pco

Polycystic ovary syndrome (PCOS) happens when a woman's ovaries or adrenal glands produce more male hormones than normal. PCOS causes cysts (fluid-filled sacs) to grow on the ovaries. Symptoms include:

• Irregular menstrual periods
• Infertility
• Pelvic pain
• Excess hair growth on the face, chest, stomach, or thighs
• Weight gain
• Acne or oily skin
• Patches of thickened skin

Women with PCOS are at higher risk of diabetes, metabolic syndrome, heart disease, and high blood pressure.

PCOS is more common in women who have obesity or have a mother or sister with PCOS. To diagnose PCOS, your health care provider may do a physical exam, pelvic exam, blood tests, and an ultrasound.

There is no cure, but diet, exercise, and medicines can help control the symptoms. Birth control pills help women have normal periods, reduce male hormone levels, and clear acne. Treatments for infertility caused by PCOS may include medicines, surgery, and in vitro fertilization (IVF).

NIH: National Institute of Child Health and Human Development

Infertility means not being able to get pregnant after at least one year of trying (or 6 months if the woman is over age 35). If a woman keeps having miscarriages, it is also called infertility. Female infertility can result from age, physical problems, hormone problems, and lifestyle or environmental factors.

Most cases of infertility in women result from problems with producing eggs. In primary ovarian insufficiency, the ovaries stop functioning before natural menopause. In polycystic ovary syndrome (PCOS), the ovaries may not release an egg regularly or they may not release a healthy egg.

About a third of the time, infertility is because of a problem with the woman. One third of the time, it is a problem with the man. Sometimes no cause can be found.

If you think you might be infertile, see your doctor. There are tests that may tell if you have fertility problems. When it is possible to find the cause, treatments may include medicines, surgery, or assisted reproductive technologies. Happily, many couples treated for infertility are able to have babies.

Dept. of Health and Human Services Office on Women's Health

The ovaries are part of the female reproductive system. They produce a woman's eggs and make female hormones. Ovarian cysts are fluid-filled sacs in or on an ovary. They usually form during ovulation, when the ovary releases an egg. They are usually harmless and go away by themselves. Most women have them sometime during their lives.

Most ovarian cysts are small and don't cause symptoms. Women may not find out that they have them until they have a pelvic exam. If there are symptoms, they may include:

• Pressure
• Bloating
• Swelling
• Pain in the lower abdomen, on the side where the cyst is

If your health care provider finds a cyst, you may be able to wait to see if it gets bigger. You may need surgery if you have pain, are past menopause, or if the cyst does not go away. If a cyst bursts or causes bleeding, you should get medical help right away. Birth control pills can help prevent new cysts.

Rarely, ovarian cysts can become cancerous. This risk increases as you get older.

A health problem that involves ovarian cysts is polycystic ovary syndrome (PCOS). Women with PCOS can have high levels of male hormones, irregular or no periods, and small ovarian cysts.

Dept. of Health and Human Services Office on Women's Health

Type 2 diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your main source of energy. It comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy. If you have diabetes, your body doesn't make enough insulin or doesn't use insulin well. The glucose then stays in your blood and not enough goes into your cells.

Over time, having too much glucose in your blood can cause health problems. But you can take steps to manage your diabetes and try to prevent these health problems.

Type 2 diabetes may be caused by a combination of factors:

• Being overweight or having obesity
• Not being physically active
• Genetics and family history

Type 2 diabetes usually starts with insulin resistance. This is a condition in which your cells don't respond normally to insulin. As a result, your body needs more insulin to help the glucose enter your cells. At first, your body makes more insulin to try to get cells to respond. But over time, your body can't make enough insulin, and your blood glucose levels rise.

You are at higher risk of developing type 2 diabetes if you:

• Are over age 45. Children, teenagers, and younger adults can get type 2 diabetes, but it is more common in middle-aged and older people.
• Have prediabetes, which means that your blood sugar is higher than normal but not high enough to be called diabetes
• Had diabetes in pregnancy or gave birth to a baby weighing 9 pounds or more.
• Have a family history of diabetes
• Are overweight or have obesity
• Are Black or African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander
• Are not physically active
• Have other conditions such as high blood pressure, heart disease, stroke, polycystic ovary syndrome (PCOS), or depression
• Have low HDL (good) cholesterol and high triglycerides
• Have acanthosis nigricans - dark, thick, and velvety skin around your neck or armpits

Many people with type 2 diabetes have no symptoms at all. If you do have them, the symptoms develop slowly over several years. They might be so mild that you do not notice them. The symptoms can include:

• Increased thirst and urination
• Increased hunger
• Feeling tired
• Blurred vision
• Numbness or tingling in the feet or hands
• Sores that do not heal
• Unexplained weight loss

Your health care provider will use blood tests to diagnose type 2 diabetes. The blood tests include:

• A1C test, which measures your average blood sugar level over the past 3 months
• Fasting plasma glucose (FPG) test, which measures your current blood sugar level. You need to fast (not eat or drink anything except water) for at least 8 hours before the test.
• Random plasma glucose (RPG) test, which measures your current blood sugar level. This test is used when you have diabetes symptoms and the provider does not want to wait for you to fast before having the test.

