A Closer Look at PCOS

Causes, Symptoms, and Diagnosis

Polycystic Ovary Syndrome is one of the most frequently diagnosed causes of infertility in women. Beyond reproductive health, PCOS can increase the likelihood of developing other serious conditions such as insulin resistance, cardiovascular disease, and metabolic syndrome. Treatment is highly individualized, depending on the range and severity of symptoms as well as a patient’s reproductive goals.

Table of Contents

When Does PCOS Typically Begin?

PCOS can begin any time after puberty, though it often becomes more noticeable in a woman’s 20s or 30s, particularly when challenges with conception arise. Certain factors may increase the likelihood of developing PCOS, including a family history of the condition and excess body weight. It is estimated that up to 15% of individuals of reproductive age may be affected by PCOS.

Recognizable Signs and Symptoms

While symptoms can vary widely, common features of PCOS may include:

  • Menstrual irregularities: Some individuals experience infrequent or absent periods, while others may encounter heavy or prolonged bleeding.

     

  • Unwanted hair growth (hirsutism): Excessive facial and body hair—particularly on the face, chest, or abdomen—is present in a majority of individuals with PCOS.

     

  • Persistent acne: Often affecting the face, chest, and back, this acne may continue into adulthood and can be resistant to standard treatments.

     

  • Weight challenges: A significant proportion of people with PCOS struggle with weight gain or obesity, which can complicate hormonal balance.

     

  • Skin changes: Darkened patches of skin in areas such as the neck, underarms, groin, or beneath the breasts (known as acanthosis nigricans) are common indicators of insulin resistance.

     

  • Multiple ovarian follicles: Enlarged ovaries with many small follicles may be observed on ultrasound, although not all people with PCOS develop cysts.

     

  • Thinning hair or hair loss: Some experience scalp hair thinning or pattern hair loss.

     

  • Skin tags: Small, benign growths of skin, commonly found around the neck or underarms.
  • Infertility: Irregular or absent ovulation can make conception difficult, making PCOS a leading cause of fertility issues.

Can PCOS Be Present Without Symptoms?

Yes. It is entirely possible for someone to have PCOS without exhibiting overt signs. Many individuals are unaware they have the condition until they encounter challenges with conception or unexpected weight gain. In some cases, symptoms may be mild and go unnoticed without clinical evaluation.

Understanding the Underlying Causes

While there is no single cause of PCOS, several interrelated factors appear to contribute:

  • Excess androgen production: Elevated levels of male hormones can interfere with ovulation, resulting in irregular cycles and other symptoms such as acne and hirsutism.

  • Insulin resistance: This common feature of PCOS results in the body’s reduced ability to respond to insulin, prompting the ovaries to produce more androgens. It may or may not lead to high blood sugar or diabetes, but it can significantly impact hormonal regulation.

  • Chronic low-grade inflammation: Studies suggest that individuals with PCOS often exhibit persistent inflammation, which may be assessed through markers like C-reactive protein (CRP) in blood tests.
  • Genetic predisposition: PCOS tends to run in families, suggesting a strong hereditary component.

Diagnosing PCOS: What to Expect

Diagnosis typically involves a combination of clinical evaluation, medical history, and diagnostic testing. A healthcare provider may:

  • Discuss current symptoms and ask about family history of reproductive or metabolic disorders

  • Perform a physical examination to assess weight, blood pressure, skin changes, and signs of excess hair growth or acne

  • Order blood tests to evaluate hormone levels and glucose metabolism

  • Conduct a pelvic ultrasound to examine ovarian structure and uterine lining

To formally diagnose PCOS, at least two of the following three criteria are usually required:

  1. Irregular or missed periods

  2. Elevated androgen levels, identified through symptoms or blood tests

  3. Ovarian enlargement or polycystic appearance on ultrasound

It’s worth noting that not everyone with PCOS develops visible ovarian cysts, and not all symptoms are always present at once.

Contact Optimum Pharmacy today to learn more about our same-day delivery services and how we can support you on your journey.

Can PCOS Affect Pregnancy or Increase Risk of Miscarriage?

Although many individuals with PCOS can conceive successfully, the condition is linked to a higher risk of certain pregnancy complications. These may include:

  • Gestational diabetes

  • Pregnancy-induced high blood pressure or preeclampsia

  • Preterm birth

  • Increased likelihood of cesarean delivery

Proper prenatal care and close medical monitoring can reduce these risks and support a healthy pregnancy.

