Polycystic ovary syndrome (PCOS) is a common condition that affects many women of reproductive age. PCOS is the most common endocrine disorder among women between the ages of 18 and 44. Early diagnosis and treatment, along with weight loss. may reduce the risk of long-term complications such as type 2 diabetes and heart disease.
What is polycystic ovary syndrome?
This is a hormonal condition that has three main features:
• irregular periods – which mean a woman’s ovaries do not regularly release eggs (ovulation)
• excess androgen – high levels of “male” hormones in the body which may cause physical signs such as excess facial or body hair
• Polycystic ovaries – a woman’s ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs.
If you have at least 2 of these features, you may be diagnosed with polycystic ovary syndrome.
What causes polycystic ovary syndrome?
The exact cause of PCOS is not known. A number of factors associated with PCOS and might play a role include:
• Excess insulin. Insulin is the hormone produced in the pancreas that allows cells to use sugar – your body’s primary energy supply. If your cells become resistant to the action of insulin, then your blood sugar levels can rise and your body might produce more insulin. Excess insulin might increase androgen production.
• Low-grade inflammation. This term is used to describe white blood cells’ production of substances to fight infection. Research has shown that women with PCOS have a type of low-grade inflammation that stimulates polycystic ovaries to produce androgens – which can lead to heart and blood vessel problems.
• Heredity. Various clinical studies have shown that certain genes might be linked to PCOS.
• Excess androgen. The ovaries produce abnormally high levels of androgen resulting in hirsutism (excess hair growth) and acne.
What are some symptoms of PCOS?
Not all women with PCOS will have all of the symptoms, and each symptom can vary from mild to severe.
If you have signs and symptoms of PCOS, they will usually become apparent during your late teens or early 20s. Symptoms include the following:
• irregular periods or no periods at all
• difficulty getting pregnant as a result of irregular ovulation or failure to ovulate
• excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks
• weight gain
• thinning hair and hair loss from the head
• oily skin or acne
PCOS is also associated with an increased risk of developing health problems, in later life, such as type 2 diabetes and high cholesterol levels.
Diagnosis
There is no test to definitively diagnose PCOS. Your doctor or gynaecologist would most likely take a detailed medical history. A physical exam will include checking for signs of excess hair growth, insulin resistance and acne – as well as a pelvic exam. Various other investigations, including an ultrasound scan of the ovaries, might be needed to aid in the diagnosis.
Treatment
At this time there is no cure for PCOS, but the symptoms can be treated. If you suspect that you might have PCOS, talk to your gynaecologist or healthcare provider.
Lifestyle changes might prove beneficial and include losing weight if you are overweight, and eating a healthy well balanced diet. Regular exercise might also improve symptoms.
Medications are also available to treat symptoms such as excessive hair growth, irregular periods and fertility problems.
If fertility medications are not effective, a simple surgical procedure called laparoscopic ovarian drilling (LOD) may be recommended.
With treatment, most women with PCOS are able to get pregnant.
What are some complications of PCOS?
If you have symptoms, and are left untreated, a number of complications might develop. Complications of PCOS can include:
• Infertility
• Gestational diabetes or pregnancy-induced high blood pressure
• Miscarriage or premature birth
• Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat accumulation in the liver
• Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increase your risk of cardiovascular disease
• Type 2 diabetes or prediabetes
• Sleep apnea
• Depression, anxiety and eating disorders
• Abnormal uterine bleeding
• Cancer of the uterine lining (endometrial cancer)
Conclusion
Polycystic ovary syndrome (PCOS) is a condition that affects a woman’s hormone levels. Women with PCOS produce higher-than-normal amounts of male hormones. This hormone imbalance causes them to skip menstrual periods and makes it harder for them to get pregnant. The exact cause of PCOS is not known, but PCOS might be due to a combination of genetic and environmental factors. There is no cure, but treatment may involve lifestyle changes such as weight loss and exercise, and the use of various medications. If you have symptoms suggestive of PCOS see your doctor so that complications can be decreased or prevented.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-seven years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
