PCOS (Polycystic Ovarian Syndrome)

tulipsPolycystic Ovarian Syndrome (PCOS) is a condition of unknown cause where cysts may be found in the ovaries (not required for the diagnosis), and there is an imbalance of hormones, often with elevated testosterone, and insulin resistance with an elevated IGF-1 (insulin-growth-factor-1).  Symptoms can include irregular or absent periods, hirsutism (excessive facial or body hair) and male pattern hair loss, all suggestive of the testosterone dominance that can develop. Other virilization (male-like) characteristics that can develop include increased hair all over, decreased breast size, clitoral enlargement, and deepening of the voice.  Weight gain, acne, skin tags, and a condition of brown patches (acanthosis nigricans) can develop most often on the back of the neck but also near arm pits, groin, and breasts. Some women experience fatigue, and loss of mental alertness, and many  experience the symptoms of insulin resistance that results in low blood sugars after carbohydrate meals, and easy weight gain. 

Untreated, PCOS can lead to obesity, hypertension (high blood pressure), high cholesterol and diabetes along with the emotional aspect of not feeling well and struggling with weight and mood. 

Your doctor can often obtain labs that will support this diagnosis, such as the hormone levels of estrogen, FSH, LH, testosterone and it’s often worth making sure the thyroid functions are normal.  Pelvic ultrasound can show the ovarian cysts. Treatment involves a good diet low in processed carbohydrates and refined flour and sugar, with a focus on eating vegetables, whole fruits, and lean meats.  Weight loss can help, and sometimes your physician may prescribe metformin (a diabetes medication). Hormones, like birth control pills or natural equivalents and other medications may be tried. 

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Dr. Paul


  • Angela

    I’m curious if the affects milk supply and what a mom can do to increase her supply if she has POCS? Thank you!

  • Great question: consider a lactation consult. Make sure you are eating enough calories, drinking enough healthy fluids and water, nursing and pumping often enough (every 2-3 hours during your waking hours and every 3 – 4 hours at night if you have a baby under 4 – 6 months who needs more. After 4 months start solid foods to help with calories. Best to you.

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