Polycystic Ovarian Syndrome
Polycystic ovarian syndrome, or PCOS, is a hormonal disorder affecting 5% to 10% of women of childbearing age. It is characterized by higher-than-normal levels of male hormones, called androgens, in the bloodstream, and by the development of fluid-filled cysts inside the ovaries. Also known as Stein-Leventhal syndrome, polycystic ovarian syndrome can greatly interrupt a woman’s menstrual cycle, causing irregular ovulation or even a complete lack of ovulation. As a result, women with PCOS often have difficulties becoming pregnant.
What Happens During Polycystic Ovarian Syndrome?
Women with polycystic ovarian syndrome develop a number of cysts inside one or both of their ovaries. Generally, 15 to 20 follicles inside of the ovaries begin to mature for ovulation every month. Usually, one follicle matures fully and is released by the ovaries, while the rest of the follicles die off. Women with PCOS however, never have one follicle mature fully. As a result, all 15 to 20 follicles stay inside of the ovaries, becoming cysts. These cysts begin to produce androgens (male hormones) causing a number of unpleasant symptoms.
What Causes Polycystic Ovarian Syndrome?
Unfortunately, researchers remain unsure as to the cause of PCOS. Certain factors do appear to play a role in the syndrome, including:
- Low FSH Levels: FHS, or follicle-stimulating hormone, is a hormone released by the pituitary gland in your brain. It helps follicles inside of your ovaries to mature, enabling ovulation.
- Excessive Male Androgens: Most women suffering from polycystic ovarian syndrome have extremely high levels of androgens, which are male sex hormones. This could interfere with ovulation and contribute to PCOS.
- Insulin Resistance: A large number of PCOS sufferers are insulin resistant. Insulin resistance occurs when the body does not manage insulin properly. Insulin is vital to proper ovarian function, however, so resistance to insulin may contribute to PCOS.
Who’s At Risk for Polycystic Ovarian Syndrome?
Though any woman can develop polycystic ovaries, certain women do appear to have a higher risk of developing the syndrome. Risk factors include:
- having a family history of PCOS (especially mother or sister)
- having diabetes or insulin resistance
- being overweight or obese
- being between the ages of 20 and 30
Polycystic Ovarian Syndrome Symptoms
Many women with PCOS never experience any symptoms associated with the syndrome. Others experience a wide variety of uncomfortable PCOS symptoms, which may include:
- irregular menstruation
- loss of menstruation (amenorrhea)
- difficulty getting pregnant
- weight gain, particularly around the waist line
- hirsutism, which causes excessive hair growth, especially on the face and body
- acne and oily skin
- decreased breast size
What are the Complications of Polycystic Ovarian Syndrome?
Unfortunately, you may experience a number of serious health complications as a result of PCOS. Possible complications include:
- Infertility: Because the syndrome interferes with ovulation, PCOS can contribute to long-term fertility problems.
- Endometrial Cancer: PCOS can cause the endometrium to become thicker and thicker, increasing your risk of developing endometrial cancer.
- Obesity-Related Illnesses: Because PCOS can increase your chances of being overweight or obese, it can also increase your risk for developing certain weight-related illnesses, including high blood pressure, diabetes, and heart disease.
In addition to the health complications posed by PCOS, the syndrome also has a significant emotional effect on the women who have it. Because of way PCOS changes a woman’s appearance, many sufferers feel isolated, alone, and depressed.
Diagnosing Polycystic Ovarian Syndrome
Diagnosis of PCOS is based upon the results of a physical examination and a number of clinical tests. Your health care provider will perform a pelvic exam, during which she will look for evidence of swelling of the ovaries. Occasionally, this is a sign of polycystic ovaries. Additionally, your health care provider will also perform a number of blood tests, including:
- FSH (follicle-stimulating hormone)
- LH (luteinizing hormone)
Your health care provider may also perform an ultrasound in order to get a detailed picture of your ovaries and any cysts that they may contain.
Treatment of Polycystic Ovarian Syndrome
There is currently no cure for PCOS, however, there are a number of PCOS treatments that can help regulate your menstrual cycle or increase your chances of getting pregnant. Common PCOS treatment options include:
- Weight Loss: Weight loss can help to regulate insulin levels and restore ovulation and menstruation.
- Birth Control Pills: Birth control pills that contain both estrogen and progesterone can help to regulate the menstrual cycle and decrease the appearance of hair growth and acne.
- Diabetes Medications: The diabetes medication, Metformin, affects the way insulin is processed in the body. It also helps to decrease testosterone levels. This may help to restore ovulation and lessen hair growth.
- Fertility Medications: The fertility medication, Clomid, or injections of gonadotropins, may help to stimulate ovulation and increase your chances of getting pregnant.
- Surgery: Ovarian drilling is often an effective procedure that can help to stimulate ovulation. During this surgery, small holes are punctured through the ovaries, allowing for a decrease in testosterone levels and an increase in ovulation.