Polycystic ovarian syndrome (PCOS) is a disorder associated with the endocrine system. It is a common hormonal disorder that affects almost 5% women in the United States. This syndrome is usually characterized by the development of small cysts in the ovaries (polycystic ovaries), and hormonal imbalance. But sometimes, many women can have cysts in the ovaries without PCOS, while a handful of women with PCOS may not have polycystic ovaries.
What causes PCOS is not known with certainty. In many instances, it has been observed that the patient usually has a family member having PCOS. But sufficient evidence is not there to establish the suspected genetic link. Another common condition associated with PCOS is an abnormality in insulin production. This has led many to suspect a possible link between insulin resistance and the development of PCOS.
When the body becomes resistant to insulin, a higher level of insulin is required to maintain the level of blood sugar in the normal range. But excess insulin in the body may cause hormonal imbalance. Polycystic ovaries generally develop due to the excess production of androgens by the ovaries, which in turn, can be stimulated either by the luteinizing hormone (LH) released by the pituitary gland, or a high level of insulin in the body.
Signs and Symptoms
One of the most common symptoms of this condition is menstrual irregularities. Sometimes, menstruation may be absent for several months, while at other times, it can become quite frequent. An excessive growth of hair on the face and other parts of the body can also occur due to hormonal imbalance, or an overproduction of androgen. This condition is known as hirsutism. Women with PCOS may also experience acne and oily skin, deepening of their voice, and depression. Obesity is another common condition associated with this endocrine disorder.
Diagnosis and Treatment
This condition is usually diagnosed with the help of ultrasound. Sometimes, magnetic resonance imaging (MRI) and CT scans are also carried out to detect the condition. Apart from these, blood is tested to detect the levels of androgen hormones, including androstenedione, testosterone, and dehydroepiandrosterone. Generally, PCOS is associated with elevated levels of these hormones.
The treatment of this condition is aimed towards reducing the level of insulin, restoring regular menstrual cycle and fertility, treating hirsutism, and preventing endometrial hyperplasia and cancer. Physicians usually combine both diet or nutrition therapy and medications. Diet therapy is mainly used to control weight, which can be effective in restoring normal ovulation or menstruation. So, a low carbohydrate diet and regular physical activity can be beneficial in regularizing the menstruation.
As far as medications are concerned, physicians can prescribe birth controls pills, which are effective in treating hormonal imbalance and restoring normal menstruation. They can help reduce the risk of uterine cancer as well. Sometimes, injections of gonadotropins may be required to treat infertility caused by PCOS. However, if the patient does not respond to any of these treatment options aimed at restoring fertility, then assisted reproductive technology, such as in vitro fertilization (IVF) may be required.
PCOS has been found to increase the risk of some serious diseases, like diabetes, high blood pressure, cardiovascular diseases, miscarriages, endometrial hyperplasia, and uterine cancer. It is one of the most important causes of infertility in women. Since a strong relationship between obesity and PCOS has been observed, regular physical activity can play an important role in maintaining an ideal body weight, and thus reduce the risk of PCOS and the associated complications.