What is Polycystic Ovary Syndrome (PCOS)?

• Family History: Having a close relative, like a mother or sister, with PCOS increases your risk. This suggests a genetic link. 
• Obesity or Being Overweight: Excess body weight can lead to insulin resistance, which is linked to PCOS and can make symptoms worse. 
• Insulin Resistance: Insulin resistance happens when your body’s cells stop responding to insulin the way they should. Insulin is a hormone made by your pancreas, and its job is to help sugar (glucose) from the food you eat get into your cells to be used for energy. When you have insulin resistance, your cells don’t let sugar in as easily, so your body makes more insulin to try to fix the problem. Over time, this can lead to high insulin levels and high blood sugar. If it continues, it can cause weight gain, make you feel tired, and even lead to health problems like type 2 diabetes or PCOS. 
• Hormonal Imbalances: An imbalance in hormones, like elevated androgens or luteinizing hormone (LH), is both a cause and risk factor for PCOS. 
• Type 2 Diabetes or Prediabetes: People with insulin resistance or diabetes have a higher risk of developing PCOS. 
• Sedentary Lifestyle: Lack of physical activity can increase weight gain and insulin resistance, raising the risk of PCOS. 
• Early Puberty or Irregular Periods: Girls who start puberty early or have irregular menstrual cycles may be at higher risk of developing PCOS. 

Additional Resources:

Hirsutism and Polycystic Ovary Syndrome Patient Education Booklet

Managing PCOS involves understanding your options, finding the approach that best meets your needs, and working with your healthcare provider. Remember, you're not alone, and there are ways to improve symptoms and enhance your well-being. 

Hormonal Treatments

If you're not aiming to become pregnant, hormonal treatment could be effective in managing PCOS symptoms. Birth control pills are a common option, as they reduce ovarian hormone production and help balance androgen levels. However, these may not be recommended if you're over 35 and a smoker. For individuals managing hirsutism (excessive hair growth), your provider might suggest spironolactone, either alone or alongside birth control pills, to reduce androgen levels. In some rare cases, GnRH analogs might also be used to decrease ovarian androgen production. Alternatively, for those primarily looking to regulate menstrual bleeding without needing contraception or addressing hirsutism, taking progesterone at regular intervals can help. 
 
If you decide to pause or stop treatment, symptoms may return, so regular follow-up is encouraged to maintain health and manage any changes.

Addressing Excess Hair and Acne

For managing excess hair and acne, there are several options. Medications that lower androgen levels can help reduce symptoms, and additional methods such as shaving, plucking, laser treatment, or electrolysis may also be effective for hair removal. Acne may improve with medications that target sebum production, but it’s helpful to consult your healthcare provider for recommendations on safe and effective treatments tailored to you.

Weight and Metabolic Health

Dietary changes and increased physical activity can be an effective strategy for managing PCOS symptoms. Additionally, weight management can be beneficial in reducing androgen levels, improving menstrual cycle regularity, and lowering the risk of diabetes and other metabolic conditions. Even a small amount of weight loss can make a difference. Talk to your healthcare provider about a safe and sustainable weight-management plan. Increasing physical activity with exercises like walking, swimming, or aerobic exercise can aid in weight loss and support both physical and mental health. 
 
Avoid fad diets, which may be tempting but often don’t provide lasting results and can sometimes lead to additional health concerns. You Ifneeded, your provider may recommend additional resources to help you develop healthy habits, such as a nutritionist. Your physician may also recommend medication or surgical options to assist with weight loss goals.

Monitoring Metabolic Health

PCOS can increase the risk of metabolic disorders, so it’s important to regularly monitor factors like cholesterol, blood pressure, and blood sugar levels. Routine screenings and working with your healthcare provider to manage these risks can support long-term health and help you stay on top of your overall wellness. 

The number on the scale is not as important as your overall health, but being overweight can often have a negative impact on your health. Here are some ways to manage your weight. 
 