Treatment for type 2 diabetes involves managing your blood sugar levels. Many people are able to do this by living a healthy lifestyle. Some people may also need to take medicine.:

• A healthy lifestyle includes following a healthy eating plan and getting regular physical activity. You need to learn how to balance what you eat and drink with physical activity and diabetes medicine, if you take any.
• Medicines for diabetes include oral medicines, insulin, and other injectable medicines. Over time, some people will need to take more than one type of medicine to control their diabetes.
• You will need to check your blood sugar regularly. Your health care provider will tell you how often you need to do it.
• It's also important to keep your blood pressure and cholesterol levels close to the targets your provider sets for you. Make sure to get your screening tests regularly.

You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. If you have a condition which raises your risk for type 2 diabetes, managing that condition may lower your risk of getting type 2 diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Every pregnancy has some risk of problems, but there are certain conditions and health issues that can raise that risk, such as:

• A health condition you had before you got pregnant
• A health condition you develop during pregnancy
• A pregnancy with more than one baby
• A health problem that happened during a previous pregnancy and could happen again
• Substance use during pregnancy
• Being over age 35

Any of these can affect your health, the health of your baby, or both.

If you have a chronic condition, you should talk to your health care provider about how to minimize your risk before you get pregnant. Once you are pregnant, you may need a health care team to monitor your pregnancy. Some common conditions that can complicate a pregnancy include:

• High blood pressure
• Kidney problems
• Autoimmune diseases
• Obesity
• HIV
• Cancer
• Infections

Other conditions that may make pregnancy risky can develop during pregnancy - for example, gestational diabetes and Rh incompatibility. Good prenatal care can help detect and treat them.

Some symptoms, such as nausea, back pain, and fatigue, are common during pregnancy. Sometimes it is hard to know what is normal. Call your health care provider if something is bothering or worrying you.

If you have diabetes, your blood sugar levels are too high. With type 2 diabetes, this happens because your body does not make enough insulin, or it does not use insulin well (this is called insulin resistance). If you are at risk for type 2 diabetes, you might be able to prevent or delay developing it.

Many Americans are at risk for type 2 diabetes. Your chances of getting it depend on a combination of risk factors such as your genes and lifestyle. The risk factors include:

• Having prediabetes, which means you have blood sugar levels that are higher than normal but not high enough to be called diabetes
• Being overweight or having obesity
• Being age 45 or older
• A family history of diabetes
• Being African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander
• Having high blood pressure
• Having a low level of HDL (good) cholesterol or a high level of triglycerides
• A history of diabetes in pregnancy
• Having given birth to a baby weighing 9 pounds or more
• An inactive lifestyle
• A history of heart disease or stroke
• Having depression
• Having polycystic ovary syndrome (PCOS)
• Having acanthosis nigricans, a skin condition in which your skin becomes dark and thick, especially around your neck or armpits
• Smoking

If you are at risk for diabetes, you may be able to prevent or delay getting it. Most of the things that you need to do involve having a healthier lifestyle. So if you make these changes, you will get other health benefits as well. You may lower your risk of other diseases, and you will probably feel better and have more energy. The changes are:

• Losing weight and keeping it off.Weight control is an important part of diabetes prevention. You may be able to prevent or delay diabetes by losing 5 to 10% of your current weight. For example, if you weigh 200 pounds, your goal would be to lose between 10 to 20 pounds. And once you lose the weight, it is important that you don't gain it back.
• Following a healthy eating plan. It is important to reduce the amount of calories you eat and drink each day, so you can lose weight and keep it off. To do that, your diet should include smaller portions and less fat and sugar. You should also eat a variety of foods from each food group, including plenty of whole grains, fruits, and vegetables. It's also a good idea to limit red meat, and avoid processed meats.
• Get regular exercise. Exercise has many health benefits, including helping you to lose weight and lower your blood sugar levels. These both lower your risk of type 2 diabetes. Try to get at least 30 minutes of physical activity 5 days a week. If you have not been active, talk with your health care professional to figure out which types of exercise are best for you. You can start slowly and work up to your goal.
• Don't smoke. Smoking can contribute to insulin resistance, which can lead to type 2 diabetes. If you already smoke, try to quit.
• Talk to your health care provider to see whether there is anything else you can do to delay or to prevent type 2 diabetes. If you are at high risk, your provider may suggest that you take one of a few types of diabetes medicines.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Metabolic syndrome is the name for a group of risk factors for heart disease, diabetes, and other health problems. You can have just one risk factor, but people often have several of them together. When you have at least three of them, it is called metabolic syndrome. These risk factors include:

