysts that interrupt the hormonal cycle.
This can cause the ovaries to release an egg infrequently
and prevent ovulation from occurring
at regular intervals.
While researchers aren't sure what causes PCOS,
Dr. Goldstein says there are treatment options for
women with the syndrome.
"If a woman is overweight, weight loss is always
the best treatment is to get menstruation back on
track," he says. "And for women who aren't ready to
become pregnant, birth control pills are an option."
That's because birth control pills help regulate a
woman's menstrual cycle, and can ease the pain and
heavy bleeding that may come with it.
Metformin, a drug commonly used to treat people
with type 2 diabetes, can also be used to alleviate
PCOS symptoms. "Women with PCOS can also be
insulin resistant," says Dr. Goldstein. "This drug regulates
high insulin levels, which interfere with the
hormones that stimulate and regulate ovulation."
PCOS and pregnancy
Because women with PCOS ovulate irregularly,
they can have difficulty getting pregnant. Gary
, a reproductive endocrinologist says:
"Up to 40 percent of the women I see suffer
He says metformin can help a woman with
PCOS and insulin resistance get pregnant by
regulating insulin levels, and allowing her
hormones to work properly.
Clomiphene is a treatment option for women
who don't respond to metformin. "Clomiphene
can help a woman get pregnant faster," says
Dr. Packin. "It stimulates her ovaries to release
an egg, increasing chances of conceiving."
For those women who do not respond to metformin
or clomiphene when trying to conceive,
injectable medications may help. With careful monitoring,
injectables have a very high success rate.
Women with PCOS may also be more likely to
develop complications in pregnancy. Virtua maternal
fetal medicine specialist Ronald Librizzi, DO
explains: "Women with PCOS are at greater risk for
gestational diabetes, high blood pressure, and birth
defects if glucose and insulin levels get too high early
in the pregnancy." Dr. Librizzi adds: "These women
may need more specialized care."
Dr. Librizzi, along with Virtua's other maternalfetal
medicine specialists, provides high-risk maternity
care to women with chronic medical conditions.
Women who see Dr. Librizzi, do so with a referral
from their obstetrician/gynecologist.
"Having PCOS doesn't automatically mean
a high-risk pregnancy," says Dr. Librizzi. "But
getting the right kind of treatment from the
best specialists at Virtua will help women have