A main underlying problem with PCOS is a hormonal imbalance. In women with PCOS, the ovaries make more androgens than normal. Androgens are male hormones that females also make. High levels of these hormones affect the development and release of eggs during ovulation. Researchers also think insulin may be linked to PCOS. Insulin is a hormone that controls the change of sugar, starches, and other food into energy for the body to use or store. Many women with PCOS have too much insulin in their bodies because they have problems using it.
The ovaries, where a woman’s eggs are produced, have tiny fluid-filled sacs called follicles or cysts. As the egg grows, the follicle builds up fluid. When the egg matures, the follicle breaks open, the egg is released, and the egg travels through the fallopian tube to the uterus (womb) for fertilization. This is called ovulation. In women with PCOS, the ovary doesn't make all of the hormones it needs for an egg to fully mature. The follicles may start to grow and build up fluid but ovulation does not occur. Instead, some follicles may remain as cysts. For these reasons, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman's menstrual cycle is irregular or absent. Plus, the ovaries make male hormones, which also prevent ovulation.
More than 50 percent of women with PCOS will have diabetes or pre-diabetes (impaired glucose tolerance) before the age of 40. The risk of heart attack is 4 to 7 times higher in women with PCOS than women of the same age without PCOS. Women with PCOS are at greater risk of having high blood pressure. Women with PCOS have high levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol. Women with PCOS can develop sleep apnea. This is when breathing stops for short periods of time during sleep.
You can also have PCOS and not have cyst just the hormone imbalance. I have had several u/s and no cysts thank god. Unfortunately 50% of women with this will be overweight. Your ovaries, adrenal glands, and fat cells produce androgen. So for women that are overweight, it is really important for these women to lose weight to reduce the androgen production and possibly reduce many of the symptoms. I am overweight by 60lbs and it just piled on in a short time. I don't eat all that bad. It is extremely difficult to lose the weight once you have gained. I tried atkins for a month and only lost 5 lbs during that time. It is a catch 22 it makes it easy to gain weight but to be near optimal weight lessens the symptoms but my re said with the hormonal imbalance it will be next to impossible to lose weight. Good luck. my re gave me practically a book on this topic so if you have any other questions let me know!