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Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS) also known as Stein-Leventhal syndrome is a complicated endocrine disorder associated with a long-term lack of ovulation (anovulation) and an excess of androgens (male hormones, e.g., testosterone). PCOS affects an estimated 6-10% of all women and most don’t even know they have it.

Formation of eight or more follicular cysts of 10 mm or smaller in the ovaries is very typical for PCOS. The process related to the anovulation – ovary’s failure to release an egg (ovum). The many cysts in a polycystic ovary are follicles that have matured but, due to abnormal hormone levels, were never released. In a normal ovary, a single egg develops and is released each month.

PCOS is one of the most frequent causes of infertility.

Polycystic Ovarian Syndrome – typical symptoms

PCOS symptoms include various menstrual problems and endocrine abnormalities. Typical symptoms of PCOS are:

Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome

  • rare periods every 3-5 months (oligomenorrhea);
  • irregular periods;
  • irregular ovulation or absence of ovulation;
  • reduced fertility and/or difficulty in becoming pregnant and/or infertility;
  • multiple cysts on the ovaries;
  • recurrent miscarriages;
  • excessive unwanted facial and/or body hair (hirsutism);
  • oily skin and/or acne;
  • obesity, overweight, rapid weight gain; difficulty in losing weight;
  • diabetes with insulin resistance or hyperinsulinemia;
  • increased level of testosterone and LH;
  • sometimes hypertension (high blood pressure);
  • sometimes the thinning of the scalp hair (alopecia).

Even if specific symptoms are not causing an immediate problem, PCOS can have significant long-term effects, including diabetes, heart disease, and endometrial or breast cancer, so seeking treatment is critical.

PCOS affects women differently – some women may only have a couple of mild symptoms, whilst others may exhibit a wider range of symptoms more severely. All girls and women are different and PCOS symptoms are also different.

Polycystic Ovarian Syndrome – causes

The cause of PCOS is unknown. Most researchers think that more than one factor could play a role in developing PCOS. Genes are thought to be one factor. Women with PCOS tend to have a mother or sister with PCOS. Researchers also think insulin could be linked to PCOS. Insulin is a hormone that controls the change of sugar, starches, and other food into energy for the body to use or store. For many women with PCOS, their bodies have problems using insulin so that too much insulin is in the body. Excess insulin appears to increase production of androgen. This hormone is made in fat cells, the ovaries, and the adrenal gland. Levels of androgen that are higher than normal can lead to acne, excessive hair growth, weight gain, and problems with ovulation.

Polycystic Ovarian Syndrome – treatment

PCOS treatment decisions depend on symptoms, age, whether or not the patient wants to become pregnant, and the degree of ovarian, adrenal and androgen excess. First line management includes diet modification, weight loss and stress reduction since obesity and stress can contribute to androgen excess. Other management and treatment approaches are directed at addressing specific symptoms (i.e. acne, excess hair growth, menstrual problems, infertility) and at preventing long-term complications, given that PCOS can begin in adolescence or earlier.

Some PCOS symptoms (acne, menstrual irregularity) may affect body image and self-esteem, and may be of concern, especially in adolescent girls. Education and support are important in helping young women cope with the physical and psychological aspects of PCOS.

Treatment should be organized by qualified doctors.

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2 Comments

  1. I missed my period the month of June 2015. Never missed a period before. Took 4 test all negative. So I went to my Obgyn they did a pregnancy test came back negative. So she told me to come back to do a ultrasound on my ovaries. Later that day got my period July 7 2015. So I believe my cycle was just changing. So 2weeks later I do my ultrasound and my OBGYN tells me I have a “string of pearls” on both of my ovaries. Basically I’m not ovulating. She did blood work. Got my period for August 2015 and she says I don’t have PCOS because everything came back fine. But my hirmones are imblanced which is causing me not to ovulate. I’m confused !!! She couldnt tell me what was off. I want to ovulate because I want kids !!!! My husband and I always have unprotected sex because we wants kids, could his sperm be why ?? I also got 1 depo shot over 1year ago didn’t like so never got it again ? Could that be why ??

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