Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome is a medical condition in which a woman’s hormones are out of balance.  It can cause problems with menstrual periods, infertility, and excess hair growth.  Untreated, it can eventually lead to serious health problems, such as diabetes and heart disease. PCOS is fairly common, possibly affecting as many as 1 in 15 women. It is one of the leading causes of infertility in the U.S.  Treatment can help control the symptoms and prevent long-term problems.

How PCOS Affects Your Body

Hormones are chemical messengers that trigger many different processes, including growth and energy production. Often, the job of one hormone is to signal the release of another hormone.For reasons that are not well understood, in PCOS the hormones get out of balance. One hormone change triggers another, which changes another. This makes a vicious circle of out-of-balance hormones.

For example:

• The sex hormones get out of balance. Normally, a woman’s ovaries produce a small amount of male sex hormones. A PCOS affected woman’s hormones make an increased amount of these male hormones.  This can cause acne and excess facial and body hair, and can also make a woman stop ovulating, resulting in infertility.
•  Insulin resistance can occur when the body does not use insulin correctly.  As a result, blood sugar levels go up, and the risk of getting diabetes increases.

Diagnosis

A woman is usually considered to have PCOS if she is not ovulating and has increased levels of the male sex hormone androgen.   However, your healthcare provider will make a diagnosis based on the following:

• Detailed questions about your medical history, current symptoms, and menstrual cycle.
• A physical examination to check for signs such as extra body hair and high blood pressure. The doctor will also check your height and weight.
• Lab tests to check your blood sugar, insulin, and other hormone levels. These tests can help to rule out thyroid or other gland problems that could cause similar symptoms.

Symptoms

Talk to your practitioner if you have one or more of the following symptoms: 

• Acne
• Weight gain
• Excess facial and body hair
• Thinning hair on the scalp
• Irregular periods, no periods, or heavy bleeding
• Fertility problems

Most women with PCOS grow many small cysts on their ovaries.  The cysts are not harmful, but can often lead to hormone imbalances.

Living with PCOS

PCOS is not a disease to be cured; rather it is a medical condition to be managed.  Treatment will vary according to the woman’s circumstances.
 
In many cases, lifestyle changes such as regular exercise and weight loss (if overweight) are enough to relieve the symptoms.  Sometimes, a regular exercise program of at least 30 minutes per day can lower insulin levels enough to allow ovulation to begin.  Other times, women are advised to take progesterone or birth control pills in order to slow the growth of body hair and bring on regular menstrual periods.  A woman who wants to become pregnant may be given medications to bring on ovulation. 
Also, medications to treat diabetes, high blood pressure and high cholesterol levels may be prescribed as needed.

Remember

While PCOS is not curable, it can be managed with the help of your physician or midwife.   The best chance of dealing successfully with some serious disorders that can arise from PCOS is to see your healthcare provider regularly.