• A large waistline, also called abdominal obesity or "having an apple shape." Too much fat around the stomach is a greater risk factor for heart disease than too much fat in other parts of the body.
• Having a high triglyceride level. Triglycerides are a type of fat found in the blood.
• Having a low HDL cholesterol level. HDL is sometimes called the "good" cholesterol because it helps remove cholesterol from your arteries.
• Having high blood pressure. If your blood pressure stays high over time, it can damage your heart and lead to other health problems.
• Having a high fasting blood sugar. Mildly high blood sugar may be an early sign of diabetes.

The more factors you have, the higher your risk for heart disease, diabetes, and stroke is.

Metabolic syndrome has several causes that act together:

• Overweight and obesity
• An inactive lifestyle
• Insulin resistance, a condition in which the body can't use insulin properly. Insulin is a hormone that helps move blood sugar into your cells to give them energy. Insulin resistance can lead to high blood sugar levels.
• Age - your risk goes up as get older
• Genetics - ethnicity and family history

People who have metabolic syndrome often also have excessive blood clotting and inflammation throughout the body. Researchers don't know whether these conditions cause metabolic syndrome or worsen it.

The most important risk factors for metabolic syndrome are:

• Abdominal obesity (a large waistline)
• An inactive lifestyle
• Insulin resistance

There are certain groups of people who have an increased risk of metabolic syndrome:

• Some racial and ethnic groups. Mexican Americans have the highest rate of metabolic syndrome, followed by whites and blacks.
• People who have diabetes
• People who have a sibling or parent who has diabetes
• Women with polycystic ovary syndrome (PCOS)
• People who take medicines that cause weight gain or changes in blood pressure, blood cholesterol, and blood sugar levels

Most of the metabolic risk factors have no obvious signs or symptoms, except for a large waistline.

Your health care provider will diagnose metabolic syndrome based on the results of a physical exam and blood tests. You must have at least three of the risk factors to be diagnosed with metabolic syndrome:

• A large waistline, which means a waist measurement of
  • 35 inches or more for women
  • 40 inches or more for men
• A high triglyceride level, which is 150 mg/dL or higher
• A low HDL cholesterol level, which is
  • Less than 50 mg/dL for women
  • Less than 40 mg/dL for men
• High blood pressure, which is a reading of 130/85 mmHg or higher.
• A high fasting blood sugar, which is 100 mg/dL or higher

The most important treatment for metabolic syndrome is a heart-healthy lifestyle, which includes:

• A heart-healthy eating plan, which limits the amount of saturated and trans fats that you eat. It encourages you to choose a variety of nutritious foods, including fruits, vegetables, whole grains, and lean meats.
• Aiming for a healthy weight
• Managing stress
• Getting regular physical activity
• Quitting smoking (or not starting if you don't already smoke)

If making lifestyle changes is not enough, you may need to take medicines. For example, you may need medicines to lower cholesterol or blood pressure.

The best way to prevent metabolic syndrome is through the heart-healthy lifestyle changes.

NIH: National Heart, Lung, and Blood Institute

Prediabetes means that your blood glucose, or blood sugar, levels are higher than normal but not high enough to be called diabetes. Glucose comes from the foods you eat. Too much glucose in your blood can damage your body over time.

If you have prediabetes, you are more likely to develop type 2 diabetes, heart disease, and stroke. But if you make some lifestyle changes now, you may be able to delay or prevent type 2 diabetes.

Prediabetes usually happens when your body has a problem with insulin. Insulin is a hormone that helps the glucose get into your cells to give them energy. A problem with insulin could be:

• Insulin resistance, a condition in which the body can't use its insulin properly. It makes it hard for your cells to get glucose from your blood. This can cause your blood sugar levels to rise.
• Your body can't make enough insulin to keep your blood sugar levels at a healthy level

Researchers think that being overweight and not getting regular physical activity are major factors in causing prediabetes.

