Polycystic Ovarian Syndrome (PCOS)
It is estimated that between 5% and 10% of women of childbearing age have PCOS. Approximately five million women in the United States may be affected. Although PCOS is usually diagnosed in women in their twenties and thirties, girls as young as eleven have developed the symptoms.
If a woman has PCOS, her ovaries are enlarged and her unbalanced hormones cause small cysts to grow on her ovaries, and while these cysts are not cancerous, they can be painful during ovulation or even cause irregular periods. If left untreated, PCOS can give rise to diabetes and heart disease.
PCOS makes it more difficult for women to get pregnant. The untimely cessation of ovulation leads to PCOS and pregnancy issues.
What Are the Symptoms of PCOS?
If you have PCOS, your symptoms are usually quite pronounced. They may include:
- Weight gain or trouble losing weight due to metabolism issues
- Extra hair on your body
- Thinning hair on your scalp
- Irregular periods — you may have fewer than nine in a year or they may cease altogether
- Very heavy periods
- Fertility problems
- Pelvic pain
- Very oily skin
- Depression, anxiety or eating disorders
- Gestational diabetes or pregnancy-induced high blood pressure
- Nonalcoholic steatohepatitis — severe liver inflammation due to fat accumulation
- Metabolic syndrome — increased blood pressure, increased blood sugar, abnormal cholesterol and triglyceride levels that significantly increase your chance of cardiovascular disease
- Type 2 diabetes or prediabetes — PCOS and diabetes sometimes go hand-in-hand
- High levels of androgen and insulin resistance, even after menopause
- Sleep apnea
- Abnormal uterine bleeding
- Endometrial hyperplasia — which is when your uterine lining becomes too thick
- Cancer of the uterine lining
Because of enlarged ovaries blocked by PCOS cysts or because the hormone androgen interferes with ovulation, infertility is a common symptom. It’s often very difficult, though not impossible, to get pregnant with PCOS. If you’re concerned about PCOS and pregnancy, ask a top OB/GYN in Queens, NYC for a definitive diagnosis.
The Tests for Diagnosing PCOS
The cause of PCOS isn’t clear, but factors include heredity, inflammation, and elevated levels of male hormones as well as high levels of insulin—a hormone that regulates how the food you eat is changed into energy and used by your body. In patients with PCOS the male sex hormone androgen is usually slightly elevated and the female sex hormone estrogen registers lower than normal. Obesity may worsen PCOS symptoms. Elevated levels of androgen have been associated with PCOS hair loss, as well as extra hair growing on your body.
While the cause of PCOS is not yet known, genetics, excess insulin and low-grade inflammation may be factors. A correct diagnosis is essential for treatment. Your Forest Hills, Queens gynecologist will perform a few tests and take a detailed medical history for assessment. A physical exam to look for extra body hair and check your blood pressure may follow. Tests may include:
- A glucose tolerance test
- A blood test to check cholesterol and triglyceride levels
- A determination of your body mass index (BMI)
- Lab tests to check your blood sugar, insulin, and other hormone levels
- Other tests to rule out thyroid or other glandular issues
Sometimes, your gynecologist orders a pelvic ultrasound to look for cysts on your ovaries. You may have a sleep study to check for obstructive sleep apnea. You may receive a screening for depression and anxiety. Your Forest Hills or Rego Park, Queens doctor takes all your symptoms into consideration before reaching a diagnosis.
Other conditions can mimic the signs of PCOS. Adrenal hyperplasia, an excess hormone production by your adrenal glands, has similar symptoms. Imbalance in the thyroid function can produce some of the same problems. Hyperprolactinemia, which is excess hormone production by the pituitary gland, also shares some characteristics. Your doctor rules these out, one by one, while correctly diagnosing PCOS.
What Are the Treatments for Polycystic Ovarian Syndrome?
There are several different treatment avenues available to help alleviate not only the underlying cause of PCOS, but also many of its symptoms. If you want to overcome the condition, it is imperative that you adhere to your doctor’s instructions regarding care and lifestyle changes. At the same time, make sure you speak up about what does and does not work for you. Treatments for the condition may include:
- A PCOS diet that’s low in carbohydrates and high in vegetables and fruits
- The PCOS diet that helps control weight gain while strengthening your immune system
- A regular exercise program, such as walking or swimming
- Cessation of smoking
- Birth control pills to help with many of the symptoms
- Metformin to regulate your periods
- Fertility medication if you are trying to get pregnant with PCOS
- Progestin therapy, which is an estrogen replacement therapy
- Spironolactone, which blocks effects of androgen on your skin
- Eflornithine cream to slow hair growth
- Clomiphene, an oral anti-estrogen medication
- Letrozole, a breast cancer treatment that can stimulate ovaries
- Gonadotropin, hormone medicine
- Electrolysis, a needle with electric current that damages and destroys hair follicles
- Counseling or support groups that can help you deal with PCOS symptoms
- Ovarian drilling to puncture and destroy a part of an ovary to reduce the hormone androgen
- Surgery, as a last resort in some cases, to remove unusually large cysts
A top OB/GYN in Queens, NYC may continue to monitor you for signs of your most worrisome symptoms, such as the relationship between PCOS and diabetes. Your liver condition, ovulation phases and cholesterol and triglyceride levels may also be monitored over time. There is no cure for PCOS, but you can treat your symptoms. The key is to maintain constant communication with your doctor.
Forest Hills Medical Services is a comprehensive clinical practice. In our office we believe that how you are treated is just as important as the medical care we provide. We are dedicated to providing the highest quality obstetrics and gynecology with warmth and compassion. Our physicians are easy to talk to and our entire staff is friendly and attentive to your needs.
The best gynecologists in Queens who are part of the Forest Hills Medical Services team are renowned for their extensive skills in diagnosing and treating PCOS.
We will listen to all your concerns and together we will come up with the treatment plan that works for you and your unique circumstances.
Call FHMS to meet our staff in our state-of-the-art offices and be heard.
Gynecologist Dr. James Gohar (OBGYN Doctor), Dr Nithya Gopal and Maris Huffman, NP
Forest Hills Medical Services
108-16 63rd Rd
Forest Hills, NY 11375
☎ (718) 897-5331