What Is PCOS?

Polycystic Ovary Syndrome, or PCOS is one of the most common hormonal endocrine disorders in women of reproductive age. The name of the condition comes from the appearance of the ovaries in most women with the disorder. Typically the ovaries are enlarged and contain numerous small cysts. Sometimes they will appear along the outer edge of each ovary in a spiral pattern called a "string of pearls" Often times, the hormonal imbalance prevents the ovaries from growing mature follicles. follicles would normally mature and release an egg during ovulation. When the follicles fail to grow they can form small cysts instead. Most of the cysts are pain free and cause no other issues. However, there are types of cysts that develope that can grow to be quiet large and cause severe pain. Not all women with PCOS will have these persistent cysts.

Doctors don't know the cause of polycystic ovary syndrome, but these factors likely play a role:

• Excess insulin. Insulin is the hormone produced in the pancreas that allows cells to use sugar (glucose) — your body's primary energy supply. If you have insulin resistance, your ability to use insulin effectively is impaired, and your pancreas has to secrete more insulin to make glucose available to cells. The excess insulin might boost androgen production by your ovaries.
• Low-grade inflammation. Your body's white blood cells produce substances to fight infection in a response called inflammation. Eating certain foods can trigger an inflammatory response in some predisposed people. When this happens, white blood cells produce substances that can lead to insulin resistance and cholesterol accumulation in blood vessels (atherosclerosis). Atherosclerosis causes cardiovascular disease. Research has shown that women with PCOS have low-grade inflammation.
• Heredity. If your mother or sister has PCOS, you might have a greater chance of having it, too. Researchers also are looking into the possibility that mutated genes are linked to PCOS.
• Abnormal fetal development. Some research shows that excessive exposure to male hormones (androgens) in fetal life may permanently prevent normal genes from working the way they're supposed to — a process known as gene expression. This may promote a male pattern of abdominal fat distribution, which increases the risk of insulin resistance and low-grade inflammation. Researchers continue to investigate to what extent these factors might contribute to PCOS.

Having polycystic ovary syndrome makes the following conditions more likely, especially if obesity also is a factor:

• Type 2 diabetes
• High blood pressure
• Cholesterol and lipid abnormalities, such as elevated triglycerides or low high-density lipoprotein (HDL) cholesterol, the "good" cholesterol
• Elevated levels of C-reactive protein, a cardiovascular disease marker
• Metabolic syndrome, a cluster of signs and symptoms that indicate a significantly increased risk of cardiovascular disease
• Nonalcoholic steatohepatitis, a severe liver inflammation caused by fat accumulation in the liver
• Sleep apnea
• Abnormal uterine bleeding
• Cancer of the uterine lining (endometrial cancer), caused by exposure to continuous high levels of estrogen
• Gestational diabetes or pregnancy-induced high blood pressure, if you do become pregnant

There's no specific test to definitively diagnose polycystic ovary syndrome. The diagnosis is one of exclusion, which means your doctor considers all of your signs and symptoms and then rules out other possible disorders.
During this process, your doctor takes many factors into account:

• Medical history. Your doctor may ask questions about your menstrual periods, weight changes and other symptoms.
• Physical examination. During your physical exam, your doctor will note several key pieces of information, including your height, weight and blood pressure.
• Pelvic examination. During a pelvic exam, your doctor visually and manually inspects your reproductive organs for signs of masses, growths or other abnormalities.
• Blood tests. Your blood may be drawn to measure the levels of several hormones to exclude possible causes of menstrual abnormalities or androgen excess that mimic PCOS. Additional blood testing may include fasting cholesterol and triglyceride levels and a glucose tolerance test, in which glucose levels are measured while fasting and after drinking a glucose-containing beverage.
• Pelvic ultrasound. A pelvic ultrasound can show the appearance of your ovaries and the thickness of the lining of your uterus. During the test, you lie on a bed or examining table while a wand-like device (transducer) is placed in your vagina (transvaginal ultrasound). The transducer emits inaudible sound waves that are translated into images on a computer screen.

The symptoms of PCOS can vary from woman to woman. Some of the symptoms of PCOS include:

• Infertility because of not ovulating. In fact, PCOS is the most common cause of female infertility.
• Infrequent, absent, and/or irregular menstrual periods
• Hirsutism— increased hair growth on the face, chest, stomach, back, thumbs, or toes
• Cysts on the ovaries
• Acne, oily skin, or dandruff
• Weight gain or obesity, usually with extra weight around the waist
• Male-pattern baldness or thinning hair
• Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black
• Skin tags — excess flaps of skin in the armpits or neck area
• Pelvic pain
• Anxiety or depression
• Sleep apnea — when breathing stops for short periods of time while asleep  

Treatment for PCOS varies from patient to patient and often times treats a specific symptom. Birth Control Pills can help to regulate cycles in women who are not trying to conceive. Metformin and other diabetes medications can help with issues caused by insulin resistance. Various fertility medications can induce ovulation in women who are hoping to get pregnant. There are also medications to treat hirsutism that may be prescribed by your doctor. Depression or anxiety medications may be needed as well as treatments for sleep apnea. Losing weight is often suggested as a way to help minimize the symptoms of PCOS and reduce the risk of diabetes and heart disease.

some information gathered from:
http://women.webmd.com/tc/polycystic-ovary-syndrome-pcos-topic-overview 
http://www.mayoclinic.com/health/polycystic-ovary-syndrome/DS00423