Polycystic Ovary Syndrome

It's considered the most common reproductive syndrome in women of childbearing age and the leading cause of infertility among women. Polycystic Ovary Syndrome (PCOS), according to The National Women's Health Information Center (NWHIC), is a syndrome in which the ovaries become larger than normal and sometimes contain painless cysts, or fluid-filled sacs. They may be the result of chronic anovulation (failure to release the egg). Other groups, such as the Polycystic Ovarian Syndrome Association (PCOSA) and the Hormone Foundation (HF), link PCOS to hormonal imbalances (Read about "Endocrine System") and say a woman can have PCOS without cysts. A woman may develop one cyst, or several, and may also experience a number of other symptoms, suspected to be caused by abnormal hormone levels. NWHIC says an estimated 5 to 10 percent of women of childbearing age may have PCOS, and some may not even realize it. According to PCOSA, PCOS is also called Stein-Leventhal Syndrome or Polycystic Ovary Disease.

Polycystic ovaries

In a normal ovary, several eggs develop but usually only one is released each month during ovulation. Sometimes, as in the case twins, triplets or other multiple pregnancies, more than one egg is released. (Read about "The Ovaries" "Multiple Birth Pregnancies") It's all part of a woman's monthly menstrual cycle. When a woman's ovaries are enlarged and contain many cysts, as is usually the case with PCOS, something has gone wrong. Ovarian cysts, according to NWHIC, are the fluid-filled sacs that form on the ovaries when follicles that contain eggs have matured, but the eggs were never released. While experts have known about this syndrome for 75-years, PCOSA says the exact cause isn't known and there is no cure. The American Academy of Family Physicians (AAFP) says PCOS often begins in the teenage years and does not go away.

Symptoms and complications

The long list of baffling symptoms and conditions related to PCOS can affect not only a woman's long-term physical health, but according to HF, her psychological health as well. HF says the underlying cause of PCOS is a hormonal imbalance that seems to be linked to the way your body processes insulin. As a result, a woman's body may have elevated levels of male hormones. Symptoms, according to HF, NWHIC and AAFP, may include some of the following:

• irregular menstrual periods (Read about "Menstrual Disorders")
• infertility (Read about "Infertility")
• acne (Read about "Acne")
• skin tags or lumps
• excess hair on face, arms, legs, abdomen, and pubic area
• thinning hair
• weight gain leading to obesity (Read about "Obesity")
• depression and anxiety related to body changes (Read about "Depressive Illnesses" "Anxiety")
• high blood pressure (Read about "Hypertension: High Blood Pressure")
• increased blood levels of male hormones

Some other potentially dangerous conditions may be related to PCOS if the syndrome is left untreated. According to HF, they include:

• Cancer of the uterus - Hormonal levels associated with PCOS, that lead irregular shedding of the uterine lining, could put you at risk for uterine cancer if PCOS is not treated. (Read about "Uterine Cancer")
• Diabetes - Some women with PCOS have problems using their insulin; this is known as insulin resistance. (Read about insulin resistance in "Metabolic Syndrome" This is a risk factor for adult-onset or type-2 diabetes and diabetes during pregnancy. (Read about "Diabetes" "Healthy Pregnancy")
• Heart disease - People with high insulin levels can also have low levels of HDL, or good cholesterol and high levels of other fats. These factors can increase the risk of heart attack or stroke later in life. (Read about "Cholesterol" "Heart Attack" "Stroke")
• Obesity and related disorders - The hormonal issues of PCOS can result in obesity and other related problems such as hypertension. (Read about "Obesity" and "Hypertension: High Blood Pressure")

Diagnosis

Diagnosing PCOS is a multi-step process that begins with a visit to your healthcare provider (HCP). According to NWHIC, your HCP will likely take a detailed medical background about your menstrual cycle, hormonal medications you may be taking and pregnancies. A physical and pelvic exam might be conducted. Blood testing could possibly (Read about "Laboratory Testing"), according to NWHIC, reveal abnormalities in the following:

• hormone levels
• insulin and glucose levels
• cholesterol and triglyceride levels

The signs and symptoms of PCOS may start to appear in the early teens so pediatricians need to be on the lookout as well as parents.

Treatment

While there is no known cure for PCOS, there are treatments that can help women lead normal and healthy lives.

Medications - There are many medications that can help control the symptoms of PCOS, according to NWHIC. The most commonly prescribed are hormone medications, which can regulate menstrual cycles, manage hormone levels and even clear acne. HF says that insulin-sensitizing medications have also proven helpful in balancing hormones and establishing a regular menstrual cycle. There are also drugs to help lower cholesterol levels and blood pressure. There are also medications that can be used to help a woman conceive.

Diet and Exercise - HF believes diet is one of the most important steps in managing PCOS. Cutting down on carbohydrates like breads, cereals and pastas and eating more fruits, grains and vegetables can help regulate your insulin response. Exercise, according to HF, can also help the body use insulin better and help you lose weight. More and more nutritionists have taken an interest in this area and can be consulted.

Surgery - Laparoscopic surgery called ovarian drilling is available to treat PCOS, when fertility is involved, according to NWHIC. A very small incision is made above or below the navel, and a small tool is inserted into the abdomen. (Read about "Endoscopy") Using a small needle that carries electric current or a laser, the doctor can make punctures in the ovary, destroying a small part of the ovary. NWHIC warns that this surgery may produce scar tissue around the ovaries and should not be the first treatment option since its success rate is less than 50 percent.

Summary

If you have irregular periods and some of the other symptoms of PCOS, you should contact your HCP. Experts also believe, according to HF, that PCOS might be a genetic condition. (Read about "Genetics") If someone in your immediate family has PCOS, it is wise for you to be checked for the syndrome as well. Too often teenagers go undiagnosed and may face lowered self-esteem from excess hair growth, acne and obesity. (Read about "Obesity") Once a diagnosis is made, HF says one of the most important things you can do is monitor your own health, eat right, exercise and take the medications needed to keep your PCOS symptoms from becoming a problem. Together with your HCP, you can manage this complex, and sometimes mysterious condition.

Related Information:

    Healthy Pregnancy

    Cervical Cancer

    The Ovaries

    Endometriosis

    Skin Care

    Hysterectomy

    Menopause

    Uterine Fibroids

    Genital Health - Female

    Woman's Health Glossary