NUTRITION

Nutrition plays a big role in keeping you healthy because the food you eat gives your body the energy and nutrients it needs to work properly, including your reproductive organs! 

• Good nutrition: Eating a balanced diet with fruits, vegetables, whole grains, protein, and healthy fats helps your body stay strong, gives you energy, helps you maintain a healthy weight, and supports all functions in the body. 
• Poor nutrition: Eating too much sugar and processed foods, or not enough healthy foods can cause insulin resistance, make you feel tired, cause weight gain, and increase the risk of health problems like heart disease, diabetes, or infertility. 

Because everyone is different, it can be helpful to visit a nutritionist or dietitian who can create a nutrition plan just for you. 
 

EXERCISE

Exercise can help manage weight and improve fertility by making your body healthier and more balanced. Here’s how it helps: 

• Healthy Weight: Being too overweight (or underweight) can affect hormones and make it harder to get pregnant. Exercise helps you stay at a healthy weight. 
• Better Blood Flow: Regular exercise improves blood flow to your reproductive organs, which can help them work better. 
• Balanced Hormones: Regular exercise lowers levels of stress hormones like cortisol, which can interfere with other hormones like estrogen and progesterone, which are important for ovulation and fertility. 
• Reduces Insulin Resistance: Exercise improves insulin resistance by helping your body use insulin more effectively. When you exercise, your muscles need energy, so they take in sugar (glucose) from your blood. This lowers your blood sugar levels and makes your cells more sensitive to insulin, meaning they respond to it better. Regular exercise also helps reduce body fat, especially around the belly, which is linked to insulin resistance. It can improve blood flow and reduce inflammation in the body, both of which help insulin work more efficiently. Over time, this makes it easier for your body to keep blood sugar levels balanced. 
• Boosts Overall Health: Staying active makes your heart, lungs, and muscles stronger, which prepares your body for a healthy pregnancy. 

Exercising in moderation is best—too much intense exercise can sometimes hurt fertility, so finding a balance is important. If you currently do not exercise at all, it’s OK! Start slow and make it a goal to move more each day.  

In addition to nutrition and exercise, your doctor may recommend medical treatments to help you lose weight and improve insulin resistance. Keep in mind that the following therapies will work best in conjunction with a healthy nutrition and exercise plan. 

MEDICATION

• Metformin, although not a weight loss medication, can help your body use insulin better, which can improve ovulation and lower the chances of getting diabetes or metabolic syndrome, and for some people can help lose a small amount of weight. 
• GLP-1 inhibitors are medicines that can help you lose weight by making your body feel full and slowing down how fast your stomach empties food. This makes you eat less because you don't feel as hungry. These medicines also help control your blood sugar levels by helping your body release the right amount of insulin when you eat. When your blood sugar is stable, your body is less likely to store extra fat. By reducing hunger and improving how your body handles food, GLP-1 inhibitors can make it easier to eat healthier and lose weight. These medications should be stopped 2 months prior to becoming pregnant, so they should be used prior to starting fertility treatments. 
• Other medications: Other medications such as Phentermine, Orlistat, or Naltrexone + Bupropion are also used for weight loss. Your doctor can help you decide if any of the above medications might be helpful for you.  

SURGICAL OPTIONS

 Bariatric surgery helps you lose weight by changing how your stomach and digestive system work. Here are the main ways it works: 

• Smaller Stomach: After surgery, your stomach is smaller, so you can’t eat as much food at one time. You feel full faster, which helps you eat less. 
• Changes How Food is Digested: Some types of bariatric surgery also change how food is absorbed in your intestines. This means your body takes in fewer calories from the food you eat. 
• Hormone Changes: Bariatric surgery can affect the hormones in your stomach and gut, which can lower your hunger and help control blood sugar levels. 

By eating less and absorbing fewer calories, you lose weight over time. This surgery is usually for people who are very overweight and haven’t been able to lose weight with other methods like diet and exercise.