Understanding PCOS: Symptoms, Prevention, and Treatment Options for Women

By Frankie D. Payne, MSN, FNP-BC | Payne Advanced Family Care | Baltimore, Maryland

What Is Polycystic Ovary Syndrome (PCOS)?

Polycystic ovary syndrome, commonly known as PCOS, is one of the most common hormonal and metabolic disorders affecting women of reproductive age. It affects an estimated 10–13% of women worldwide, although many remain undiagnosed.

PCOS occurs when hormonal and metabolic changes interfere with normal ovarian function. Women with PCOS may experience irregular menstrual cycles, elevated androgen levels (hormones such as testosterone), acne, unwanted facial hair, and difficulty becoming pregnant.

Despite its name, women do not need to have ovarian cysts to be diagnosed with PCOS.

At Payne Advanced Family Care in Baltimore, Maryland, we believe understanding your body is the first step toward improving your health. Early diagnosis and individualized treatment can help women manage PCOS symptoms and reduce long-term complications.

What Are the Symptoms of PCOS?

PCOS symptoms vary from person to person. Some women experience mild symptoms, while others have significant hormonal and reproductive concerns.

Common signs and symptoms include:

• Irregular menstrual periods: Infrequent, unpredictable, or absent periods caused by irregular ovulation.

• Excess facial or body hair: Hair growth on the chin, upper lip, chest, or abdomen, known as hirsutism.

• Persistent acne: Particularly on the face, chest, shoulders, and back.

• Thinning scalp hair: Hair loss associated with increased androgen activity.

• Weight gain or difficulty managing weight: Particularly when insulin resistance is present, although PCOS also occurs in women with lower body weights.

• Difficulty becoming pregnant: Irregular ovulation can make conception more challenging.

• Darkened skin: Velvety, dark patches around the neck, underarms, or groin, known as acanthosis nigricans, may indicate insulin resistance.

Not every woman with PCOS experiences all these symptoms.

What Causes PCOS?

The exact cause of PCOS is not fully understood. Research suggests that several factors contribute to its development.

Genetics: PCOS often runs in families, suggesting an inherited component.

Insulin resistance: Many women with PCOS have difficulty using insulin effectively. Higher insulin levels may stimulate the ovaries to produce additional androgens.

Hormonal imbalance: Increased androgen activity can interfere with normal ovulation and contribute to acne and excess hair growth.

Metabolic factors: PCOS is associated with increased risks of prediabetes, type 2 diabetes, abnormal cholesterol levels, and other metabolic concerns.

Can PCOS Be Prevented?

There is currently no proven way to prevent PCOS from developing. PCOS is not caused simply by eating unhealthy foods, gaining weight, or failing to exercise.

However, healthy lifestyle choices can help manage symptoms and reduce the risk of complications.

1. Maintain a balanced, nutritious diet

Choose vegetables, fruits, whole grains, lean proteins, beans, and foods rich in fiber. Limiting sugary beverages and highly processed foods may help improve metabolic health.

2. Stay physically active

Regular physical activity helps improve insulin sensitivity, cardiovascular health, and overall well-being. A common goal for adults is at least 150 minutes of moderate physical activity weekly, adjusted to individual abilities.

3. Support a healthy weight when appropriate

For women with excess weight, modest weight reduction may improve ovulation and metabolic markers. However, women of all body sizes can develop PCOS, and treatment should not focus exclusively on weight loss.

4. Prioritize sleep and stress management

Consistent sleep and healthy stress-management practices support overall metabolic and emotional health.

5. Schedule regular women's health examinations

Routine evaluations can help identify menstrual abnormalities, insulin resistance, and other health concerns early.

How Is PCOS Diagnosed?

At Payne Advanced Family Care, evaluating possible PCOS begins with a detailed medical history, menstrual history, physical examination, and appropriate laboratory testing.

Your provider may recommend:

• Total and free testosterone testing

• DHEA-S testing when clinically indicated

• TSH to evaluate thyroid disorders

• Prolactin testing

• 17-hydroxyprogesterone to exclude certain adrenal conditions

• Hemoglobin A1c, fasting glucose, or preferably a 75-gram oral glucose tolerance test when appropriate

• Lipid screening

• Pelvic ultrasound when necessary

In adults, PCOS is generally diagnosed when at least two of three findings are present: irregular ovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology on ultrasound or elevated anti-Müllerian hormone (AMH) under appropriate circumstances, after excluding other causes.

Ultrasound is not always necessary, and diagnostic criteria differ for adolescents.

What Are the Treatment Options for PCOS?

Although PCOS has no permanent cure, effective treatments can control symptoms, improve reproductive health, and lower the risk of complications.

1. Hormonal birth control

Combined hormonal contraceptives may help regulate menstrual cycles, reduce acne, and improve unwanted hair growth in women who are not trying to become pregnant and have no contraindications.

Progestin-based treatments may also help protect the uterine lining in patients with infrequent periods.

2. Metformin

Metformin may be recommended for women with PCOS who have insulin resistance or metabolic risk factors. It can improve certain metabolic outcomes and sometimes menstrual regularity.

3. Medications for unwanted hair and acne

Spironolactone may help reduce androgen-related symptoms in selected patients. Reliable contraception is necessary when pregnancy is possible because antiandrogen medications can harm fetal development.

Dermatologic treatments and hair-removal therapies may also help.

4. Weight management and nutritional counseling

Individualized nutrition, exercise, and behavioral support can improve overall health and metabolic outcomes.

For eligible adults with higher body weights, medications such as GLP-1 receptor agonists may be considered for weight management. These medications are not a cure for PCOS and require individualized counseling, including pregnancy considerations.

5. Fertility treatment

Women with PCOS who wish to become pregnant may benefit from ovulation-inducing medications.

Letrozole is generally the preferred first-line medication for ovulation induction in women with PCOS-related anovulatory infertility when no other infertility factors are present, under appropriate clinical supervision.

Why Is Treating PCOS Important?

Without appropriate monitoring and management, PCOS may increase the risk of:

• Type 2 diabetes and prediabetes

• High blood pressure and abnormal cholesterol

• Endometrial hyperplasia and endometrial cancer, particularly with prolonged untreated menstrual irregularity

• Sleep apnea

• Fertility difficulties

• Depression and anxiety

Having PCOS does not mean you will develop these complications. Regular screening and appropriate treatment can significantly improve long-term health.

PCOS Care in Baltimore, Maryland

At Payne Advanced Family Care, we understand that women's health involves more than treating individual symptoms. We focus on identifying underlying concerns, educating patients, and developing personalized care plans.

Our primary care and women's health services include menstrual and hormonal evaluations, metabolic screening, weight management, chronic disease management, preventive care, and referrals for specialized reproductive or fertility treatment when needed.

Whether you are experiencing irregular periods, persistent acne, unwanted facial hair, or difficulty managing your weight, our practice is here to help you understand your options.

Schedule Your Women's Health Appointment Today

Don't ignore changes in your menstrual cycle or symptoms that may indicate a hormonal imbalance.

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