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Jun 15, 2006
Polycystic ovary syndrome (PCOS)
by SirGan
 Polycystic ovary syndrome (PCOS) is a hormone imbalance that can cause irregular periods, unwanted hair growth, and acne. Is also known as Stein-Leventhal Syndrome or Polycystic Ovary Disease. It usually begins during the teenage years and can be mild or severe. Polycystic ovary syndrome is a health problem that can affect a woman's hormone levels, periods, and ovulation. This can affect fertility and pregnancy. It can also cause male-type body changes. The name comes from the fact that the ovaries of women with this syndrome are large and studded with numerous cysts. These cysts are follicles, fluid-filled sacs that contain immature eggs. It has been identified for 75 years and they still aren't sure what causes it. Incidence of the conditionAn estimated five to 10 percent of women of childbearing age have PCOS. Polycystic ovary syndrome is considered the most common hormonal disorder among women of reproductive age in the United States, affecting an estimated 5 percent to 10 percent.
Signs and symptoms of PCOSThe fact is that symptoms of PCOS can vary from women to women but experts are saying that, to diagnose a woman with PCOS, she should have at least two of the following indications:
The fact is that this is definitely the most common symptom in PCOS. What exactly is irregular menstruation? Well, it means having menstrual cycles that occur at intervals longer than 35 days or fewer than eight times a year.
This is also a very common symptom! It is well known that elevated levels of male hormones may result in physical signs such as long hair on face, chest, lower abdomen, back, upper arms or upper legs, acne and male-pattern baldness.
It is proven that one of the hormonal abnormalities in PCOS, a raised level of luteinizing hormone, seems to be linked with miscarriage. Women with raised LH have a higher miscarriage rate compared with those who have normal LH values.
This symptom is usually detected with ultrasound. However, it is important to understand that not all women have polycystic ovary syndrome if they have ovaries with multiple cysts. Sometimes even woman with PCOS may have ovaries that appear normal.
It is a fact that many women with polycystic ovary syndrome are obese.
Other possible conditions associated with polycystic ovary syndrome are:
Normal physiology of ovariesWoman’s reproductive cycles is a very complex process! Although this is not a completely understood, there are some things that are certain! The main parts of the woman's reproductive cycle process is regulated by fluctuating levels of hormones produced by the two organs:
What happens in PCOS?Several researches done in the past have came to the fact that, in PCOS, some of the follicles remain immature, never growing to full development or ovulating to produce an egg capable of being fertilized. The outcome is predictable- for the woman this means that she rarely ovulates and so is less fertile. She also does not have regular periods and may go for many weeks without a period. Other features of the condition are excess weight and excess body hair. In polycystic ovary syndrome, female body produces an excess of androgens, and ratio of LH to FSH is often abnormally high. The process of ovaries releasing eggs occurs less frequently than normal, or the ovaries don't release eggs at all. In the absence of ovulation, the menstrual cycle is irregular or absent.
Possible cause of PCOS
Doctors don't know the cause of polycystic ovary syndrome, but research suggests a link to excess insulin. Insulin is the hormone produced in the pancreas that allows cells to use sugars, body's primary energy supply. Although the mechanisms are still unknown - excess insulin is thought to boost androgen production by ovaries.
Studies also indicate that genetic factors may play a role in this syndrome. While it is not known if women are born with this condition, this syndrome seems to run in families. Interestingly, when PCOS is passed down the man's side of the family, the men are not infertile, but they do have a tendency to become bald early in life, before the age of 30.
Women are also more at risk if they are overweight. Maintaining weight or body mass index below a critical point is probably very important to determine whether some women develop the symptoms and physical features of the condition.
Diagnosis of polycystic ovary syndromeThere are several diagnostic tools to diagnose a PCOS! Doctors should evaluate patient for reproductive, hormonal and cardiovascular disorders.
Other tests may include:
Patient’s blood may be drawn for laboratory tests to measure levels of some hormones such as testosterone, DHEA and androstenedione, LH, FSH, progesterone, Prolactin, and thyroid-stimulating hormone (TSH).
Doctors usually request a pelvic ultrasound to check patient’s ovaries and the thickness of the lining of your uterus.
Differential diagnosisExperts have found out that several other disorders can cause signs and symptoms similar to those of polycystic ovary syndrome:
In this condition, woman body produces too little thyroid hormone, which can lead to an absence of menstruation – condition called amenorrhea.
This condition causes woman’s pituitary gland to produce too much Prolactin, a hormone that stimulates the production of breast milk and suppresses ovulation.
Tumors of the ovary or adrenal gland can be responsible for excess androgen levels.
Treatment of polycystic ovary syndromeUnfortunately, there is no cure for PCOS because the cause is still unknown! But it is proven that some of the next treatment options could be beneficial for the woman suffering from the PCOS symptoms! Women with polycystic ovary syndrome may benefit from simple counseling to help with healthy-eating choices and regular exercise.
It is well known fact that birth control pills can regulate menstrual cycles, reduce male hormone levels, and help to clear acne. It is perfect for the women that doesn’t want to end up pregnant! However, women should understand that the birth control pill does not cure PCOS.
Several researches done in the past have proven that the medications which are used to treat type 2 diabetes, also helps with PCOS symptoms. These medications will not cause a person to become diabetic.
It is understood that the main fertility problem for women with PCOS is the lack of ovulation. Well, there are some medications which can be used to stimulate the ovary to ovulate. But, there is one important thing to know about this- PCOS patients are at increased risk for multiple births when using these medications.
The fact is that, if a woman is not trying to get pregnant, there are some other medicines that may reduce hair growth, especially Spironolactone! It is one blood pressure medicine that has been shown to decrease the male hormone’s effect on hair. Other non-medical treatments such as electrolysis or laser hair removal are effective at getting rid of hair.
If nothing helped then surgery called ovarian drilling is available to induce ovulation. What is important about this operation? The doctor makes a very small incision above or below the navel, and inserts a small instrument which is used to puncture the ovary. This instrument has a small needle carrying an electric current to destroy a small portion of the ovary. This surgery can lower male hormone levels and help with ovulation.
Maintaining a healthy weight is another way women can help manage PCOS. Since obesity is common with PCOS, a healthy diet and physical activity help maintain a healthy weight. A diet composed of mainly low-GI foods combined with regular exercise will also help to combat the effects of insulin resistance.
Complications if left untreated
Women with polycystic ovary syndrome are at increased risk of:
Because PCOS disrupts the reproductive cycle and exposes the uterus to a constant supply of estrogen, women with PCOS are at risk of:
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