Eunice Kennedy Shriver National Institute of Child Health and Human Development

Lower proportions of participants with higher androgen levels achieved pregnancy (29.9 percent versus 40.2 percent) and had live births (20.1 percent versus 33.1 percent). Participants with higher androgen levels took longer to achieve pregnancy than those with lower androgen levels (41.8 months versus 33.9 months). Little research has been conducted on the potential influence of androgen levels on pregnancy outcomes in people with PCOS. Health care providers look for two or more features—absence of ovulation, resulting in light or skipped periods; high androgen levels; and follicle growths in one or both ovaries—to diagnose PCOS. PCOS symptoms can include menstrual irregularities, cardiovascular issues, acne, insulin resistance, and obstructive sleep apnea. You should discuss the risks and possible side effects of treatments with your health care provider. To balance out the high levels of insulin, the body makes more androgens,9 which contribute to symptoms of PCOS. Often, women and health care providers may not suspect PCOS because the symptoms may seem unrelated.

The treatment(s) your health care provider suggests will depend on your symptoms, overall health, and plans for pregnancy.
High levels of androgens can interfere with signals from the brain that control ovulation, making it occur sporadically or not at all.
If these treatments are not successful, your health care provider may suggest in vitro fertilization (IVF), or another type of assisted reproductive technology (ART).16 IVF may offer the best chance of pregnancy for women with PCOS.
The symptoms of PCOS tend to run in families, so genetics have long been a focus of PCOS research.
To balance out the high levels of insulin, the body makes more androgens,9 which contribute to symptoms of PCOS.
Fertility problems related to PCOS often are linked to the absence of ovulation (called anovulation), a key feature of PCOS.
Adjusting your diet to reduce foods that can cause or increase inflammation could also be beneficial.7 Talk to your health care provider about designing a diet and physical activity plan just for you.
Many women with PCOS also have problems with another hormone called insulin, which helps move sugar (also called glucose) from the bloodstream into cells to use as energy.
Because some of the common treatments for PCOS symptoms can prevent pregnancy or may harm the fetus during pregnancy, it's important to discuss your fertility goals with your health care provider when discussing treatment options.

NICHD Archive

As a result, many women aren't diagnosed with PCOS until they have trouble getting pregnant, or until they have menstrual irregularities.
The treatments come in a variety of forms, such as pills, creams, or gels, and in different strengths; higher strength options may require a prescription.
Please note that treatments have risks and side effects, some of them serious.
Because retinoids can cause congenital anomalies, those who are or wish to become pregnant should not use the treatments.2
Because PCOS has a broad range of symptoms, health care providers may use a variety of treatments for this condition and its symptoms.1
A health care provider may consider PCOS treatments for severe symptoms even without a diagnosis of PCOS.3
Recent research suggests that there are 19 possible changes, or variants, in genes that can increase a person’s risk of developing PCOS.1 These variants could explain why the features and symptoms of PCOS are so different from one person to the next.
Because anti-androgens can cause congenital anomalies, they are often taken with oral contraceptives to prevent pregnancy.14 Be sure to talk with your health care provider about the risks of these treatments, especially if you want to become pregnant.
Often, women and health care providers may not suspect PCOS because the symptoms may seem unrelated.

Fertility problems related to PCOS often are linked to the absence of ovulation (called anovulation), a key feature of PCOS. Oral contraceptives can help lower the risk of certain types of cancers, but they may also raise the risk of other types of cancers.8 There is no one oral contraceptive that works best for women with PCOS. You can also review the treatment options for infertility related to PCOS. When cells don't respond normally to insulin, the level of sugar in the blood rises. Research conducted in animal models suggests that exposure to increased levels of androgen hormones in the womb may also increase the likelihood of PCOS in offspring.5,6 However, she and her health care providers may want to monitor her health for signs of these issues as part of her regular care. Some women diagnosed with PCOS have the first two features, as well as symptoms of PCOS, but do not have growths in their ovaries. “As it may take longer to conceive with the type of PCOS that includes high levels of androgens, these patients may be advised to start trying to conceive sooner or to seek fertility care more expeditiously,” Dr. Chan said.

What are the symptoms of PCOS?

Although PCOS usually is considered to be a condition related to the ovaries, researchers found these genetic variants in both females and males.
In fact, males with these genetic variants experienced cardiac and metabolic symptoms similar to those experienced by females with PCOS.2
NICHD research explores causes, predictors, treatments, and other topics related to PCOS.
Correlation of polycystic ovarian syndrome phenotypes with pregnancy and neonatal outcomes.
Participants with higher androgen levels took longer to achieve pregnancy than those with lower androgen levels (41.8 months versus 33.9 months).
High insulin levels are linked to a skin condition called acanthosis nigricans, which results in thickened dark, velvety patches of skin.10

High insulin levels are linked to a skin condition called acanthosis nigricans, which results in thickened dark, velvety patches of skin.10 Many women with PCOS also have problems with another hormone called insulin, which helps move sugar (also called glucose) from the bloodstream into cells to use as energy. The ovaries, testes, and adrenal glands produce reproductive hormones that are involved in regulating reproductive processes and health.

