Polycystic ovary syndrome (PCOS), formerly known as the Stein-Leventhal syndrome, is an enigmatic hormonal disorder that affects women of the reproductive age group. The exact cause of PCOS is unknown. Early diagnosis and treatment, along with weight loss, may reduce the risk of long-term complications.
What is polycystic ovary syndrome?
Polycystic ovary syndrome (PCOS) is a condition that affects how a woman’s ovaries work. It also involves other hormone producing organs. It is a very common condition affecting one in every ten women worldwide. The term ‘PCOS’ was coined by two doctors: Irving Stein and Michael Leventhal in 1935.
What causes PCOS?
The exact cause of PCOS is not known at this time. Factors that might play a role include:
• Excess insulin. Excess insulin might increase androgen production – causing difficulty with ovulation.
• Low-grade inflammation. 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. Research suggests that certain genes might be linked to PCOS.
• Excess androgen. The ovaries produce abnormally high levels of androgen, resulting in hirsutism and acne.
What are some signs and symptoms of polycystic ovary syndrome?
Signs and symptoms of PCOS vary. A diagnosis of PCOS is made when you experience at least two of these signs:
• Irregular periods. Infrequent, irregular or prolonged menstrual cycles are the most common sign of PCOS. For example, you might have fewer than nine periods a year, more than 35 days between periods, and abnormally heavy periods.
• Excess androgen. Elevated levels of male hormones may result in physical signs, such as excess facial and body hair (hirsutism), and occasionally severe acne and male-pattern baldness.
• Polycystic ovaries. Your ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function regularly.
Diagnosis
There is no test to definitively diagnose PCOS. Your doctor would take a detailed history and carry out a physical examination to include a pelvic examination. A number of investigations might be ordered to rule out other conditions that might mimic PCOS. If you have a diagnosis of PCOS, your doctor might recommend additional tests for complications of PCOS.
What are some complications of PCOS?
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 apnoea
• Depression, anxiety and eating disorders
• Abnormal uterine bleeding
• Cancer of the uterine lining (endometrial cancer)
Obesity is associated with PCOS and can worsen complications of the disorder.
Treatment
The signs and symptoms of PCOS vary tremendously. You and your doctor would decide on the best course of treatment. PCOS treatment focuses on managing your individual concerns such as infertility, hirsutism, acne or obesity. Specific treatment might involve lifestyle changes or medication. Your doctor may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Even a modest reduction in your weight — for example, losing 5 percent of your body weight — might improve your condition. Losing weight may also increase the effectiveness of medications your doctor recommends for PCOS, and can help with infertility. If left untreated, PCOS can become a serious problem. All of the symptoms you experience can lead to other health risks, like cancers, acne scars, and heart disease, if you do not see a qualified doctor and receive treatment.
Conclusion
Polycystic ovary syndrome is a common hormonal disorder affecting many women in Anguilla. Making the diagnosis might be challenging, but once diagnosed and correctly treated many of the complications can be minimised or prevented. If you have symptoms and signs suggestive of PCOS please seek professional help.
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-eight years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
