Polycystic Ovary Syndrome: What It Is, How to Manage It

“Missing your period for more than three months is not normal,” said Dr. Rackow. “You should see your physician. And testing for PCOS should be done before starting birth control pills to regulate periods.”

There isn’t one diagnostic test for PCOS and experts don’t always agree on criteria required to make the diagnosis. The Androgen Excess Society states that a diagnosis of PCOS requires:

  • High androgen level. Androgen is often described as a male hormone, but it’s also naturally present in women. Excess androgen, however, can cause severe acne and excess facial or body hair. Your doctor may order a blood test to measure your levels.

And one of the following:

  • Infrequent or absent ovulation. The ovary usually releases an egg each month, but with PCOS, high levels of androgen hormone may prevent the regular release of an egg monthly or stop it altogether.

  • Twelve or more cysts on your ovaries on ultrasonogram.

PCOS is one of the most common causes of female infertility that occurs when ovulation either isn’t happening or is happening infrequently and irregularly. If ovulation is irregular, it’s difficult to time sex to occur when you’re most fertile. On the other hand, if you want to avoid pregnancy, you want to make sure you don’t have unprotected sex during that fertile time. If you have PCOS, you may spontaneously ovulate at any time, so it is important to use birth control to prevent an accidental pregnancy.

If you are overweight and trying to conceive with PCOS, try to lose weight. Losing as little as five percent of your total body weight may decrease your androgen level, induce ovulation, regulate your periods and improve your fertility.

If you have PCOS and wish to get pregnant, your doctor may recommend a first-line treatment for infertility, which is to induce ovulation. A doctor will often prescribe clomiphene citrate (Clomid). Another oral medication, letrozole, or an injectable drug may be used if Clomid fails to induce ovulation. All increase the risk of twins or multiple births in women with PCOS. If all medications fail, your doctor may suggest trying a surgical procedure that uses laser or heat to destroy small portions of your ovary, which sometimes increases ovulation.

Women with PCOS are at increased risk for pregnancy complications, including gestational diabetes, hypertensive disorders, preterm birth and miscarriage. To increase your chance of a healthy pregnancy and birth, see your health care provider for preconception counseling at least three months before you plan to conceive.

The most critical time for organ development in the fetus occurs before many women are aware that they are pregnant, so it is important to be as healthy as possible at the time of conception. If you have diabetes or hypertension, getting those medical conditions under control before conceiving will increase the chance that all will go well during pregnancy. Obesity can also exacerbate your risks for pregnancy problems. If you are overweight, your physician may recommend that you lose weight before conceiving.