Why Does My Doctor Think I Have PCOS?

Have you ever wondered if you have PCOS and what exactly it is?  Sher Fertility Institute New York’s fertility expert, Dr. Cary Dicken, will discuss PCOS, or polycystic ovarian syndrome, a diagnosis that is commonly given to women with irregular periods in her latest blog.  The truth about PCOS is that not all women with this diagnosis have the stereotypical characteristics.  If you “Google” PCOS you will likely find images or descriptions of overweight women with acne who have excessive/abnormal hair growth.  In reality, women with PCOS tend to fall somewhere along the spectrum of symptoms.  Bottom line is that not all women with the diagnosis of PCOS are the same.

PCOS is a diagnosis of exclusion.  What does that mean?  Your doctor needs to rule out all other reasons why your periods may be irregular before suspecting PCOS.  In addition, to be diagnosed with PCOS women must have 2 of the following findings:

1) irregular periods

2) evidence of elevated androgens – either physically (i.e. male pattern hair growth) or based on blood work

3) polycystic-appearing ovaries on ultrasound

Technically, if a woman meets two of the above criteria, and there is no other explanation for why her periods are irregular, she has PCOS.  Women with PCOS, despite not “appearing” to have PCOS still need to be treated the same way.  Testing for associated conditions like impaired glycemic control is important.  Irregular hormone levels and metabolic conditions can affect egg quality, which of course then impacts fertility, miscarriage and pregnancy complications.

Management of PCOS depends on a woman’s reproductive goals.  When a woman with PCOS is not interested in getting pregnant the treatment for PCOS may be as simple as going on a birth control pill.  When pregnancy is desired, then fertility treatment may be required.  The irregular periods associated with PCOS are due to delayed and irregular ovulation.  Any woman with PCOS will tell you that it is difficult to time intercourse in hopes of conceiving because she never knows when she is going to ovulate.  Apps and home ovulation predictor kits are often unreliable for women with PCOS.  Achieving a pregnancy may be as simple as using an oral medication like Clomid to induce ovulation, but other women with PCOS do not respond to oral medications and require more advanced treatment like intrauterine insemination (IUI) of in vitro fertilization (IVF) to achieve a healthy pregnancy.  The choice of treatment is not only dependent on a woman’s diagnosis of PCOS, but also needs to take into account her age, additional history and her partner’s fertility testing.

Other than fertility treatment, women with PCOS should use supplements aimed at improving egg quality.  Your doctor can recommend over the counter options and depending on testing may also discuss prescription medication as well.  Lifestyle changes geared towards weight loss can also be beneficial for women with PCOS.

If you feel that you might have PCOS and want to discuss this further please  contact Sher Fertility Institute New York at 646-792-7476 or click here to  schedule an appointment with one of our fertility doctors .