About Polycystic Ovary Syndrome (PCOS)
What is Polycystic Ovary Syndrome (PCOS)?
PCOS is a health issue that can affect individuals with a uterus and ovaries and can first be diagnosed as a teenager. This condition is common, about 10% of all women have PCOS. This condition occurs when individuals have extra testosterone in their body. Due to the increased amount of testosterone, the physical symptoms of PCOS start to show. PCOS can affect many aspects of an individual’s life, but most often the menstrual cycle, hair growth, skin, weight, and the ability to have children.
What Causes PCOS?
PCOS symptoms are caused by high levels of testosterone and thought to be caused by a mixture of genetic factors and daily habits. High testosterone is most often related to high insulin levels but can also be related to changes in how the brain and ovaries work.
Causes for high insulin:
• If your family levels but diabetes, your insulin doesn’t work well, so you have to make extra insulin.
• If your family has PCOS, the ovary thinks the insulin is high even if it normal.
• Certain medications can make insulin high.
Habits that increase insulin:
• Eating sugary foods – candy, desserts
• Eating too much food with too many carbohydrates – rice, pasta, bread, flour tortilla’s
• Drinking sugary drinks including juice, soda, energy drinks, coffee drinks
• Not exercising
• Not enough sleep at night
• Snoring with trouble breathing at night
Image created with BioRender by Melanie Cree.
Who gets PCOS?
Often, PCOS is diagnosed in female adolescents. PCOS can be difficult to diagnose during this stage of life, due to the overlap of normal pubertal developmental symptoms and PCOS symptoms. Genetic factors play a role in causing PCOS, but this condition is also caused by weight gain and other currently unknown factors. This condition is common, 5-10% of all women have PCOS.
Understanding Periods
Step 1 of Diagnosis – Why are my periods irregular? (not once a month)
PCOS can be difficult to diagnose in teens, due to the overlap of normal pubertal developmental signs and PCOS symptoms.
Non-Hormone Causes: Different shape of the uterus or the vagina, changes in genes (chromosomes)
Hormone Causes:
Reproductive | |
Cause | Hormone pattern |
Ovary not working | High LH, FSH, low estrogen |
LH and FSH hormones not working | Low LH, FSH, low estrogen, low testosterone |
Hypothyroid (low) | High TSH and normal/low T4 |
Hyperthyroid (high) | Low TSH and high T4 |
Prolactinoma (breast feeding hormone) | High Prolactin (> 30 mg/dL) |
Pregnant | High HCG |
Prematurity of period hormones | Normal hormones, only 1-3 years from first period |
Androgenic (hormones with male-type properties – face and body hair growth, acne, deeper voice) | |
Cause | Hormone pattern |
Polycystic Ovary Syndrome | High testosterone |
Adrenal enzyme problem (rare) | High 17 hydroxyprogesterone is the most common pattern |
Adrenal tumor (extremely rare) | High DHEAS (more than 25% above upper limit of normal) |
Cushing’s (extremely rare) | High Cortisol more than once |
For more information on diagnosing PCOS in adolescents, listen to Dr. Cree on Charting Pediatrics. The episode is available here or wherever you listen to podcasts.
Conditions Associated with PCOS
High insulin and high testosterone and the combination of the two can cause many health problems in addition to PCOS. Click on each tab below to learn more.
Image created with BioRender by Melanie Cree.
Treating PCOS
Goal: Keeping you healthy and feeling good about yourself
Skin: Hormones with estrogen, spironolactone, Accutane, antibiotics, creams. Minoxidil shampoo for hair loss on head. Amlactin to decrease dark skin.
Metabolic risk: Food changes to decrease sugar, exercise, enough sleep, fix snoring, metformin, weight loss medications, bariatric surgery
Mood: Counseling, support from other people, medicine
Cancer: Goal is regular periods or decreased periods because of taking a medication. It is okay to try lifestyle changes first. Hormone therapies are the best for keeping the lining of the uterus healthy.
Image created with BioRender by Melanie Cree.
Department of Pediatrics
CU Anschutz
Administrative Pavilion
13123 E. 16th Ave.
B065
Aurora, CO 80045
720-777-2715
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