How is PCOS Diagnosed?
In most cases, your doctor can diagnose PCOS after an examination. They may order further tests to help confirm, or to understand the extent of your level of PCOS. Here are some of the other things your doctor will do:
- Ask about your family’s medical history
- Talk to you about all of your symptoms and medical history
- Take your weight and blood pressure
- Preform a full physical exam, looking specifically for excess facial hair, acne, discolored skin, and skin tags.
- Perform a pelvic exam to look for swollen ovaries or other growths in your uterus.
- Order blood tests to check all hormone levels and glucose levels.
- Perform a pelvic ultrasound to check for cysts in your ovaries and the thickness of the lining of your uterus, if present.
In most cases, a diagnosis for PCOS comes when at least two of these are present:
- Irregular or missed periods, or heavy bleeding accompanying periods.
- Cysts on one or both ovaries.
- Signs of excessive hair growth or a blood test confirming excess androgen levels.
Managing your PCOS
Your doctor will help you to decide on the best course of action for your situation, symptoms, history, and any other health conditions you might have. They will also discuss fertility, and your decisions on future attempts at pregnancy. Treatments can often include medications, lifestyle changes, or a combination of both.
If you are a female who does not plan to become pregnant, treatment options might include:
- Lifestyle changes: Losing weight and eating a healthy diet can have a positive effect on insulin levels.
- Medications to block androgens: Some drugs can block the effect of androgens. This helps control acne or hair growth caused by PCOS. Talk to your healthcare provider about whether they’re right for you.
- Insulin-sensitizing medicine: Metformin is a drug used to treat diabetes. It works by helping your body process insulin. Once insulin is controlled, some people with PCOS see improvements in their menstrual cycles.
- Hormonal birth control: Options include birth control pills, patches, shots, a vaginal ring or an intrauterine device (IUD). Hormonal birth control helps to regulate your menstrual cycle, improve acne and help with excess hair growth.
If you are a female who wants to possibly become pregnant in the future, treatment options may include:
- Drugs to induce ovulation (releasing an egg): A successful pregnancy begins with ovulation. Certain drugs have been proven to induce ovulation in women with PCOS. The medications clomiphene and letrozole are taken orally, while gonadotropins are given by injection.
- Surgery: A surgical procedure called ovarian drilling can trigger ovulation by removing tissues in the ovaries that are producing androgen hormones. With newer medications available, surgeons now rarely perform this procedure.
- In vitro fertilization (IVF): Your egg is fertilized with your partner’s sperm in a lab and then transferred to your uterus. This is an option for women with PCOS when medication doesn’t help with ovulation.
Prevention & Outlook with PCOS
There is no valid way to prevent polycystic ovarian syndrome from happening, but there are small things that can be done to reduce the symptoms. Things like eating nutritious foods, exercising regularly, and managing your weight can help to lessen the effects of PCOS.
The hormonal changes that menopause brings could make the PCOS go away, but this does not always happen. In some cases, the imbalance of hormones continues into menopause, and will not change as you age. If the symptoms are affecting your quality of life, talk to your doctor or medical care team to revisit better treatment options.
Risks for Other Health Conditions
Polycystic ovarian syndrome puts people at risk for the following health conditions, which might include:
- Depression and anxiety
- Sleep disorders and sleep apnea
- Endometrial cancer
- Endometrial hyperplasia
- Cardiovascular disease
- High blood pressure
If you suspect you have or have been diagnosed with PCOS, talk to your doctor to learn more about your risks.