What it is
PCOS is a hormone pattern, not a disease of the ovary alone. The ovary starts follicles each month but often does not release one. Periods turn unpredictable.
Androgen levels run high in many women with PCOS. That drives acne, oily skin and coarse hair on the face, chest or belly. Insulin often runs high alongside it.
The name misleads. The cysts seen on ultrasound are ordinary follicles that stalled. They are not painful and they do not need removing.
What you might notice
- Periods more than 35 days apart, or several skipped months
- Acne that started or worsened well after your teens
- Coarse hair on the chin, upper lip, chest or lower belly
- Thinning hair at the crown
- Weight that climbs around the middle and resists dieting
- Dark velvety skin in the neck folds or armpits
- Heavy bleeding when a period finally arrives
- Trouble getting pregnant
How Dr. Mueller finds the cause
- 1
Period history
Dr. Mueller maps when your periods come and how long they last.
- 2
Physical exam
She checks hair pattern, skin and the pelvis.
- 3
Blood work
Androgens are measured. Thyroid and prolactin rule out look-alikes.
- 4
Pelvic ultrasound
The scan counts follicles and measures the uterine lining.
- 5
Insulin and lipids
A1c and a lipid panel are checked because PCOS travels with insulin resistance.
- 6
Treatment plan
She reviews the results and treats the part bothering you most.
Questions people ask
- Does PCOS mean I cannot get pregnant?
- No. Many women with PCOS conceive, some with help ovulating. Irregular ovulation is the obstacle, not the ovary itself.
- Do the cysts need to be removed?
- No. They are stalled follicles, not true cysts. Surgery is not the treatment for PCOS.
- Do I have to be overweight to have PCOS?
- No. Lean women get PCOS. Weight changes how loudly it shows, not whether it is there.
- Will my periods ever be regular?
- They often can be. Treatment aims either at ovulating or at giving the lining a regular reason to shed.
- Why does the lining matter if I am not trying to conceive?
- Months without a period let the lining keep building. Dr. Mueller watches for that.