Sushrutha Sridhar, an endocrinology fellow at Penn State College of Medicine, began noticing unusual symptoms during medical school in 2018. At 27, she experienced irregular periods, unwanted facial hair, and weight gain.
An ultrasound confirmed she had polycystic ovarian syndrome (PCOS), a common hormone disorder affecting more than 5 million women in the U.S.
PCOS is often misunderstood as simply having ovarian cysts. However, Richard Legro, chair of Obstetrics and Gynecology at Penn State Health, explains that the name can be misleading.
Women with PCOS often do not ovulate regularly, so the small follicles in their ovaries do not develop into cysts. The condition involves the ovaries but is not limited to them.
The symptoms of PCOS vary. Stephanie Estes, a reproductive endocrinologist at Penn State, says diagnosis is based on irregular menstrual cycles, excess hair growth or acne, and sometimes the appearance of the ovaries on ultrasound.
The disorder also causes excess androgens—male hormones like testosterone—that lead to acne, facial hair growth, and hair thinning on the scalp. These hormone imbalances make ovulation irregular, which can cause fertility problems.
PCOS often runs in families, though research has yet to confirm it as hereditary. Women can be diagnosed as early as two years after their first period, but diagnosis is more common in their 20s or 30s when they try to conceive. Many women are initially told their irregular periods are normal and are prescribed birth control without further hormone testing. Penn State Health focuses on early diagnosis to avoid delayed care.
Treatment usually starts with hormone management. Birth control pills help balance hormones by reducing androgen levels and regulating menstrual cycles. Progesterone in the pills also lowers the risk of uterine cancer. Exercise and weight loss are recommended to improve symptoms and overall health.
Sridhar tried Metformin, a diabetes drug often used for PCOS, but stopped due to side effects. Despite efforts, her weight remained stable. Later, she discovered she also had precancerous uterine lesions. With the help of specialists Legro and Estes, she began treatment with GLP-1 agonists, a medication for type 2 diabetes and obesity, which helped her lose over 60 pounds and improved both her PCOS and uterine condition.
Legro emphasizes that while weight loss can improve PCOS symptoms and treatment response, PCOS is not caused by weight alone. Weight loss supports reproductive and metabolic health and enhances medication effectiveness.
Researchers at Penn State are exploring new treatments. Estes leads the REBALANCE Study, testing a less invasive ovarian ablation method to trigger ovulation, which could reduce risks and recovery time compared to current surgery. Legro is studying inositol supplements, which may lower insulin resistance like Metformin, though more research is needed to confirm benefits.
PCOS is a complex but manageable condition. Awareness, early diagnosis, and tailored treatments can help women control symptoms and improve fertility and health outcomes.
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