Polycystic ovarian syndrome (PCOS) is a condition caused by an imbalance of reproductive hormones that results in problems in the ovaries. Monthly ovulation does not occur and levels of male hormones (androgens) in females are elevated.
PCOS does not go away. There is no cure for PCOS, and the goal of treatment is to manage symptoms. Many people will need a combination of treatments, such as:
- Hormonal birth control
- Helps make the menstrual cycle more regular
- Lowers the risk of endometrial cancer
- Can improve acne and reduce excess hair growth
- Examples include:
- Patch
- Shot
- Vaginal ring
- Hormonal intrauterine device (IUD)
- Anti-androgen medications such as spironolactone
- Metformin (Glucophage)
- Can help lower insulin and androgen levels
- Is not approved by the Food and Drug Administration (FDA) to treat PCOS
- Eflornithine HCl cream to slow hair growth in unwanted places
- Prescription skin treatments or oral antibiotics for acne
- Infertility medications
- Clomiphene
- Letrozole: used to treat breast cancer but may be effective in people with PCOS who want to conceive
- Gonadotropin therapy (follicle-stimulating hormone [FSH] injections)
Home treatments to help PCOS symptoms include:
- Weight loss
- Regular exercise
- Hair removal treatments
- Creams/depilatories
- Electrolysis
- Laser hair removal
- Hair replacement and wigs for scalp hair loss
What Are Symptoms of PCOS?
Symptoms of PCOS (polycystic ovarian syndrome) usually start around puberty, but some people may not develop symptoms until late adolescence or early adulthood. Early signs of PCOS may include:
- Missed menstrual periods
- Irregular menstrual cycle
- Weight gain, obesity, or difficulty losing weight
- Acne
- May be severe or unresponsive to usual treatments
- Oily skin
- Difficulty conceiving
- PCOS is a common cause of infertility and cysts in the ovaries
Other symptoms of PCOS may include:
- Excess hair growth (hirsutism)
- Occurs on the face, chin, neck, sideburn area, chest, abdomen, upper arm, inner thighs, or other parts of the body where men usually grow hair
- Thinning hair or hair loss on the scalp; male-pattern baldness
- Darkening of the skin (acanthosis nigricans), especially along skin folds
- Skin tags
- Increased risk of heart disease and heart attack
- Sleep apnea
- Depression
- Anxiety
- Sexual dysfunction
- Eating disorders, including bulimia and binge eating
What Causes PCOS?
The cause of PCOS (polycystic ovarian syndrome) is unknown but several factors are thought to play a role, such as:
- Insulin abnormalities
- I Glucose intolerance (also called “prediabetes”)
- Type 2 diabetes
- Insulin resistance
- Hyperinsulinemia
- Irregular menstrual cycle
- Reproductive system abnormalities
- High levels of male hormones (androgens)
- Abnormal levels of the pituitary hormone luteinizing hormone (LH)
How Is PCOS Diagnosed?
PCOS (polycystic ovarian syndrome) is diagnosed with a patient history and physical examination and tests such as:
- Pelvic exam
- Pelvic ultrasound (sonogram)
- Body mass index (BMI) measurement and waist size
- Blood tests
- Androgen hormone levels
- Cholesterol levels
- Blood glucose
- Pregnancy
- Prolactin level
- Thyroid-stimulating hormone (TSH)
- Follicle-stimulating hormone (FSH)
- Sleep studies for sleep apnea screening
Once other conditions are ruled out, a diagnosis of PCOS may be made when at least two of the following symptoms occur:
- Irregular periods
- Signs of high levels of androgens such as:
- Thinning of scalp hair
- Excess male-pattern hair growth (hirsutism)
- Acne
- High blood levels of androgens
- Multiple cysts on one or both ovaries
From 
Image source: iStock Images
https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome
https://www.uptodate.com/contents/polycystic-ovary-syndrome-pcos-beyond-the-basics?search=pcos&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2