PCOS and Hirsutism
Approximately 10% of women have polycystic ovary syndrome (PCOS). Women with PCOS experience increased body hair (hirsutism), increased weight and infertility due to both lack of ovulation and recurrent miscarriage. In addition, women with PCOS are subject to a markedly increased risk of heart disease, endometrial cancer and possibly breast cancer. If you have menstrual irregularities, you may have PCOS.


At Cedars-Sinai, our physicians are actively evaluating new ways of diagnosing and treating this potentially devastating condition. We are conducting several exciting studies to assess new diagnostic tests and promising new therapies for PCOS.

Some women with PCOS also have hirsutism, but not all women with hirsutism have PCOS. Hirsutism is excessive body hair on a woman, similar to that of a man. Affecting approximately seven percent of women ages 18 to 45 years, hirsutism may indicate the presence of other hormonal problems that require examination. The most common cause of hirsutism is an extra amount of male hormones or androgens.


Symptoms
PCOS symptoms vary widely and are similar to symptoms for other conditions. Therefore, women with these symptoms do not necessarily have PCOS.


Symptoms include:

Excess hair growth (hirsutism), acne or balding
Infertility
Irregular ovulation and abnormal menstrual periods
Obesity and insulin resistance
Polycystic ovaries

Diagnosis
PCOS has such a wide range of symptoms that no single test can be used to diagnose the syndrome. Several exams and tests to diagnose PCOS may be done, depending on your symptoms.

These include:

Blood tests
Insulin level tests
Medical history
Pelvic exam
Thyroid level tests
Transvaginal ultrasound
Urinalysis
If you have been diagnosed with PCOS, you will need yearly tests to determine your insulin, glucose, cholesterol and triglyceride levels. Regular testing will help reduce the risk of any long-term complications.
In order to determine the cause of hirsutism, your doctor will obtain blood tests for different hormone levels. Your doctor may also order a pelvic ultrasound or X-rays to make certain you do not have an ovarian or adrenal tumor. The adrenal gland may also be checked by performing an adrenal stimulation test.


Treatment
Since there is no specific cure for PCOS, treatment focuses on managing PCOS symptoms and preventing long-term complications.

Drug therapy may include birth control pills to correct irregular menstrual cycles, insulin-sensitizing medications, fertility medications, weight loss pills and acne medications.
Cosmetic therapy can include treatments for hair removal and for clearing up acne.
Hormone replacement therapy may be prescribed to correct the hormone imbalance associated with PCOS.
Nutritional counseling is available to treat obesity and help alleviate insulin resistance.
Surgery to remove the ovaries or uterus (bilateral salpingo-oophorectomy or hysterectomy) is an option for women with severely symptomatic PCOS who do not want future pregnancies.
To stop the progression of hirsutism, most women, hirsutism should first be treated with hormones, most commonly birth control pills. Once the hormone treatment has taken full effect, electrolysis can be used to permanently remove any remaining hairs. Facial creams, waxing and shaving are also helpful in reducing unwanted hair.