What are the treatments for PCOS?

These symptoms can include changes in metabolism, menstrual and reproductive health, and heart and blood function, as well as inflammatory responses and other outward characteristics.
Many symptoms of PCOS result from an imbalance of hormones, chemicals that control functions in the body.
Because some lifestyle choices, such as smoking cigarettes, can increase these risks, you should discuss all these factors with your health care provider before making decisions about treatments.
Talk to your health care provider about any concerns you may have about these medications.13
Research conducted in animal models suggests that exposure to increased levels of androgen hormones in the womb may also increase the likelihood of PCOS in offspring.5,6
PCOS often includes growths resembling cysts on one or both ovaries, sporadic ovulation resulting in reduced fertility and irregular periods, and high androgen levels leading to increased body or facial hair.
The authors concluded that evaluating androgen levels and other features of PCOS may allow physicians to more effectively guide PCOS patients who are trying to become pregnant.

Pregnant women who have PCOS, however, are at higher risk for certain problems, such as miscarriage. For many adolescents, these symptoms may also be part of puberty, especially early in the process. Many women don't find out that they have PCOS until they have trouble getting pregnant. People with PCOS may also have metabolic issues, such as insulin resistance or obesity.

Anti-Androgens

Participants with higher androgen levels also had a higher average body mass index (35.5 versus 31.9) and lower fasting insulin levels (21.6 versus 14.7 micro-international units per milliliter). However, your health care provider may recommend them to treat symptoms of PCOS, such as acne and irregular periods. Because some lifestyle choices, such as smoking cigarettes, can increase these risks, you should discuss all these factors with your health care provider before making decisions about treatments. After 4 to 6 months of using these medications, women with PCOS who have ovaries may start ovulating naturally.12 Adjusting your diet to reduce foods that can cause or increase inflammation could also be beneficial.7 Talk to your health care provider about designing a diet and physical activity plan just for you. The following information describes available treatments for different symptoms of PCOS. NICHD research explores causes, predictors, treatments, and other topics related to PCOS. PCOS is a set of symptoms—including metabolic and reproductive—related to a hormonal imbalance. Because retinoids can cause congenital anomalies, those who are or wish to become pregnant should not use the treatments.2 The treatments come in a variety of forms, such as pills, creams, or gels, and in different strengths; higher strength options may require a prescription. A health care provider may consider PCOS treatments for severe symptoms even without a diagnosis of PCOS.3 For example, increased hair growth, dark patches of skin, acne, insulin resistance, and irregular menstrual bleeding are all possible symptoms of PCOS. PCOS may cause menstrual cycle changes; skin changes such as increased facial and body hair and acne; growths in one or both ovaries, often clumps of ovarian follicles that have stopped developing; and infertility.

What are the treatments for PCOS?

If these treatments are not successful, your health care provider may suggest in vitro fertilization (IVF), or another type of assisted reproductive technology (ART).16 IVF may offer the best chance of pregnancy for women with PCOS. Because many women don't consider oily skin, increased hair growth, or acne to be symptoms of a serious health condition, they may not mention these things to their health care providers. PCOS often includes growths resembling cysts on one or both ovaries, sporadic ovulation resulting in reduced fertility and irregular periods, and high androgen levels leading to increased body or facial hair. Because anti-androgens can cause congenital anomalies, they are often taken with oral contraceptives to prevent pregnancy.14 Be sure to talk with your health care provider about the risks of these treatments, especially if you want to become pregnant.

Oral Contraceptives

You should discuss all the options thoroughly with your health care provider before deciding.
One reproductive hormone, called estrogen, plays a role in regulating the menstrual cycle, breast health, bone development, and other important functions.7 Another such hormone, called androgen, contributes to hair growth, muscle development, sperm production (in males), and voice deepening.8
Three types feature high androgen levels and one does not.
These medications either prevent the body from making androgens or limit the activities or effects of those hormones.
PCOS is a set of symptoms—including metabolic and reproductive—related to a hormonal imbalance.
Anti-androgen medications are not FDA approved to treat PCOS but may help reduce symptoms.
You should discuss the risks and possible side effects of treatments with your health care provider.
Before beginning treatment for infertility possibly related to PCOS, work with your health care provider to rule out other causes.1

High levels of androgens can interfere with signals from the brain that control ovulation, making it occur sporadically or not at all. Women with PCOS have higher levels of androgens and may have lower levels of estrogen. Many symptoms of PCOS result from an imbalance of hormones, chemicals that control functions in the body. Although PCOS is a leading cause of infertility, many women of reproductive age with PCOS can and do get pregnant.

