Overview
Polycystic Ovarian Syndrome (PCOS) is a reproductive condition that occurs in women of child-bearing age. It affects the menstrual cycle fertility and hormones but it can also include insulin production the heart blood vessels and physical appearance. For women with PCOS there appears to be a higher rate of miscarriage gestational diabetes pregnancy-induced high blood pressure and premature delivery. An estimated five to 10 percent of women of childbearing age have PCOS.
Symptoms
With PCOS the ovary doesn't make all of the hormones needed for the eggs to fully mature. Since no egg matures or is released ovulation does not occur and the hormone progesterone is not made. Without progesterone a menstrual cycle is irregular or absent. Instead eggs may begin to grow but never enough to be fertilized. They then accumulate fluid and become cysts. These cysts produce male hormones which in turn prevent ovulation.
Symptoms may include: - pelvic pain
- absent or irregular menstrual periods
- high levels of male hormones called androgens
- small cysts in your ovaries
- infertility or inability to get pregnant because of not ovulating
- increased growth of hair on the face chest stomach back thumbs or toes
- acne oily skin or dandruff
- weight gain or obesity usually carrying extra weight around the waist
- diabetes (type 2)
- high cholesterol
- high blood pressure
- thinning hair
- patches of thickened and dark brown or black skin on the neck arms breasts or thighs
- skin tags which look like tiny excess flaps of skin in the armpits or neck area
- excessive snoring and sleep apnea
Causes No one knows the exact cause of PCOS. Women with PCOS frequently have a mother or sister with PCOS but there is still not enough evidence to say for certain that there is a genetic link to this disorder. Many women with PCOS have a weight problem so researchers are looking at the relationship between PCOS and thebody¹s ability to make insulin.
Treatment Currently there is no cure for PCOS. Treatments are based on the symptoms and whether or not you want to conceive or need contraception. Birth control pills For women who don¹t want to become pregnant birth control pills can regulate menstrual cycles reduce male hormone levels and help to clear acne. However the birth control pill does not cure PCOS. The menstrual cycle will become abnormal again if the pill is stopped. Sometimes a doctor will prescribe progesterone pills like Provera to regulate the menstrual cycle and prevent endometrial problems. But progesterone alone will not help reduce symptoms of acne and hair growth.
Diabetes medications
Metformin which is used to treat type 2 diabetes also helps with PCOS. Metformin affects the way insulin regulates glucose and decreases testosterone production. Abnormal hair growth will slow down and ovulation may return after a few months of use. These medications will not cause you to become diabetic. No one yet knows if Metformin is safe for pregnant women. Because the drug crosses the placenta doctors are concerned that the baby could be affected by the drug. Research is ongoing.
Fertility drugs
Clomiphene (pills) and gonadotropins (shots) can be used to stimulate the ovary to ovulate. However you are at increased risk for multiple births when using these medications. In Vitro Fertilization (IVF) is sometimes recommended.
Medicine to stimulate hair growth or boost male hormone production
Spironolactone is a blood pressure medicine that has been shown to decrease the male hormone's effect on hair. Propecia a medicine taken by men for hair loss is another medication that blocks this effect. Both of these medicines can affect the development of a male fetus and should not be taken if pregnancy is possible. Other non-medical treatments such as electrolysis or laser hair removal are effective at getting rid of hair.
Surgery Although not recommended as the first course of treatment a type of surgery called ovarian drilling will induce ovulation. The doctor makes a very small incision above or below the navel and inserts a small instrument that acts like a telescope into the abdomen. This is called a laparoscopy. The doctor then punctures the ovary with a small needle carrying an electric current to destroy a small portion of the ovary. This procedure carries a risk of developing scar tissue on the ovary but can lower male hormone levels and help with ovulation. The effect may only last for a few months. Having a laparoscopy will not help with increased hair growth and loss of scalp hair.
Healthy weight
A healthy diet along with regular physical activity will lower glucose levels and help your body use insulin more efficiently. This may be enough to restore a normal period. | 