Polycystic ovary syndrome (PCOS) is one of the most common hormonal and metabolic disorders affecting women of reproductive age. While the exact cause isn't fully understood, genetics, insulin resistance, and hormonal imbalances are believed to play key roles in its development.
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Polycystic Ovary Syndrome (Now Known as PMOS)
Overview
What Is Polycystic Ovary Syndrome (PCOS)?
Polycystic ovary syndrome (PCOS), now medically referred to as polyendocrine metabolic ovarian syndrome (PMOS), is a common hormonal condition that affects how the ovaries work. It's estimated to affect about 1 in 8 women of reproductive age. The updated name reflects what doctors have understood for years: PCOS isn't really about ovarian cysts. It's a broader hormonal and metabolic condition that can affect periods, fertility, skin, weight, and long-term health.
If you are experiencing unexplained weight fluctuations, irregular menstrual cycles, or any of the other symptoms listed below, please know that support is available. Consult with an OB-GYN specialist at M Health Fairview to discover effective strategies for managing and treating PCOS.
What Are Polycystic Ovary Syndrome Symptoms?
Polycystic ovary syndrome symptoms can vary widely from person to person, with some people exhibiting very few symptoms. Common PCOS (PMOS) symptoms include:
- Irregular, infrequent, or absent periods: One of the most common signs of PCOS is irregular ovulation, which can cause menstrual cycles to occur fewer than eight times a year, more than 35 days apart, or stop altogether. This is often the first symptom people notice and a common reason they seek medical evaluation.
- Excess androgen (male hormone) symptoms: Elevated androgen levels can lead to acne, excess facial or body hair (hirsutism), or thinning hair on the scalp. These symptoms vary from person to person and may initially be mistaken for unrelated skin or hair concerns.
- Weight gain or difficulty losing weight: Insulin resistance is another common symptom of polycystic ovary syndrome. It can make it harder to manage weight, even with a consistent diet and exercise. Because many factors can contribute to weight changes, this symptom alone isn't enough to diagnose PCOS.
- Skin changes: Insulin resistance associated with PCOS can also cause dark, velvety patches of skin (acanthosis nigricans) or skin tags, most commonly around the neck or underarms. While these changes are usually painless, they should be discussed with a healthcare provider during an evaluation.
- Enlarged ovaries with multiple small follicles: A pelvic ultrasound may reveal enlarged ovaries with multiple small follicles. However, having multiple follicles alone does not necessarily mean someone has PCOS, since this can occur in other conditions as well.
- Difficulty getting pregnant: Irregular or absent ovulation can make conceiving more challenging without treatment. Since the condition often develops gradually, fertility challenges are sometimes the first sign that leads to a diagnosis.
What Causes Polycystic Ovary Syndrome?
Unfortunately, there isn’t one single cause of PCOs. Instead, it is likely a combination of genetic and lifestyle factors that affect hormone levels. Common contributing factors include:
- Insulin resistance: Many people with PCOS have cells that don't respond normally to insulin, causing the body to produce more of it. Excess insulin can raise androgen (male hormone) production, which disrupts ovulation.
- Excess androgen production: The ovaries may produce higher-than-typical levels of androgens, which can prevent regular ovulation and lead to symptoms like acne and excess hair growth.
- Low-grade inflammation: Some research links PCOS to inflammation, which may further stimulate androgen production from the ovaries.
- Family history: PCOS tends to run in families, suggesting a genetic component. Your risk may be higher if a parent or sibling has the condition.
Who’s at Risk for Polycystic Ovary Syndrome (PCOS)?
PCOS is most often diagnosed in people in their 20s and 30s, but it can begin as early as puberty. Risk factors include:
- Family history of PCOS
- Obesity or rapid weight gain
- Type 2 diabetes or prediabetes
- Irregular periods since adolescence
What are the Types of PCOS?
PCOS isn't a single, uniform condition. It can present differently from person to person depending on which symptoms and hormone changes are present.
Healthcare providers often classify PCOS into four phenotypes based on a combination of three key features: irregular ovulation, elevated androgen (male hormone) levels, and polycystic ovaries seen on ultrasound. Identifying your phenotype helps guide treatment and provides insight into your potential metabolic and reproductive health risks.
- Phenotype A (Classic PCOS): Includes all three features: irregular ovulation, elevated androgen levels, and polycystic ovaries. This is the most common presentation and is often associated with the highest risk of insulin resistance, metabolic syndrome, and fertility challenges.