About 1 out of every 3 adults has prediabetes. It is more common in people who:

• Are overweight or have obesity
• Are age 45 or older
• Have a parent, brother, or sister with diabetes
• Are African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander American
• Are not physically active
• Have health conditions such as high blood pressure and high cholesterol
• Have had gestational diabetes (diabetes in pregnancy)
• Have a history of heart disease or stroke
• Have metabolic syndrome
• Have polycystic ovary syndrome (PCOS)

Most people don't know they have prediabetes because usually there are no symptoms.

Some people with prediabetes may have darkened skin in the armpit or on the back and sides of the neck. They may also have many small skin growths in those same areas.

There are a few different blood tests that can diagnose prediabetes. The most common ones are:

• Fasting plasma glucose (FPG) test, which measures your blood sugar at a single point in time. You need to fast (not eat or drink) for at least 8 hours before the test. The results of the test are given in mg/dL (milligrams per deciliter):
  • A normal level is 99 or below
  • Prediabetes is 100 to 125
  • Type 2 diabetes is 126 and above
• A1C test, which measures your average blood sugar over the past 3 months. The results of an A1C test are given as a percentage. The higher the percentage, the higher your blood sugar levels have been.
  • A normal level is below 5.7%
  • Prediabetes is between 5.7 to 6.4%
  • Type 2 diabetes is above 6.5%

If you have prediabetes, you may be able to delay or prevent type 2 diabetes through lifestyle changes:

• Losing weight, if you are overweight
• Getting regular physical activity
• Following a healthy, reduced-calorie eating plan

In some cases, your health care provider may also recommend taking diabetes medicines.

If you are at risk for prediabetes, those same lifestyle changes (losing weight, regular physical activity, and a healthy eating plan) may prevent you from getting it.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

If you are struggling with your weight, you are not alone. In the United States, more than 70 percent of adults are overweight or have obesity. Having this extra weight raises your risk for many health conditions, such as type 2 diabetes, heart disease, kidney disease, and certain cancers.

Reaching and staying at a healthy weight can be challenging. But a having a healthy lifestyle, including healthy eating patterns and regular physical activity, can help you lose weight. It can also lower your chance of developing weight-related health conditions.

You gain weight when you take in more calories (through food and drinks) than you use up from physical activity and daily living. But there are many different factors that can affect weight gain, such as:

• The world around you. Your home, community, and workplace all may affect how you make daily lifestyle choices. For example:
  • It is often easier to find food and beverages high in calories, sugar, and fat. For instance, vending machines, cafeterias, and special events may not offer healthy, lower calorie options.
  • Less healthy foods may be cheaper than healthier foods.
  • Many people are getting less physical activity because they are spending more time using smartphones and other devices.
• Families. Overweight and obesity tend to run in families. Overweight and obesity tend to run in families. This suggests that genes may play a role in weight gain. Families may also share eating and lifestyle habits. For example, some families may often have foods and drinks that are high in calories, sugar, and fat. And some families may tend to be less active and spend more time doing things like sitting and watching TV or using computers.
• Not enough sleep. People who don't get enough sleep may eat more calories and snack more.
• Emotions. Some people eat when they feel bored, sad, or stressed, even if they are not hungry.
• Medicines and health conditions. Taking certain medicines, such as steroids and certain antidepressants, can lead to weight gain. Some chronic health problems can also cause you to gain weight. A few examples are Cushing's syndrome and polycystic ovary syndrome (PCOS).

Getting to and staying at a healthy weight involves finding a balance of food and activity. To lose weight, you need to take in fewer calories than you use up. Some ways to do this are:

• Eating more nutrient-rich foods, such as foods with lots of vitamins, minerals, and fiber.
• Eating and drinking less of the foods and beverages that have lots of calories, salt, sugar, and fat.
• Limiting alcohol.
• Finding healthier ways to cook, such as using healthier oils to cook with and baking or grilling instead of frying foods.
• Getting more physical activity. The general recommendation is for adults to get 150 minutes of physical activity each week, including:
  • Aerobic activity, which is also called cardio. It uses your large muscle groups (chest, legs, and back) to speed up your heart rate and breathing.
  • Muscle-strengthening activity, which is also called strength training. It works your muscles by making you push or pull against something.

You may decide to do these lifestyle changes on your own, or you may decide to try a weight-loss diet or program. Before you start, it's important to check with your health care provider first. Your provider can tell you what a healthy weight is for you, help you set goals, and give you tips on how to lose weight.

If making lifestyle changes or doing a weight-loss program are not enough to help you lose weight, your provider may prescribe medicines. The prescription medicines to treat overweight and obesity work in different ways. Some may help you feel less hungry or full sooner. Others may make it harder for your body to absorb fat from the foods you eat.

Another treatment is weight loss surgery. Your provider may recommend the surgery if you have severe obesity or serious obesity-related health problems and you have not been able to lose enough weight.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases