What is Polycystic Ovarian Syndrome?
What is Polycystic Ovarian Syndrome?
Polycystic Ovarian Syndrome, better known as PCOS, is a hormonal disorder found in women of reproductive age. It is a common disorder and the name is derived from the appearance. With PCOS the ovaries most often become enlarged and there are numerous small cysts along the outer edge of each ovary.
The Cause of PCOS
The cause of PCOS is unknown, but there are several factors that play a roll in Polycystic Ovarian Syndrome.
Excess Insulin- Insulin is a hormone that is produced by the pancreas that allows the cells to use glucose, sugar, for energy. With insulin resistance your body is not able to use the insulin effectively and in turn your pancreas has to work harder to secrete more insulin to make insulin available to the cells. The excess insulin can boost androgen production by the ovaries.
Heredity- If your mother or sister has PCOS you may have a greater chance of having it. Researchers are also investigating the possibility that mutated genes might be linked to PCOS.
Low-grade Inflammation- Inflammation is your body’s response to fight infection. With inflammation, your body’s white blood cells produce a substance to fight off the infection. The substance that your white blood cells produce can lead to insulin resistance and cholesterol accumulation in blood vessels (atherosclerosis). Atherosclerosis causes cardiovascular disease. Research has shown that women with PCOS have low-grade inflammation.
Abnormal Fetal Development- Through some research it has been shown that excessive exposure to male hormones (androgens) in fetal life may permanently prevent normal genes from working the way they're supposed to. This is a process better known as gene expression. This can promote a male pattern of abdominal fat distribution, which increases the risk of insulin resistance and low-grade inflammation. Researchers continue to research the extent that these factors affect PCOS.
Your PCOS Treatment
How was your PCOS treated?
Signs and Symptoms of Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome usually begins soon after a female begins to have periods, known as menarche. It is possible for PCOS to develop further into a female’s reproductive life with things such as a substantial gain in weight.
The signs and symptoms vary from person to person, as well as the severity of the symptoms. Some women may experience just one symptom and some may experience all of the symptoms to the fullest extent of the severity.
Menstrual Abnormalities- The most common characteristic is menstrual abnormalities. Menstrual abnormalities can include intervals of 35 days or more between menstruation, fewer than eight menstrual cycles a year, or failure to menstruate for four months or longer; and prolonged periods that may be scant or extremely heavy.
Excess Androgen- Excess androgen, male hormones, can result in physical signs. You may have signs of facial hair, hair on your chest and around your nipples, male patterned baldness, adult acne, or sever adolescent acne. The physical signs of androgen excess can vary with ethnicity.
Polycystic Ovaries- Enlarged ovaries containing numerous cysts along the outer edge. This symptom can be diagnosed with an ultrasound. This symptom alone does not diagnose PCOS. To have a diagnosis of PCOS you must have menstrual abnormalities or excess androgen. There are few women who have PCOS with no cysts on their ovaries, but it is rare.
PCOS and Ovulation
PCOS and Reproduction
PCOS can affect ovulation. Many women that have PCOS have a difficult time conceiving or may become infertile. In women with PCOS, the ovary doesn't make all of the hormones it needs for an egg to fully mature. The follicles may start to grow and build up fluid but ovulation does not occur. When ovulation does not occur some of the follicles may remain as cysts.
Woman with PCOS who become pregnant have a higher risk of miscarriage, Gestational diabetes, pregnancy-induced high blood pressure (preeclampsia), and premature delivery
Babies born to women with PCOS have a higher risk of spending time in a neonatal intensive care unit or of dying before, during, or shortly after birth. Most of the time, these problems occur in multiple-birth babies (twins, triplets, etc.).
Polycystic Ovarian Syndrome and Treatment
There is no cure for PCOS, but most often with lifestyle changes it can be managed. One of the key factors of managing PCOS is by maintaining a healthy weight along with a healthy diet. PCOS can cause additional weight gain, therefore it is important to eat healthy and incorporate an exercise program that is manageable in your life. It is important to avoid processed foods and foods with added sugars. A female with PCOS should add more lean proteins, whole-grains, fruits and vegetables to their diet.
There are also several medications that can help manage PCOS.
Birth control pills are another way to help manage PCOS. Birth control pills can help regulate menstruation, reduce male hormone levels, and help clear up acne.
Metformin is a pill used in patients with Type 2 diabetes. It has been found to help with the symptoms of PCOS. Metformin affects the way insulin controls blood glucose and lowers testosterone production. It slows the growth of abnormal hair and can help ovulation return.
Medications that stimulate ovulation can also help. Listed below are some of these medications.
- Clomiphene- better known as Clomid is the first choice therapy to stimulate ovulation for most patients.
- Metformin taken with clomiphene-may be tried if clomiphene alone fails. The combination may help women with PCOS ovulate on lower doses of medication.
- Gonadotropins- given as shots, but are more expensive and raise the risk of multiple births compared to clomiphene.
In some cases ovarian drilling can be used for ovulation if fertility drugs fail.
Medications that help slow the growth of excess hair:
- Vaniqa- cream to reduce facial hair
- Laser hair removal or electrolysis to remove hair
- Hormonal treatment to keep new hair from growing
The Importance of Early Diagnosis and Treatment
Women with PCOS have a high risk of developing Type 2 diabetes. In fact, 50% of women with PCOS will develop Type 2 diabetes or be diagnosed as pre-diabetic before the age of 40. Women with PCOS also have a higher risk of heart attack, high LDL or bad cholesterol, high blood pressure, and an increased risk of developing sleep apnea, which means you stop breathing for short periods of time during sleep.
If you are suffering from Polycystic Ovarian Syndrome or are having symptoms of PCOS, see your physician for diagnosis. Diagnosis and treatment are extremely important in order to prevent additional complications.
© 2014 Victoria Baughman