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Polycystic Ovary Syndrome
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Polycystic ovary syndrome (PCOS) is a hormonal disorder characterized by any two of the following three characteristics:
 Chronic anovulation (absence of ovulation)
Chronic hyperandrogenism (elevation of serum testosterone or other androgens)
Polycystic appearing ovaries (PCO) on ultrasound
PCOS is a common cause of infertility, menstrual irregularity, and hirsutism (excessive hair growth). It affects about 5% of women. |
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Symptoms and Diagnosis |
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PCOS symptoms include:
Irregular, infrequent menstrual cycles
Hirsutism
Acne
Infertility
Obesity
High blood pressure
Enlarged ovaries with many small follicles are distinct indicators of PCOS in most women. These multiple small follicles can be seen as cysts on ultrasound (hence the term polycystic). Polycystic appearing ovaries are also seen in approximately 20% of women with normal menstrual cycles. Owing to its variable nature, a combination of clinical, ultrasound, and laboratory features may be needed to diagnose PCOS. |
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How Harmful is it |
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PCOS may result in serious health complications for many women, including reproductive problems, insulin and sugar metabolism problems, heart and blood circulation problems and even breathing/sleep problems. |
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A characteristic feature of PCOS is the absence of ovulation. It continuously exposes the uterine lining (endometrium) to |
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estrogen, which may cause excessive thickening of the endometrium and heavy, irregular bleeding. Exposure over many years to the hormone estrogen without enough of the hormone progestin to balance it (unopposed estrogen) can result in endometrial cancer. |
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PCOS increases the risk of developing the metabolic syndrome, which is characterized by a group of health problems that |
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include abdominal obesity, elevated blood pressure (hypertension), insulin resistance that impairs blood sugar regulation, and low HDL cholesterol. |
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Type 2 diabetes and even heart disease can also surface in women with PCOS. |
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Obesity is common in women with PCOS. |
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Prevention |
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Polycystic Ovary Syndrome cannot be prevented. However, early diagnosis and treatment of PCOS helps prevent long-term complications associated with PCOS, such as infertility, metabolic syndrome, obesity, diabetes, and heart disease.
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Treatment Options |
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Regular exercise, a healthy diet, and weight control are key treatments for PCOS. These behavioral changes should be the first lines of therapy for a woman with PCOS. The benefits include:
Improved frequency of ovulation
Improved fertility
Lowered risk of diabetes
Lowered androgen levels
Treatment of PCOS depends upon your focus areas. You may want to overcome PCOS induced infertility or you may wish to correct menstrual cycle regulation, hirsutism, or acne. Regardless of your primary goal, PCOS should be treated because of the long-term health risks it poses. |
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For Fertility |
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Treatments that help women with PCOS achieve fertility are discussed below:
Clomiphene citrate, an orally administered fertility medication, can induce ovulation
Medications that increase the body’s sensitivity to insulin, such as metformin, may lead to more regular ovulation
If simpler treatments are not effective, Gonadotropins (injectable fertility medications) may be used to induce ovulation
However, Gonadotropin therapy is expensive and associated with a greater chance of multiple pregnancy and side effects than oral therapies |
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For concerns other than fertility |
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Treatments targeting problems like menstrual cycle regulation, hirsutism, or acne are discussed below: |
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Hormonal therapies are usually successful in temporarily correcting problems (other than fertility) associated with PCOS |
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Oral contraceptive pills (OCs) are commonly prescribed to reduce hirsutism and acne, maintain regular menstrual periods, |
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prevent endometrial cancer, and prevent pregnancy |
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Hirsutism can also be corrected by using OCs combined with medications that decrease androgen action, such as |
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| spironolactone |
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Hair removal methods like electrolysis and laser are also effective in treating hirsutism |
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How to Cope |
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Embarrassing symptoms and difficulty in conceiving can make living and dealing with PCOS emotionally difficult. Education and support are the keys to managing a life with PCOS. There are a number of available treatments that can help you manage the symptoms, and help you conceive if you are having difficulty. It is important to consult your physician as soon as possible to discuss the treatments available for PCOS. Following your doctor’s advice, living a healthy lifestyle, and going in for prompt treatment can minimize or eliminate many of the unwanted complications of PCOS. |
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Polycystic Ovary Syndrome |
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