Polycystic Ovary Syndrome (PCOS)
What is PCOS?
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age, affecting around 5-10% of this population group. It is characterized by an overproduction of male hormones (androgens) in the ovaries, leading to various symptoms, including irregular menstrual cycles, excessive hair growth (hirsutism), and acne. The term “polycystic ovary” (PCO) refers to small “cysts” in the ovaries (these correspond to small follicles) that are characteristic of PCOS.
What symptoms may indicate polycystic ovary syndrome (PCOS)?
The presence of polycystic ovaries does not necessarily indicate the presence of PCOS. Possible symptoms include irregular or missed periods, increased facial or body hair, hair loss, body weight gain, acne or oily skin, and difficulties becoming pregnant. The characteristics vary from woman to woman.
Diagnosis of PCOS: An eye on the “Rotterdam criteria”
The diagnosis of PCOS is based on the so-called “Rotterdam criteria”. According to those, at least two of the following criteria must be met:
- An extended cycle length (> 35 days) or no cycle at all
- An increase in male hormones, which can be measured in blood and/or showing symptoms of increased male horomones such as acne or increased hair growth, particularly on the face or other areas where men normally have more body hair.
- Many small cysts/follicles in the ovaries, visible on ultrasound
Causes of PCOS:
The exact cause of PCOS isn't fully known, but it may have genetic components: There is an increased risk if close relatives also have PCOS.
PCOS and fertility: treatment options
A frequently recommended approach, in the case of an increased body weight, is initially weight loss through diet changes and exercise, which can also be supported with medication if necessary. This measure alone can reactivate ovulation, regulate the menstrual cycle and thus enable a natural pregnancy. Weight loss also improves the effectiveness of medications and reduces potential risks during pregnancy.
If these initial steps do not produce the desired results, there are further treatment options. This includes administering medications that stimulate follicle growth and eventually lead to ovulation. Should these measures also not be sufficient, further options may be considered, including the use of other medications that stimulate follicle growth (known as gonadotropins), ovarian surgery or in vitro fertilization (IVF).
The choice of appropriate treatment depends on various factors. Individual advice from healthcare professionals is therefore important to plan the most appropriate steps and optimize the chances of a successful pregnancy.
I am a professor and specialist in gynecology and obstetrics with a focus on gynecological endocrinology and reproductive medicine.
