Polycystic Ovary Syndrome (PCOS)

Approximately 10% of American women are affected by polycystic ovary syndrome. Despite the commonality of this condition, there is a lot that we still have to learn, such as how a woman can become aware of her risk and the potential medical issues related to polycystic ovary syndrome.

What Is Polycystic Ovary Syndrome?

Polycystic ovary syndrome, or PCOS, is a problem within a woman’s endocrine system that causes overproduction of androgens, or male hormones, in the ovaries. The presence of these androgens inhibits the opening of the egg-releasing follicle during the monthly cycle. Instead of releasing an egg, this follicle adheres to the ovary.  This may turn into numerous small cysts.

What Causes PCOS?

PCOS is not necessarily caused by androgens. It is thought that the fluid follicles that form on the ovaries may be the result of excess male hormones. However, the small cysts also produce androgens. This has created a bit of confusion as to which comes first, the androgens or the cysts.

There are potential reasons that could explain the onset of polycystic ovary syndrome. These include:

• Family history. Women whose mother or sister has PCOS are more likely to develop the condition.
• Chronic, low-grade inflammation stimulated by the white blood cells may increase androgen production in the ovaries.
• Excess insulin has been linked to interrupted ovulation as well as increased androgen production.

PCOS Symptoms

You should speak with your healthcare provider if you experience symptoms such as:

• Menstrual irregularities such as heavy bleeding, missing periods, or menstruation outside of the normal cycle (too frequent or infrequent periods).
• Excess hair growth, present in 70% of PCOS cases.
• Obesity, present in 80% of PCOS cases.
• Acne-prone skin after adolescence, or severe acne.
• The excessive oiliness of the skin.
• Patches of skin that have become dark, velvety, and thick.

Diagnosis of Polycystic Ovary Syndrome

The challenge with PCOS is that the nature of various symptoms could lead a woman to obtain a specific type of care. For instance, oily, acne-prone skin may be treated by a dermatologist who knows nothing of the patient’s irregular periods. A gynecologist may be told of abnormal menstruation, but hear nothing of excessive hair growth. The more that women understand the potential symptoms of PCOS, the better they can advocate for successful health care.

Diagnostic tests that we may perform to confirm or rule out PCOS include:

• History and physical. The general assessment performed includes height and weight and a brief medical history.
• The pelvic examination includes manual inspection of the ovaries that may indicate swelling or cysts.
• Lab work. We may test your blood for glucose levels, triglycerides and cholesterol, and specific hormones that relate to PCOS as well as other conditions that may mimic it.
• Ultrasound facilitates observation of the ovaries and the uterus. We may perform the procedure through the vagina in order to examine ovarian structure as well as the uterine lining.

Diagnosing Polycystic Ovary Syndrome

Because PCOS is more than a cyst problem, women should speak with their healthcare provider regarding symptoms. This is an endocrine condition, which means that it can affect your general health and wellness without treatment.

In addition to infertility, a woman with PCOS is at risk of Type II diabetes, metabolic syndrome, and cardiovascular disease as a result of insulin resistance. There is also an increased risk for endometrial hyperplasia, a condition in which the uterine lining thickens. Endometrial hyperplasia raises the chance of endometrial cancer.

PCOS Treatment

Hormonal birth control pills work as treatment In some cases, for women who do not currently want children. This hormone therapy adds estrogen and progestin to the body, which overrides androgens. As a result, a woman’s menstrual cycle may become more regular. Also, acne and excessive hair growth may cease. The regulation of hormone levels and menstruation decreases the risk of endometrial cancer.

When obesity is related to polycystic ovary syndrome, a woman may improve her health by losing weight. Research has indicated that the menstrual cycle can improve with weight loss as little as 10 to 15 pounds. Maintaining a healthy weight also decreases the risk of Type II diabetes, high cholesterol, and cardiovascular disease.

Some women with polycystic ovary syndrome use insulin-sensitizing medication for treatment. These drugs facilitate optimal physical response to insulin, and can thus lower androgen levels in the body. Ovulation may improve as a result.