- Phenotype B: Includes irregular ovulation and elevated androgen levels but does not involve polycystic ovaries on ultrasound. People with this phenotype commonly experience irregular periods, acne, excess facial or body hair, or scalp hair thinning despite having normal-appearing ovaries.
- Phenotype C (Ovulatory PCOS): Includes elevated androgen levels and polycystic ovaries, but ovulation remains regular. Although menstrual cycles may be predictable, symptoms such as acne, hirsutism, or hair loss can still occur due to excess androgen production.
- Phenotype D (Non-Hyperandrogenic PCOS): Involves irregular ovulation and polycystic ovaries without elevated androgen levels or noticeable androgen-related symptoms. This phenotype is generally associated with a lower risk of metabolic complications, though it can still affect fertility and menstrual regularity.
It's important to remember that a PCOS phenotype isn't permanent. Hormone levels, ovulation patterns, and symptoms can change over time due to factors such as age, weight changes, pregnancy, or treatment. Your healthcare provider at M Health Fairview may reassess your phenotype as your condition evolves to ensure your treatment plan continues to meet your needs.
How Is Polycystic Ovary Syndrome Diagnosed & Treated?
There's no single test that can diagnose PCOS. Instead, your healthcare provider will:
- Review your medical history
- Discuss your menstrual cycle and symptoms
- Perform a physical exam
- Order blood tests to evaluate hormone levels
- Screen for conditions with similar symptoms
A pelvic ultrasound may also be recommended to assess the ovaries and gather additional information before confirming a diagnosis.
Treatment is personalized based on your symptoms, health goals, and whether you're trying to become pregnant. Your care plan may include:
- Lifestyle changes to improve insulin sensitivity and support weight management
- Medications to regulate menstrual cycles or manage hormone-related symptoms
- Treatment for insulin resistance, when appropriate
- Fertility treatments for those trying to conceive
See PCOS treatments and services at M Health Fairview to learn more.
What Are the Benefits of Diagnosis & Treatment?
Early diagnosis and treatment of PCOS can reduce your chances of experiencing longer-term complications. Treatment can also improve your chances of getting pregnant, though you may face a higher risk of miscarriage, gestational diabetes, or high blood pressure during pregnancy.
Recent research from the Harvard Apple Women's Health Study also links irregular menstrual cycles to broader long-term health risks, including cardiovascular health, which is part of why early diagnosis matters.
Left untreated, PCOS is associated with a higher risk of:
- Obesity
- Type 2 diabetes
- Cardiovascular conditions, including high blood pressure, high cholesterol, and metabolic syndrome
- Infertility
- Diabetes or high blood pressure during pregnancy
- Sleep apnea
- Abnormal uterine bleeding
- Cancer of the uterine lining (endometrium)
- Depression and anxiety
- Non-alcoholic fatty liver disease
- Metabolic syndrome
Our approach
Polycystic Ovary Syndrome affects more than reproductive health, so M Health Fairview takes a coordinated approach that looks at the whole picture. Here’s what you can expect from our OB-GYNs specializing in PCOS:
- Multidisciplinary care: Our OB-GYN specialists work alongside endocrinology and nutrition providers when needed, so hormonal, metabolic, and fertility concerns are addressed together rather than through separate, disconnected visits.
- Individualized treatment planning: No two cases of PCOS look the same, so treatment plans are built around your specific phenotype, symptoms, and goals, whether that's cycle regulation, fertility, or long-term metabolic health.
- Updated, evidence-based patient education: M Health Fairview OB-GYNs incorporate the latest clinical understanding of PCOS and help patients understand their diagnosis beyond outdated or oversimplified explanations.
FAQs About Polycystic Ovary Syndrome
PCOS, medically known as polyendocrine metabolic ovarian syndrome (PMOS), is a hormonal condition affecting how the ovaries function. It can impact periods, fertility, weight, and skin, and is one of the most common hormonal disorders in women of reproductive age.
The earliest sign is usually irregular, infrequent, or absent periods, often starting in the teen years or 20s. Other early indicators include new acne, excess hair growth, or unexplained weight gain. Symptoms vary, so a provider evaluation is the best way to confirm a diagnosis.
PCOS is caused by a combination of factors, primarily insulin resistance and excess androgen (hormone) production. Genetics also plays a role, as PCOS often runs in families. Researchers haven't identified one single cause.
Treatment for polycystic ovary syndrome depends on your symptoms and goals, and may include lifestyle changes, medications to regulate periods or manage insulin resistance, or fertility treatments. An OB-GYN specialist can help build a personalized treatment plan.