Treatment Approaches Based on Individual Needs

Treatment plans for PCOS are tailored based on whether the individual wishes to conceive, their metabolic profile, and symptom severity.

For Non-Fertility Goals

  • Hormonal birth control (oral pills, patches, IUDs, etc.) can regulate menstrual cycles, reduce androgen symptoms, and protect the uterine lining.

  • Metformin helps manage insulin resistance and may indirectly improve menstrual regularity.

  • Anti-androgens such as spironolactone may be prescribed to address acne or hirsutism (not recommended during pregnancy).

  • Lifestyle interventions, including a balanced diet and regular exercise, are cornerstone strategies to improve insulin sensitivity and hormone balance.

For Those Seeking Pregnancy

  • Ovulation induction medications, such as Clomiphene or Letrozole, are first-line therapies to stimulate ovulation.

  • Injectable gonadotropins or IVF may be recommended if oral medications are not successful.

  • Laparoscopic ovarian drilling, a minor surgical procedure, is now rarely performed but may be considered in select cases.

Our fertility pharmacy provides same-day access to all commonly prescribed fertility medications, including oral and injectable agents, and offers full pharmacist support to ensure proper administration and monitoring.

Will PCOS Ever Go Away?

There is currently no cure for PCOS. However, symptoms can become less noticeable over time, particularly with lifestyle changes or hormonal adjustments that accompany aging. Even after menopause, some women may retain certain features of PCOS, so ongoing health monitoring remains important.

Pregnancy and PCOS: Is It Possible?

Yes, many women with PCOS go on to have healthy pregnancies. With the right treatment plan—including medication, lifestyle adjustments, and, when necessary, assisted reproductive technology such as IVF conception is often achievable. It is essential to work closely with a healthcare provider to optimize ovulation and minimize pregnancy-related risks.

Preventing and Living with PCOS

While PCOS cannot be prevented entirely, its effects can be managed through proactive health measures. Regular exercise, a balanced diet, weight management, and mental health support are vital components of long-term wellness.

If symptoms such as unwanted hair growth, acne, or mood disturbances are affecting quality of life, seeking care from a multidisciplinary team—including dermatologists, endocrinologists, and fertility specialists—can be highly beneficial.

Compassionate Support for PCOS — From Diagnosis to Daily Care

Managing PCOS is not just about medications; it’s about receiving the right support, timely access to care, and knowledgeable guidance throughout your journey. At Optimum Specialty Pharmacy, we are committed to walking alongside you—whether you’re just beginning to explore your symptoms, planning for pregnancy, or working to manage long-term health.

As the only fertility specialty pharmacy in Newmarket and one of the few in the Greater Toronto Area (GTA), we proudly provide:

  • Immediate access to fertility and hormone-related medications, including ovulation inducers, insulin-sensitizing agents, and compounded therapies

  • Same-day delivery or pickup, ensuring that time-sensitive treatments are never delayed

  • Affordable pricing and flexible options for both compounded and non-compounded medications

  • Direct billing to most extended health insurance plans to simplify the financial process

  • Expert pharmacist consultations to support understanding, safety, and confidence in your treatment

At Optimum, we understand the complexity and urgency of PCOS and fertility care. Our dedicated team is here to provide compassionate service, professional guidance, and reliable access to the treatments you need—every step of the way.

Visit us in Newmarket or contact our team today to learn how we can help you manage PCOS with confidence and clarity.

References

National Institutes of Health (NIH), Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Polycystic Ovary Syndrome (PCOS).

Centers for Disease Control and Prevention (CDC).
Polycystic Ovary Syndrome (PCOS) and Diabetes.

Cleveland Clinic.
Polycystic Ovary Syndrome (PCOS): Symptoms, Causes & Treatment.

Mayo Clinic.
Polycystic Ovary Syndrome (PCOS).

The Journal of Clinical Endocrinology & Metabolism (JCEM).
Moran, L. J., et al. (2011). Lifestyle changes in women with polycystic ovary syndrome. JCEM, 96(5), 1238–1248.

Office on Women’s Health, U.S. Department of Health & Human Services.
Polycystic Ovary Syndrome (PCOS).

Fertility Society of Australia and New Zealand (FSANZ).
PCOS and Fertility.