Ovarian Drilling

For this reason, birth control pills that contain a low-androgenic progestin that does not activate these side effects are more effective at treating the symptoms of PCOS.9 Research shows that, if a person with PCOS has overweight or obesity, losing a small amount of weight and being more physically active can minimize many PCOS symptoms and related health issues, especially cardiovascular risks.2 Please note that treatments have risks and side effects, some of them serious. Be sure you fully understand your treatment options and their effects on pregnancy before deciding on a course of treatment. In addition, the body produces more and more insulin to get glucose into the cells. Anti-Androgens

NICHD News and Features

In addition, the body produces more and more insulin to get glucose into the cells.
You can also review the treatment options for infertility related to PCOS.
Retinoids, antibacterial agents, and antibiotics are common ways to treat acne; the specific treatment recommended depends on the severity of the acne.
For this reason, birth control pills that contain a low-androgenic progestin that does not activate these side effects are more effective at treating the symptoms of PCOS.9
After 4 to 6 months of using these medications, women with PCOS who have ovaries may start ovulating naturally.12
PCOS symptoms can include menstrual irregularities, cardiovascular issues, acne, insulin resistance, and obstructive sleep apnea.
Health care providers look for two or more features—absence of ovulation, resulting in light or skipped periods; high androgen levels; and follicle growths in one or both ovaries—to diagnose PCOS.
The ovaries, testes, and adrenal glands produce reproductive hormones that are involved in regulating reproductive processes and health.

In fact, males with these genetic variants experienced cardiac and metabolic symptoms similar to those experienced by females with PCOS.2 Although PCOS usually is considered to be a condition related to the ovaries, researchers found these genetic variants in both females and males. Recent research suggests that there are 19 possible changes, or variants, in genes that can increase a person’s risk of developing PCOS.1 These variants could explain why the features and symptoms of PCOS are so different from one person to the next. The symptoms of PCOS tend to run in families, so genetics have long been a focus of PCOS research. These symptoms can include changes in metabolism, menstrual and reproductive health, and heart and blood function, as well as inflammatory responses and other outward characteristics. The authors concluded that evaluating androgen levels and other features of PCOS may allow physicians to more effectively guide PCOS patients who are trying to become pregnant. Of the 1,376 participants in both studies, 1,249 had PCOS with higher androgen levels and 127 had lower androgen levels. Three types feature high androgen levels and one does not. As a result, many women aren't diagnosed with PCOS until they have trouble getting pregnant, or until they have menstrual irregularities. Women with PCOS may experience a range of symptoms that may seem unrelated to ovaries. Symptoms can affect metabolic, cardiovascular, inflammatory, reproductive, and other aspects of health. Correlation of polycystic ovarian syndrome phenotypes with pregnancy and neonatal outcomes. In these studies, researchers treated PCOS patients trying to achieve pregnancy with drugs to induce ovulation.

Because retinoids can cause congenital anomalies, those who are or wish to become pregnant should not use the treatments.2
Because anti-androgens can cause congenital anomalies, they are often taken with oral contraceptives to prevent pregnancy.14 Be sure to talk with your health care provider about the risks of these treatments, especially if you want to become pregnant.
As a result, many women aren't diagnosed with PCOS until they have trouble getting pregnant, or until they have menstrual irregularities.
The treatments come in a variety of forms, such as pills, creams, or gels, and in different strengths; higher strength options may require a prescription.
A health care provider may consider PCOS treatments for severe symptoms even without a diagnosis of PCOS.3
Often, women and health care providers may not suspect PCOS because the symptoms may seem unrelated.
However, she and her health care providers may want to monitor her health for signs of these issues as part of her regular care.
Because PCOS has a broad range of symptoms, health care providers may use a variety of treatments for this condition and its symptoms.1

Before beginning treatment for infertility possibly related to PCOS, work with your health care provider to rule out other causes.1 Talk to your health care provider about any concerns you may have about these medications.13 However, some pills contain progestin, and some types of progestin have “androgenic” side effects, such as oily skin, acne, and increased hair growth. Because symptoms of PCOS can differ widely, researchers and health care providers focus on specific features to diagnose the condition.

Treatments for Infertility Resulting from PCOS

Retinoids, antibacterial agents, and antibiotics are common ways to treat acne; the specific treatment recommended depends on the severity of the acne. Currently, the best type of anti-androgen for treating PCOS symptoms is not known. Insulin-sensitizing medications, such as metformin, are not FDA approved to treat PCOS, but may help reduce symptoms. The authors concluded that evaluating androgen levels in PCOS patients could help physicians more effectively guide them and treat their infertility. You should discuss all the options thoroughly with your health care provider before deciding. Health care providers may also recommend one or more of the following treatments to improve fertility in women with PCOS. Anti-androgen medications are not FDA approved to treat PCOS but may help reduce symptoms. These medications either prevent the body from making androgens or limit the activities or effects of those hormones. Because some of the common treatments for PCOS symptoms can prevent pregnancy or may harm the fetus during pregnancy, it's important to discuss your fertility goals with your health care provider when discussing treatment options. One reproductive hormone, called estrogen, plays a role in regulating the menstrual cycle, breast health, bone development, and other important functions.7 Another such hormone, called androgen, contributes to hair growth, muscle development, sperm production (in males), and voice deepening.8 The treatment(s) your health care provider suggests will depend on your symptoms, overall health, and plans for pregnancy. Because PCOS has a broad range of symptoms, health care providers may use a variety of treatments for this condition and its symptoms.1 High androgen levels can also cause ovarian follicles—small, fluid-filled sacs where eggs grow and mature—to stop developing and clump together.9,10 Androgen levels also play a role in increased hair growth and acne.10