Most women with PCOS are unaware they have it. In fact, less than 25% of women with the classic symptoms of PCOS have actually been diagnosed. This is due to a large number of women women and their doctors viewing the symptoms of PCOS individually rather than collectively. Most women are not diagnosed until they suffer with infertility and seek out a reason for their inability to get pregnant.

If you have tried to get pregnant and suspect that you might have infertility caused by PCOS, it is important to get an accurate diagnosis.

 

What are the Symptoms of Polycystic Ovarian Syndrome?

There is a wide range of symptoms caused by PCOS. Every woman who has PCOS will likely experience different symptoms, but will have some or all of them. The common symptoms include:

• irregular menstruation due to irregular ovulation
• amenorrhea (no menses) due to anovulation (no ovulation)
• weight gain and difficulty losing weight
• male pattern baldness
• hirsutism (typically mustache and beard-like facial hair growth along with increased lower belly hair)
• insulin resistance (pre-diabetes)
• heavy, unpredictable vaginal bleeding episodes, frequently with bad cramps

PCOS and Infertility

One of the biggest complications associated with PCOS is the infertility that it often causes. Because ovulation and menstruation is so irregular, many women find it impossible to become pregnant. Some women may even lose their menstrual periods entirely. In fact, it is estimated that over 90% of women with irregular periods and 30% of women without periods are actually experiencing PCOS.

If you're having difficulty conceiving and experiencing symptoms of PCOS, seeing your doctor for a diagnosis can lead to effective treatments to help you get pregnant and relieve the symptoms of PCOS.

PCOS can only be diagnosed through assessing hormone levels in the blood, primarily LH (luteinizing hormone), FSH (follicle stimulating hormone), testosterone, DHEAS (dehydroepiandrosterone sulfate), and insulin. It is crucial that your doctor evaluate your symptoms and medical history as part of the evaluation and diagnosis. An small and seemingly unrelated thing, like hair you pluck off your chin, may seem unimportant; but is one of the symptoms of PCOS; ; therefore, you need to be open and honest about all of your symptoms, even if you think they are unrelated to your inability to conceive.

Diagnosing PCOS

If you are trying to get pregnant, a reproductive endocrinologist or gynecologist will likely investigate the cause of your menstruation or ovulation problems. Specific tests can confirm if you are suffering from PCOS.

These include:

• Total Blood Testosterone (some doctors also measure the "free" testosterone levels, but it is not clear if this adds any additional information)
• Pelvic Ultrasound (the most accurate scans are done with the vaginal probe scanner)
• Blood levels of Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) will help distinguish borderline cases, but are not always done but are extremely helpful in the diagnosis
• Blood levels of DHEAS may be taken, but again are not routine

Treating PCOS

If you are diagnosed with PCOS, the good news is that there are a variety of treatments that may be suitable to help you to minimize your symptoms and restore your fertility.

The most common treatments include:

Weight loss. In overweight women with PCOS, weight loss is always beneficial. In the slender women, it is generally not recommended. Although weight loss may not cause regular periods to come back in all women, it makes the medical treatment of the disorder much easier. Carbohydrate (sugar, starch)-restricted diets for weight loss are gaining popularity. Some women find that they can achieve dramatic results where low calorie efforts were ineffective.

Use of the fertility drug Clomiphene Citrate (Clomid), a drug used to help induce ovulation. It can help to restore your ovulation to enable you to achieve conception. It may also be used if you will be using assisted reproductive services like IUI, or advanced reproductive technology like IVF.

Use of oral contraceptives, or birth control pills. While using birth control pills may seem counter-intuitive, they can help to restore your hormones and reduce your symptoms. However, you will be unable to become pregnant while using oral contraceptives so you’ll work with your doctor to time when you stop the pills and start other medication to attempt to conceive.

There are also a variety of surgical options available to women with PCOS. A wedge resection and ovarian drilling are two surgical procedures that may help to restore ovulation in women with PCOS. In fact, between 70% and 90% of women who undergo these procedures, begin to ovulate within one year following the surgery. This treatment is very controversial, and many leading authorities now strongly counsel against having these procedures done.