Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders among women of reproductive age. This is a very complex syndrome involving metabolic, hypothalamic, pituitary, ovarian, and adrenal interactions.
What is polycystic ovarian syndrome?
The name of the condition comes from the appearance of the ovaries in most, but not all, women with the disorder — enlarged and containing numerous small cysts located along the outer edge of each ovary (polycystic appearance). The exact cause of polycystic ovary syndrome is unknown
Infrequent or prolonged menstrual periods, excess hair growth, acne and obesity can all occur in women with polycystic ovary syndrome. In adolescents, infrequent or absent menstruation may signal the condition. In women past adolescence, difficulty becoming pregnant or unexplained weight gain may be the first sign. Early diagnosis and treatment may reduce the risk of long-term complications, such as type 2 diabetes and heart disease.
Polycystic ovary syndrome is very common, affecting as many as 1 out of 15 women. Often the symptoms begin in the teen years.
What are the symptoms of polycystic ovarian syndrome?
The symptoms and signs of polycystic ovarian syndrome vary from person to person, in both type and severity. To be diagnosed with the condition, your doctor looks for at least two of the following:
• Menstrual abnormality. This is the most common characteristic. Menstrual abnormality includes menstrual intervals longer than 35 days; fewer than eight menstrual cycles a year; failure to menstruate for four months or longer; and prolonged periods that may be scant or heavy.
• Excess androgen. Elevated levels of male hormones (androgens) may result in physical signs, such as excess facial and body hair (hirsutism), adult acne or severe adolescent acne, and male-pattern baldness (androgenic alopecia).
• Polycystic ovaries. Enlarged ovaries containing numerous small cysts can be detected by ultrasound scanning of the ovaries. Despite the condition’s name, polycystic ovaries alone do not confirm the diagnosis. To be diagnosed with PCOS, you must also have abnormal menstrual cycles or signs of androgen excess. Some women with polycystic ovaries may not have PCOS, while a few women with the condition have ovaries that appear normal.
What causes PCOS?
We do not know the exact cause of polycystic ovary syndrome, but several factors likely play a role. These include excess insulin, low-grade inflammation, and heredity factors. If your mother or sister has PCOS, you might have a greater chance of having it, too.
What are the complications of PCOS?
Some patients who have polycystic ovarian syndrome, especially those who remain untreated can develop several. Some of these complications include the following:
• Type 2 diabetes
• High blood pressure
• Cholesterol and lipid abnormalities
• Metabolic syndrome, a cluster of signs and symptoms that indicate a significantly increased risk of cardiovascular disease
• Nonalcoholic steatohepatitis, a severe liver inflammation caused by fat accumulation in the liver
• Sleep apnea
• Abnormal uterine bleeding
• Cancer of the uterine lining (endometrial cancer) caused by exposure to continuous high levels of estrogen
• Gestational diabetes or pregnancy-induced high blood pressure, if you do become pregnant
Treatment
Polycystic ovary syndrome treatment generally focuses on management of your individual main concerns such as infertility, hirsutism, acne or obesity. Sometimes a team of doctors might be needed in the management of this syndrome.
Treatment can help control the symptoms and prevent long-term problems.
Paying attention to the foods you eat and your activity levels may help offset the effects of PCOS. Exercise helps lower blood sugar levels. If you have PCOS, increasing your daily activity, and participating in a regular exercise programme, may treat or even prevent insulin resistance and help you keep your weight under control.
Conclusion
Polycystic ovary syndrome (PCOS) is a health problem that can affect a woman’s hormone levels, periods, and ovulation. The exact cause of this syndrome is unknown at this time. Treatment is needed to prevent complications. If you have symptoms suggestive of this syndrome you should see your doctor.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
