Women's Health: Understanding PCOS
by Kenneth L. Noller, MD
President, The American College of Obstetricians and Gynecologists
Polycystic ovary syndrome (PCOS) is a condition that affects approx-imately 4% to 6% of women in the US, yet many have never heard of it.
The causes of PCOS are unknown, and many women may ignore the seemingly unrelated symptoms, such as irregular periods, being overweight, and having extra facial hair. But PCOS is a serious disorder that can make it hard to become pregnant and can lead to other severe health problems, so proper diagnosis and treatment is very important.
Under normal circumstances, a single egg matures every month in a woman's ovary. The egg is surrounded by cells, which produce the hormone estrogen. After the egg is released (ovulation), the cells begin to emit a second hormone, progesterone.
Polycystic ovaries have many eggs, but they are not released. The result is a build-up of estrogen and a lack of progesterone that can cause irregular menstruation and infertility because ovulation has not occurred.
Women with PCOS have higher than normal levels of male hormones (androgens), which also interfere with ovulation. Additionally, excess androgens can cause acne and hair growth on the face, the lower part of the abdomen, between the breasts, and on the inner thighs. Women with severe PCOS may experience balding and develop bigger muscles and a deeper voice.
Women with the disorder often handle glucose (sugar) in the bloodstream inefficiently and may also produce too much insulin, the hormone that lowers blood sugar. These problems may lead to weight gain or make it harder to lose weight. PCOS sufferers are at an increased risk of diabetes, high blood pressure, and heart disease. They also are prone to obesity and weight gain in the mid-section.
To diagnose PCOS, your ob-gyn will perform a physical examination, including a pelvic exam, and will order laboratory tests. A pelvic ultrasound may be done. Your doctor will ask about your menstrual history and lifestyle habits.
You may be advised to increase your physical activity (at least 30 minutes of daily exercise) and lose weight, which may help lower insulin levels. Less insulin can stimulate ovulation and slow undesired hair growth. Your doctor may also prescribe progesterone or birth control pills to regulate your menstrual cycle or medication to control insulin. If you want to become pregnant, medications can be used to induce ovulation.
Though PCOS cannot be cured, it can be treated and your symptoms can be relieved.
For more information, the Patient Education Pamphlet "Polycystic
Ovary Syndrome" is available at www.acog.org/publications/patient_education/bp121.cfm.