Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a condition in which a woman experiences a hormonal imbalance. This syndrome can lead to difficulty conceiving as well as problems with periods. PCOS can also lead to unwanted changes in appearance and if the condition is not treated, it can eventually lead to significant health problems, including heart disease and diabetes.

The majority of women who have polycystic ovary syndrome will develop small cysts on the ovaries, hence the name of the disorder. Polycystic ovaries affect 1 in 10 to 1 in 20 women who are of childbearing age and the condition can affect those who are 11 years old or older. There may be 5 million women affected in the U.S.

Symptoms of Polycystic Ovary Syndrome

In most cases, women will experience gradual onset of polycystic ovary syndrome symptoms. In many cases, the hormonal changes leading to PCOS will begin during the early teens and symptoms may begin being noticeable following a weight gain.

Some of the symptoms of polycystic ovary syndrome will include changes to the menstrual cycle:

  • Irregular periods (timing, duration, and heaviness)
  • Secondary amenorrhea (not having a period after having at least one normal one during puberty)

Additional PCOS symptoms may include:

  • Skin changes, including thick or dark skin markings as well as creases around the breasts, neck, groin, and armpits
  • Acne along the back, chest, or face
  • Extra body hair around the nipples, face, belly, or chest
  • Fertility problems (repeat miscarriages or not ovulating)
  • Insulin resistance as well as too much insulin, leading to skin tags and upper body obesity
  • Mood swings or depression
  • Breathing problems during sleep (due to insulin resistance and obesity)

Someone who experiences developing male characteristics most likely has another problem as these are not indicative of PCOS. Therefore if you notice these symptoms, your doctor will consider another condition:

  • Decrease of breast size
  • Voice deepening
  • Clitoral enlargement
  • Male pattern baldness

Complications of Polycystic Ovary Syndrome

Suffering from polycystic ovary syndrome can increase the risk of the following conditions, particularly when obesity is also involved:

  • High blood pressure during pregnancy or gestational diabetes
  • Endometrial cancer from exposure to high estrogen levels
  • Abnormal uterine bleeding
  • Anxiety and depression
  • Sleep apnea
  • Infertility
  • Nonalcoholic steatohepatitis (severe liver inflammation from fat accumulation)
  • Metabolic syndrome (and increased risk for cardiovascular disease)
  • Lipid and cholesterol abnormalities
  • High blood pressure
  • Type 2 diabetes

PCOS and Pregnancy

Women with polycystic ovary syndrome tend to show higher rates of the following: premature delivery, preeclampsia (pregnancy-induced high blood pressure), gestational diabetes, and miscarriage. Babies of mothers with PCOS have an increased risk of dying before, shortly after, or during birth or of being in neonatal intensive care units. These problems are more likely to occur with multiple births.

When to Visit a Doctor

You should visit your doctor any time that you have concerns surrounding your menstrual periods, infertility, or if there are indications of excess androgen, including male-pattern hair growth and acne.

What Causes Polycystic Ovary Syndrome?

Experts are still unsure as to what causes PCOS, but they are aware of possible factors:

  • Excessive Insulin: This hormone is produced by the pancreas and is responsible for letting cells use sugar, which is the primary energy supply. Insulin resistance reduces the ability to effectively use insulin, meaning the pancreas must secrete more so cells have access to glucose (sugar). This excess insulin may also lead to increased androgen production by the ovaries, interfering with ovulation.
  • Low-Grade Inflammation: White blood cells help fight infections via inflammation, in which they produce certain substances. Women with PCOS tend to have low-grade inflammation which stimulates the polycystic ovaries, producing more androgens.
  • Heredity: The chances of having polycystic ovary syndrome may increase if your sister or mother have it and researchers are examining possible genetic links.

How to Diagnose Polycystic Ovary Syndrome

In order to diagnose PCOS, your doctor will:

  • Ask about your menstrual cycles, past health, and symptoms.
  • Conduct a physical examination to check for symptoms, including high blood pressure, extra body hair, and an unhealthy body mass index (BMI).
  • Conduct lab tests to examine insulin, blood sugar, and hormone levels. These hormone tests may rule out other gland problems (such as with the thyroid) that may be causing the symptoms.
  • Use a pelvic ultrasound to check for ovarian cysts. It is possible to determine whether you have PCOS without the ultrasound, but it can help rule out other issues.

How to Treat Polycystic Ovary Syndrome

Weight control, healthy foods, and regular exercise all help treat polycystic ovary syndrome. Treatment helps to reduce symptoms while preventing long-term health problems.

  • Moderate and/or vigorous activity is recommended.
  • Try eating heart-healthy foods, such as fruits, vegetables, beans, nuts, and whole grains while limiting foods with high amounts of saturated fat, like fried foods, cheeses, and meats.
  • Eat low-carbohydrate foods to reduce insulin levels, but don’t be overly restrictive.
  • Many women will PCOS will see improvement from weight loss. Even 10 pounds or 4.5 kilograms can balance hormones and help regulate the menstrual cycle. Try to reduce portion sizes and use smaller plates.
  • Quitting smoking can reduce androgen levels.

Birth control pills may also reduce symptoms, while metformin may help with regularizing menstrual cycles. There are also fertility medications to help when trying to conceive. Over-the-counter medications help treat the associated acne. Your doctor will suggest regular tests for high blood pressure and diabetes.

Preventing Complications

The best way to reduce the risk of complications associated with PCOS is to control the symptoms as early as possible. Instead of focusing on a particular symptom, work with your doctor to treat all of the symptoms as a whole. One example would be to treat all symptoms instead of only fertility issues. You should also be sure to take regular tests for diabetes. 

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