is due to a combination of genetic and environmental factors. Risk factors include obesity
, not enough physical exercise, and a family history of someone with the condition. Diagnosis is based on two of the following three findings: no ovulation, high androgen levels, and ovarian cysts
may be detectable by ultrasound
. Other conditions that produce similar symptoms include , hypothyroidism, and hyperprolactinemia.they need to be ruled out first.
Treatment may involve lifestyle changes such as weight loss
and exercise. Birth control pills
may help with improving the regularity of periods, excess hair, and acne. Efforts to improve fertility
include weight loss, clomiphene, or metformin
. In vitro fertilization is used by some in whom other measures are not effective.
Where PCOS is associated with overweight or obesity, successful weight loss is the most effective method of restoring normal ovulation/menstruation,
Not all women with PCOS have difficulty becoming pregnant
. For those that do, anovulation or infrequent ovulation is a common cause. Other factors include changed levels of other hormones in body. Like women without PCOS, women with PCOS that are ovulating may be infertile due to other causes, such as tubal blockages due to a history of sexually transmitted diseases.
For those women that after weight loss still are anovulatory or for anovulatory lean women, then the ovulation-inducing medications clomiphene citrate and FSH
are the principal treatments used to promote ovulation.Previously, the anti-diabetes medication metformin was recommended treatment for anovulation,
For women not responsive to clomiphene and diet and lifestyle modification, there are options available including assisted reproductive technology procedures such as controlled ovarian hyperstimulation with follicle-stimulating hormone (FSH) injections followed by in vitro fertilisation (IVF)