PCOS

Polycystic ovary syndrome or PCOS affects as many as 1 out of 15 women.

Often the symptoms begin in the teen years. Treatment can help control the symptoms and prevent long-term problems.

Polycystic ovary syndrome is a problem in which a woman’s hormones are out of balance. It can cause problems with your periods and make it difficult to get pregnant. PCOS may also cause unwanted changes in the way you look. If it is not treated, over time it can lead to serious health problems, such as diabetes and heart disease.

About Polycystic Ovary Syndrome or PCOS

Women who have Polycystic Ovary Syndrome (PCOS) usually have a normal uterus and fallopian tubes. However, these women have ovaries which contain several small cysts measuring approximately 8 mm in size. These cysts can usually be detected with the use of an ultrasound. These small cysts do not require surgical removal, and are not associated with an increased risk of ovarian cancer. The cause of PCOS is not known. There may be dysregulation of the pituitary hormones LH and FSH that usually work together to stimulate ovulation. There may be an abnormality of hormone signaling in the ovaries. The end result is the development of small, abnormally functioning immature follicles that do no develop fully and ovulate.

As a result of abnormal pituitary function, the levels of LH and FSH are not regulated, and a mature egg cannot completely develop. Because of this, the ovulatory process is not completed and the partially stimulated follicle forms a cyst.

Symptoms of PCOS include:

Irregular menstruation: The constant production of estrogen causes the endometrium to become abnormally thick and to be shed spontaneously. This coupled with irregular or absent ovulation causes intermittent bouts of amenorrhea or periods of heavy bleeding.

  • Fertility Problems: Irregular or absent ovulation means that pregnancy is difficult or impossible to achieve.
  • Miscarriage: Women who have PCOS have a higher rate of miscarriage due to elevated levels of LH.
  • Excess Hair Growth and Acne: Women who have PCOS, often have excessive testosterone production which contributes to increased hair growth and acne.
  • Obesity: About one-half of all women with PCOS are obese. Obesity tends to increase abnormal estrogen and androgen production which in turn increases problems with hair growth and irregular bleeding.
  • Abnormal Insulin Action: Women with PCOS have more resistance to the action of insulin than normal women and are at a greater risk of developing diabetes.
  • Cardiovascular Disease: PCOS patients may have several factors including increased weight, abnormal androgen production, abnormal cholesterol function that contribute to cardiovascular disease.
  • Diabetes: Sensitivity to insulin is sometimes abnormal in women with PCOS. In addition, their increased weight can contribute to diabetes.
  • Patients seeking pregnancy with PCOS are normally treated with ovulation inducing drugs such as clomiphene or in some case gonadotropin preparations.