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What is PCOS and What Causes it?

Polycystic Ovarian Syndrome (PCOS) is a common hormonal disorder affecting one in ten women of childbearing age. It is caused by a hormone imbalance that creates problems in the ovaries and can involve the development of cysts (fluid-filled sacs) in the ovaries. Women with PCOS can experience a wide range of symptoms varying in severity, making the syndrome somewhat difficult to manage. While the cause of PCOS is unknown, there are numerous treatments and therapies to help ease the symptoms and side effects of the disorder.

pcos honu 1 Honu Women's Health OB / GYN & Aesthetics Physician - Honolulu Hawaii
pcos Honu Women's Health OB / GYN & Aesthetics Physician - Honolulu Hawaii

Our Philosophy on PCOS Therapy

 PCOS is different for every woman. Some women may experience the entire spectrum of PCOS symptoms including acne, weight gain, body or facial hair growth and irregular periods, while other women may experience less extreme symptoms which cumulatively add up to a PCOS diagnosis. The good news about PCOS is that since it is a hormonal disorder, it can be treated effectively in most cases by balancing hormones. Our board-certified OBGYN, Dr. Aya Sultan, has an in-depth understanding of how the body synthesizes foods, medications, stress and other lifestyle factors that can drive hormone imbalances. Therefore, at Honu Women’s Health, PCOS treatment begins with nutrition optimization and weight loss for many patients.


Even when combined with other therapies, nutrition is an important facet of PCOS management. For example, insulin is a hormone that controls how the food you eat is changed into energy. Many women with PCOS have insulin resistance, especially if they are overweight, eat unhealthily or do not get enough exercise. As a result, insulin levels become higher than normal and exacerbate the symptoms of PCOS, such as heavy menstrual bleeding. With nutrition coaching and in some cases, a prescription to reduce insulin levels, Dr. Sultan can help many women get their PCOS symptoms under control.

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 Common Symptoms and Side-Effects of PCOS

 PCOS is different for every woman. Some women may live their entire childbearing years with PCOS and hardly feel its effects, while others may experience severe pain or even infertility due to PCOS. The most common symptoms of PCOS include:

Irregular or Absent Menstrual Cycles

Women with PCOS may miss periods or have fewer periods in a year. Or, their periods may come every 21 days or more often. Some women with PCOS stop having periods altogether.

Hirsutism (Unwanted Male-Pattern Hair Growth)

Unwanted growth of dark or coarse hair on the face, chin or parts of the body where men usually have hair is a common side effect of PCOS.


The face, chest and upper back can break out routinely if you have PCOS.

Thinning Hair

Hair loss on the scalp, oftentimes as male-pattern baldness, can occur with PCOS.

Weight Gain or Difficulty Losing Weight

Women with PCOS may experience unexplainable weight gain or inability to lose weight with diet and exercise.

Darkening of the Skin

This most commonly occurs along neck creases, in the groin and underneath the breasts in women with PCOS.

Skin Tags

These usually form in areas where there are excess flaps of skin, such as the armpits or neck area.

Treatments for Specific Symptoms of PCOS

Hormones, Nutrition and Exercise

The standard treatment for PCOS starts with hormone therapy, usually to reduce testosterone levels, but also to bring back in balance your estrogen and progesterone levels. Other medications may also be recommended depending on each individual patient. Dr. Sultan will obtain a comprehensive history from you to determine the right treatment strategy that addresses your specific needs. Beyond medication, Dr. Sultan will discuss lifestyle changes, including healthier eating and exercise to help naturally balance hormones and decrease some of the severe symptoms of PCOS.

Laser Hair Reduction

In addition to addressing PCOS with hormone therapy to reduce elevated testosterone levels and lifestyle changes such as healthier eating and increased exercise to naturally balance hormones, individual symptoms can also be targeted with specific treatments. For example, women dealing with unwanted hair growth can benefit from laser hair reduction treatments. Instead of constantly plucking, shaving or waxing the unwanted hair occurring as a side-effect of PCOS, laser hair reduction can help you look and feel your best. At Honu Women’s Health, your laser treatment will be personally conducted by Dr. Sultan, who is extremely experienced in laser hair reduction and has attended numerous trainings on the best strategies for this type of treatment.

Platelet Rich Plasma

Women who are experiencing thinning hair of the scalp as a symptom of PCOS may benefit from Platelet Rich Plasma (PRP). In this type of treatment, Dr. Sultan will inject your body’s own blood plasma, which is rich in growth factors, into the scalp to signal hair follicles to function. This prolongs the growing phase of the hair cycle and helps to promote hair growth. PRP for hair restoration is an excellent supplement to other measures that can be taken to promote hair growth.


Acne, as a symptom of PCOS, can also be treated in our office with a combination of Dermalinfusion that is specifically tailored to fight acne and a skincare cream at-home regimen. In addition to cleaning out pores that can become clogged due to overactive oil production from PCOS, these treatments infuse serums specifically tailored for acne-prone skin deep within the skin to help stop and prevent acne from developing. Honu Women’s Health also carries a variety of cosmeceutical/medical-grade products in our office to help reverse.

If PCOS is interfering with your quality of life, schedule a consultation with Dr. Sultan today. During your visit, you can learn more about our approach to treating PCOS and our options for reversing or lessening its side effects.