What is Polycystic Ovary Syndrome?

Polycystic ovary syndrome (PCOS) is a hormonal imbalance condition which affects an estimated 5-10% of women from puberty to menopause. As many as 30 percent of women have some characteristics of the syndrome.

It affects ovulation and is the most common cause of irregular periods and infertility. For these women, normal, regular ovulation does not occur. This hormonal imbalance also affects other body systems, such as metabolism and the cardiovascular system. The cause of PCOS is not fully known. There is no cure, though it can be managed and treated with medications, diet, and exercise.

Polycystic ovary syndrome was originally named Stein-Leventhal Syndrome in recognition of the two physicians who, in 1935, first described the condition. These physicians noted the "string of pearls" appearance on the ovary and began calling it bilateral polycystic ovary.

Other names for Polycystic Ovary Syndrome are Stein-Leventhal Syndrome, hyperandrogenic chronic anovulation, functional ovarian hyperandrogenism, and Polycystic Ovary Disease.

What causes it?

In the past it was thought that PCOS was caused entirely by excess androgen production, but recent research has shown that the factor that causes the problem is insulin resistance and hyperinsulinemia, which in turn cause overproduction of androgens. Treatment previously revolved around treating the androgen imbalance, and wasn't necessarily very effective.

The cause of PCOS is (still) unclear at this time, but is believed to be strongly associated with insulin resistance, a condition in which the cells of the body become less sensitive to the hormone insulin. Insulin is responsible for controlling the body's level of sugar. When cells cannot use insulin, it begins to accumulate in the blood and leads to various symptoms including obesity and a disruption in the normal menstrual cycle. This disruption frequently results in anovulation, and therefore infertility.

As a matter of clarification, polycystic ovary syndrome is not a disease! (though it is sometimes called Polycystic Ovary Disease). PCOS has many signs and symptoms that occur either early in the condition or develop gradually. Because there is such a wide range of symptoms, PCOS is defined as a syndrome. Symptoms will vary among women, but can include:

• Irregular or absent menses
• Numerous cysts on the ovaries in many, but not all, cases.
• High blood pressure
• Elevated insulin levels, Insulin Resistance, or Diabetes
• Acne
• Infertility
• Excess hair on the face and body (Hirsuitism)
• Thinning of the scalp hair, male pattern balding (alopecia)
• Weight Problems or obesity that is centered around your mid section

What you may not know…

• Studies show that if left untreated, insulin resistance may eventually turn into Type II diabetes.
• Endometrial cancer can result from untreated amenorrhea.
• Postmenopausal breast cancer has been linked to anovulation and amenorrhea in increasing numbers.
• PCOS affects 1 in 10 women...most of them aren't even aware of it's existence.

Treatment Options For PCOS

• Treatment With Insulin-Sensitizing Medications - The Newest Option
• A number of recent studies have shown that treating women with PCOS with insulin-lowering medications such as Metformin (also known as Glucophage) used to treat adult-onset diabetes, can not only reduce the risks of heart disease and diabetes by treating the underlying insulin problems, but also relieve many of the bothersome symptoms and even make weight loss possible. (Please note that these are not weight-loss drugs; women whose weight problems stemmed from insulin resistance may lose weight when the problem is corrected.) This drug does not lower blood sugar and so is generally safe even for those with hypoglycemia, though patients may experience side effects.
•  Risks of Metformin:
• Abdominal Bloating
• Diarrhea
• Excess Gas
• Headache
• Heartburn
• Indigestion
• Nausea
• Taste Disturbances
• Vomiting
• The biggest risk of taking Metformin is developing lactic acidosis, or a build up of lactic acid in the blood. Some symptoms you may experience if you are developing lactic acidosis are as follows: light-headedness or dizziness, generalized weakness, slow or irregular heartbeat, trouble breathing, and muscle aches. Chances of developing lactic acidosis are rare (approx. 1 in 33,000), and it is more likely to occur in those patients who have existing kidney problems. Talk to your medical provider for more information.
• How you may benefit:
• Blood Pressure Lowered
• Free Testosterone Level Lowered
• HDL (good) Cholesterol Elevated
• Increased Fertility (Possibility of Conception)
• Insulin Level Lowered
• LDL (bad) Cholesterol Lowered
• Reduced Hyperinsulinemia
• Reduction or Loss of Unwanted Body Hair (Hirsuitism)
• Regular Menstrual Cycles
• Spontaneous Ovulation (in some cases)
• Triglycerides Lowered
• Weight Loss (often significant)
• In summary, there are many pros and cons to taking Metformin for PCOS. Ongoing clinical trials show that it may reduce the high long term risk of heart attack and stroke in PCOS patients. Other ongoing clinical trials suggest that if a PCOS patient continues to take Metformin, she is much less likely to have a miscarriage and increase the chances of carrying to full term.

• For acne or excess hair growth, a water pill (diuretic) called spironolactone can help. For PCOS women who desire pregnancy, a medication called clomiphene (CLOMID) can be used to induce ovulation (cause egg production).

Click Here for Help with Medical Terms

Amenorrhea: The absence of any menstrual flow by the age of 16

Androgen: A male sex hormone that promotes the development and maintenance of the male sex characteristics. The major androgen is testosterone.

Cysts: A fluid-filled sac in the ovary.

Hypoglycemia: Low blood sugar (glucose).

 

Some helpful links:

The Official Website of the Polycystic Ovarian Syndrome Association (PCOSA)

SoulCysters

Overcoming Infertility

PCOS (A Personal Site)

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Thanks for your hard work Nadia!