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POLYCYSTIC OVARIAN SYNDROME
Q. What is Polycystic Ovarian Syndrome (PCOS)?
A. PCOS is a disorder occurring in women of reproductive age. This condition is caused when a woman's hormones are not in balance, usually resulting in higher levels of androgens ("male" hormones) in her system. Its name comes from the fact that some women with PCOS have enlarged ovaries, with many fluid-filled sacs or cysts. Ovarian cysts can form when egg-containing cysts in the ovary grow but do not release the egg. These small cysts are not harmful-they are not cancer and do not need to be removed.
The symptoms of the disorder include infrequent, irregular, or absent menstruation, excessive growth of body hair, excessive body weight, and infertility.
Q. How many women does it affect?
A. It is estimated that between 5% and 10% of adolescent girls and women in their reproductive years have or develop this condition. It is important to understand that the condition varies from mild to very severe cases.
Q. What groups of women are most often affected?
A. Polycystic Ovarian Syndrome usually begins shortly after puberty, but can begin at any time during a woman's reproductive years. However, as a general rule, if it hasn't developed by the age of 25, it is usually not going to be a problem. PCOS crosses all ethnic and racial boundaries, and does not seem to affect women of any socioeconomic class more often than another.
Q. What are the symptoms of PCOS?
A. A number of symptoms may be present. While no two women are affected in exactly the same way, the most common symptoms include:
- Amenorrhea (lack of menstruation)
- Anovulation (lack of ovulation)
- Abnormal uterine bleeding
- Excessive hair growth
- Hair growth in unusual places
- Infertility
- Male-pattern of hair loss and fat deposition
- Weight gain
- Acne/oily skin
Less common features include:
- Thinning hair or male-pattern baldness
- Skin tags or tiny excess flaps of skin in the armpits or neck area
- Abnormal lipid levels, such as high total cholesterol and low HDL ("good") cholesterol.
- High blood pressure (above 140/90 mmHg).
- Diabetes.
Q. What are the causes of PCOS?
A. There are probably a number of causes of PCOS, many of which we do not understand. It appears that most women with the disorder have an abnormal elevation of testosterone and luteinizing hormone levels. These abnormally elevated hormone levels cause a disruption of the normal menstrual cycle. More recently, it appears that many patients have an abnormal response to insulin. Immature cysts develop and remain in the ovary, giving it the characteristic cystic appearance, and thus the name poly (many) cystic ovarian syndrome.
Q. What are the treatments for PCOS?
A. Although no cure exists, PCOS can be treated in several ways, often with excellent results. The treatment depends on the patient's presenting symptoms and whether the patient desires pregnancy. If the patient is infertile and desires pregnancy, the possible treatments include: Clomiphene Citrate, Pergonal, or surgical "drilling" of the ovary. If fertility is not an issue, treatments include: oral contraceptives, Provera, or Spironolactone. For patients who have insulin resistance, treatment choices include: Metformin, Rezulin, and carbohydrate-controlled diet. While there is no known cure for PCOS, many patients can control the disorder with diet, weight loss, and medical intervention.
Thomas G. Stovall, M.D.
Dr. Stovall is a Clinical Professor of Obstetrics and Gynecology at the University of Tennessee Health Science Center in Memphis, Tennessee and Partner of Women's Health Specialists, Inc.
Date Published: 2004-03-04
7800 Wolf Trail Cove, Germantown, TN 38138
Phone: (901) 682-9222; Fax: (901) 682-9505