Untreated PCOS can increase the risk of longer-term complications, including type 2 diabetes, cardiovascular issues, and abnormal uterine bleeding that may raise the risk of endometrial cancer over time. It can also make conceiving more difficult and may contribute to anxiety or depression. Early diagnosis and treatment can help manage symptoms and reduce these risks.
Providers for Polycystic Ovary Syndrome (Now Known as PMOS)
Polycystic Ovary Syndrome Specialists at M Health Fairview in Minnesota
M Health Fairview's OB-GYN specialists have extensive experience diagnosing and treating PCOS (PMOS), offering personalized care plans for symptom management, fertility, and long-term health.
When to See a Specialist about PCOS
Talk to a specialist if you have irregular or absent periods, are struggling to get pregnant, are noticing new acne or hair growth changes, or have other symptoms above that are affecting your daily life. Early evaluation can help prevent longer-term complications.
Polycystic Ovary Syndrome Treatment Near You in Minnesota
Locations for Polycystic Ovary Syndrome (Now Known as PMOS)
M Health Fairview Clinics and Specialty Center - Princeton
M Health Fairview Clinics and Specialty Center - Princeton
M Health Fairview Clinics and Surgery Center - Minneapolis
M Health Fairview Clinics and Surgery Center - Minneapolis
M Health Fairview Clinics and Specialty Center - Maplewood
M Health Fairview Clinics and Specialty Center - Maplewood
M Health Fairview Women's Clinic - Minneapolis
M Health Fairview Women's Clinic - Minneapolis
M Health Fairview Clinics and Specialty Center - Fridley
M Health Fairview Clinics and Specialty Center - Fridley
M Health Fairview Clinics and Surgery Center - Maple Grove
M Health Fairview Clinics and Surgery Center - Maple Grove
Treatments for Polycystic Ovary Syndrome (Now Known as PMOS)
Polycystic Ovary Syndrome Treatment Services at M Health Fairview
M Health Fairview offers a full range of screening, diagnostic testing, and treatment services for PCOS, focused on early detection, prevention, and personalized gynecologic care. Every treatment plan is built around your specific symptoms, whether that's irregular periods, fertility goals, skin and hair changes, or long-term metabolic health.
If you are diagnosed with PCOS (PMOS), your care provider may use a combination of the following treatment options:
Diagnostic Testing & Hormone Screening
PCOS diagnosis starts with bloodwork to measure androgen, insulin, and other hormone levels, paired with a pelvic ultrasound to check for ovarian cysts and assess uterine lining thickness.
Providers may also screen for related conditions like insulin resistance, prediabetes, and cholesterol abnormalities, since these commonly occur alongside PCOS. This helps confirm a diagnosis and rule out other conditions with overlapping symptoms, such as thyroid disorders.
Lifestyle & Metabolic Management
For many patients, the first line of treatment is a personalized nutrition and exercise plan designed to improve insulin sensitivity, support a healthy weight, and regulate menstrual cycles. Even modest weight changes can meaningfully reduce androgen levels and improve ovulation.
M Health Fairview providers may also coordinate with nutrition or endocrinology specialists for patients managing insulin resistance or prediabetes alongside PCOS.
Hormonal Medication for Cycle Regulation
Combined hormonal birth control (pills, patches, or rings) is commonly prescribed to regulate periods, reduce excess androgen levels, and improve acne and unwanted hair growth.
For patients who can't take estrogen-containing birth control, progestin therapy can help regulate periods and protect the uterine lining without addressing androgen-related symptoms.
Insulin-Sensitizing Medication
Metformin is a medication that improves the body's response to insulin. It is often prescribed for patients with PCOS and insulin resistance and can help regulate menstrual cycles and support modest weight management. It may also improve ovulation in patients trying to conceive.
Anti-Androgen Medication for Skin & Hair Symptoms
For patients primarily bothered by acne, excess hair growth, or hair thinning, anti-androgen medications like spironolactone can reduce the hormone activity driving these symptoms. These are typically combined with hormonal birth control and may take several months of consistent use before visible improvement in skin and hair symptoms.
Fertility Treatment for PCOS-Related Infertility
For patients trying to conceive, ovulation-inducing medications like letrozole or clomiphene are often the first step, helping trigger regular ovulation. If oral medications aren't effective, providers may recommend injectable fertility medications, intrauterine insemination (IUI), or referral for in vitro fertilization (IVF) depending on individual fertility goals and history.
Services for Polycystic Ovary Syndrome (Now Known as PMOS)
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