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PCOS, Causes and Treatments

Dr. Marwan Shaykh treats Polycystic Ovarian Syndrome (PCOS), the most common hormonal reproductive problem for women of reproductive age. Approximately 5 to 10 percent of women in this age group are afflicted with PCOS. This disorder is characterized by high levels of androgens (male hormones), irregular or no menstrual cycle for an extended period of time, and small cysts on the ovaries. Read the sections below to find out if PCOS could be the reason for your infertility, and learn how Dr. Shaykh can treat the condition.

While the exact cause of Polycystic Ovarian Syndrome is unknown, correlations do exist that can give clues about the nature of PCOS. If a woman is diagnosed with PCOS, it is common for her to have a mother or sister who also has the syndrome. However, there is not enough evidence for a definite genetic link to be confirmed.

Additionally, women with PCOS frequently have weight problems due to insulin resistance, a condition in which the body does not use insulin effectively, causing high levels of insulin to circulate in the blood.

This information led researchers to begin studying the link between producing too much insulin and having increased androgen levels, which is one of the indicators of PCOS. High levels of insulin, or hyperinsulenemia, are related not only to high androgen levels, but also to obesity and type 2 diabetes. Obesity can lead to increased insulin levels, further aggravating the PCOS symptoms.

Both heredity and insulin resistance are heavily correlated with PCOS, but the full implications of this are not yet known. Symptoms vary from woman to woman in occurrence and severity. You may be suffering from PCOS if you have:

  • Enlarged or polycystic ovaries
  • Irregular, infrequent, or absent menstrual periods
  • High levels of testosterone
  • Infertility due to lack of ovulation
  • Hirsutism – excessive growth of hair on the face, chest, stomach, back, thumbs, or toes
  • Acne, oily skin, or dandruff
  • Pelvic pain
  • Weight gain or obesity, especially around the waist and abdomen
  • Type 2 diabetes
  • High cholesterol
  • High blood pressure
  • Male-pattern baldness/thinning hair
  • Acanthosis nigricans – patches of thickened dark brown or black skin on the neck, arms, breasts, or thighs
  • Skin tags – tiny flaps of skin in the armpits or neck area
  • Sleep apnea―excessive snoring and halting of breathing while asleep


If you have any of these symptoms, you should schedule a consultation with Dr. Shaykh to determine whether PCOS could be the cause for your infertility. Ovulation is a process in which a fully grown egg cell is released from one of the two ovaries, which are the female reproductive organs.

Upon being released, the egg travels down the fallopian tube, where it is either fertilized by a sperm cell and implanted in the uterus or shed with the uterine lining and passed through the vagina during menstruation. The term ovulation refers to the point when the egg is released from the ovaries.

When a woman has PCOS, her reproductive system does not produce all of the necessary hormones for the egg to develop and mature. The ovaries cannot produce the hormones that are needed for ovulation and healthy function of the menstrual cycle. They may become inflated and grow small cysts which produce androgens, further preventing normal ovulation and menstrual cycle.

While there is no cure for PCOS, the problems associated with it can and should be managed in order to prevent complications such as type 2 diabetes and heart disease. Treatment for PCOS varies depending on the patient’s age, medical history, tolerance for certain medication, and the extent of the disorder.

If your goal is to get pregnant, Dr. Shaykh will be primarily concerned with reducing your weight and promoting ovulation. Increased physical activity and a healthy diet will promote the efficient use of insulin, as well as lower blood glucose levels. More regular ovulation is often one of the benefits of diet and exercise. In certain cases, Dr. Shaykh may recommend ovulation induction medications.

Clomid and metformin both stimulate the ovary to make follicles (sacs that contain eggs) and release an egg for fertilization. These medications can raise the risk of having a multiple birth. In more severe cases there are surgical options that can help, such as ovarian drilling to induce ovulation. However, this treatment method can cause scarring and is usually reserved until other treatments have failed.

If you are seeking treatment for PCOS, schedule an appointment with Dr. Shaykh to discuss your goals and treatment options.