5 Common Causes of Heavy Menstrual Bleeding
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PCOS: Understanding the Most Common Cause of Infertility and Your Treatment Options
Polycystic ovary syndrome (PCOS) is a medical condition caused by an imbalance of reproductive hormones. It affects about 1 in 10 women in their childbearing years, and many women don’t know they have it until they experience difficulty becoming pregnant.
At Progressive Women's Health OB/GYN in Friendswood, Texas, Dr. Asia Mohsin and our team treat many causes of infertility, including the most common form: PCOS. Here’s what you need to know about the condition and the options available to treat it effectively.
PCOS symptoms and causes, and how they affect fertility
A woman with PCOS may experience missed, infrequent, or even longer-than-usual menstrual cycles. The most characteristic symptom is developing many small cysts (fluid-filled sacs) that interfere with the ovaries’ ability to produce and release an egg during ovulation.
Additional symptoms include:
- Weight gain or trouble losing weight
- A propensity toward Type 2 diabetes
- Skin darkening, mostly in the groin, on the neck, and underneath the breasts
- Skin tags in the armpits or on the neck
The precise cause of PCOS is unknown, but it’s believed several factors play a role:
Genetics
You’re at increased risk of PCOS if your mother, sister, and/or aunt has the condition.
High androgen levels
All women produce small quantities of androgens, hormones that primarily control male traits. However, an abnormally high amount interferes with the menstrual cycle. Specifically, it prevents the ovaries from releasing an egg.
High androgen levels may also produce facial hair growth, alopecia (pattern baldness), and acne. If you experience this collection of symptoms, it’s a good indicator you have PCOS.
High insulin levels
Insulin is a hormone produced in the beta cells of the pancreas; it transports glucose into the cells, which convert the sugar into usable energy. Cells that develop a resistance to insulin, as in Type 2 diabetes, don’t allow insulin to do its job, and your insulin and blood sugar levels rise.
Many women with PCOS develop insulin resistance, particularly those who are overweight or obese, eat an unhealthy diet, and lead a sedentary life.
Complications from PCOS
Left untreated, PCOS may lead to complications beyond infertility, including:
- Miscarriage or premature birth
- Gestational diabetes (often resolves after birth)
- Eclampsia (pregnancy-induced hypertension)
- Liver inflammation
- Sleep apnea
- Depression, anxiety, and/or eating disorders
- Uterine bleeding
- Endometrial cancer
PCOS may also lead to metabolic syndrome. It’s a collection of conditions that includes high blood pressure, high blood sugar levels, and abnormal cholesterol and/or triglyceride levels, the latter of which increase your risk of heart disease.
Treatments for PCOS that increase fertility
PCOS isn’t curable, but if you want to get pregnant, you have options. These include:
Medications
If your doctor can eliminate other causes of infertility in both you and your partner, she might prescribe a drug to stimulate ovulation, such as clomiphene (Clomid®).
Intrauterine insemination (IU) or in vitro fertilization (IVF)
If medication doesn’t help, your next options are IU or IVF. With IU, your egg is fertilized with your partner's sperm within your uterus. With IVF, fertilization is performed in a tube or dish. In the latter procedure, the doctor implants the fertilized egg in your uterus, where it develops.
Weight loss
If you’re overweight or obese, especially if you have prediabetes or Type 2 diabetes, losing weight by eating a healthy diet and getting regular exercise can help make your menstrual cycle more regular, increasing your fertility.
Surgery
Surgery is performed only when all other options fail. One possible procedure is ovarian drilling. Women with PCOS have a thickened outer shell (cortex) on their ovaries, which may be at least partly responsible for preventing spontaneous ovulation.
In this procedure, the doctor drills through the ovary’s shell, creating holes in its surface. That usually restores ovulation, but it only lasts 6-8 months.
In 85%-90% of cases, PCOS-caused infertility can be treated successfully with conventional medical therapies.
If you’re struggling to get pregnant, Progressive Women's Health OB/GYN can help. Call our office at 281-626-7694 to schedule a consultation, or book online today. We also offer telehealth appointments.
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