Polycystic Ovarian Syndrome

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder that occurs in women of reproductive age when the female sex hormones estrogen and progesterone are out of balance. PCOS develops due to the elevation or overproduction of androgens (male hormones such as testosterone) by the ovaries.  This condition is the most prevalent cause of ovulatory-based infertility and affects approximately 5 to 10 percent of women between the ages of 18 and 44.  PCOS often leads to the growth of ovarian cysts as well as a host of other health issues.  However, it is worth noting that there is a distinction between polycystic ovaries and polycystic ovary syndrome.  Not all women diagnosed with PCOS have polycystic ovaries (ovaries with many tiny cysts).  The syndrome is therefore established by the hormonal and menstrual abnormalities with or without polycystic ovaries.

PCOS is characterized by a collection of symptoms and physical findings that may include: heavy or irregular periods, signs of elevated male hormones (i.e. acne, male-pattern hair loss, excess facial and/or body hair), increased levels of androgen in the blood, patches of thick or dark skin, infertility or reduced fertility, pelvic pain, absent or infrequent ovulation, obesity, and/or polycystic ovaries.  Furthermore, patients diagnosed with PCOS also appear to be associated with an increased risk of developing the following health issues: type-2 diabetes, sleep apnea, endometrial cancer, cardiovascular disease, and mood disorders.

The exact cause of PCOS is currently not known.  However, many doctors believe that the condition may be caused by genetic factors, excess insulin production, and/or environmental factors.  Diagnosis of PCOS may be determined by the combination of blood tests (for hormone levels), a physical exam, and/or a pelvic ultrasound (to detect enlarged ovaries and/or the presence of cysts).  The physician may also choose to run tests for blood sugar and insulin levels to aid in the diagnostic process.

Unfortunately, there is currently no cure for PCOS.  Treatment focuses instead on managing the symptoms of the disease and may involve:

• Lifestyle changes: Lifestyle changes may include an exercise regime and/or weight loss program if the patient is overweight.  Losing weight can help reduce the high levels of insulin that occur in PCOS and may help in reducing testosterone.
• Hair reduction methods: Hair reduction treatments for excess hair growth may include hair removal creams, shaving/waxing, electrolysis, laser treatments, and oral medications (i.e. anti-testosterone medicine and/or contraceptive pills).
• Acne medications: Acne medications include topical creams, oral medication i.e. birth control pills), antibiotic medications, anti-androgen medications, etc.
• Birth control pills: Birth control pills may also be used to help correct menstrual irregularity.
• Diabetes medication: Metformin is used to treat patients with diabetes and may result in a decrease in insulin levels in the blood.  This may assist in counteracting an underlying cause of PCOS (i.e. excess insulin).  Metformin may also be used in hormone therapy to help kick start ovulation.
• Fertility medications or in vitro fertilization: Fertility medications such as Metformid, Clomid, and Gonadotropins may be helpful for women having difficulty getting pregnant.  In vitro fertilization may be successful in some patients with PCOS and unsuccessful in others.

A healthy diet and lifestyle are essential in preventing any long-term issues and conditions associated with PCOS.

Patients with additional questions or concerns pertaining to PCOS should contact our office to schedule an appointment with one of our experienced providers.

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