Polycystic ovary syndrome

What is polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a disorder in which many benign cysts form on the ovaries under a thick, white covering. It is most common in women under 30 years old.

The ovaries are glands located on either side of the uterus (womb) in a woman's lower abdomen. The ovaries produce the female hormones oestrogen and progesterone. Before menopause, they also produce eggs.

Ovarian cysts are fluid-filled sacs that result from ovulation cycles. Many ovarian cysts go away without treatment. The most common cysts are just enlargements of normal egg follicles.

What is the cause?

Polycystic ovary syndrome is caused by an abnormal production of two hormones by the pituitary gland in the brain. These two hormones are LH (luteinizing hormone) and FSH (follicle-stimulating hormone). Imbalance of these hormones prevents the ovaries from releasing an egg each month. The ovaries produce more of the male hormone testosterone. They continue to produce oestrogen but not progesterone.

What are the symptoms?

The symptoms may include:

• irregular menstrual periods, particularly long cycles
  
• very light or very heavy bleeding during your period
  
• infertility
  
• more hair on the face, chest, and lower abdomen
  
• obesity
  
• acne

Many young women with polycystic ovaries start having menstrual periods at a normal age. After a year or two of regular menstruation, the periods become quite irregular and, then, infrequent. Obesity and excessive body hair are symptoms in about 50% of the cases.

How is it diagnosed?

The doctor records a detailed medical history and asks for some these of these tests and examinations:

• a physical examination
  
• blood tests to check hormone levels
  
• an ultrasound scan

How is it treated?

Treatment depends on how severe the symptoms are and whether the lady wishes to get pregnant.

If one is not trying to get pregnant the doctor may prescribe birth control pills. With hormones or birth control pills menstrual cycles become regular and one may have less abnormal hair growth. This treatment will also reduce the risk of developing endometrial hyperplasia, a condition that can become uterine cancer.

If pregnancy is desired the doctor may prescribe fertility drugs. In rare cases the doctor may surgically remove or destroy a wedge of ovarian tissue. This usually results in regular menstrual cycles for a while, or it may cure the problem. Electrolysis to remove excess body or facial hair may be recommended. If the patient is obese, a weight control programme might be needed.

How long will the effects last?

Many women with this disorder who want to become pregnant are treated successfully with fertility drugs, but it can be a long, complicated treatment.

Does PCOS cause long-term problems?

Patients with PCOS are more likely to get high blood pressure or diabetes. This means they have a greater risk for strokes and heart attacks.

Because of irregular menstrual periods, women with PCOS are more likely to be infertile (unable to get pregnant). They may also have a higher risk for cancer of the uterus or breast.  

How can one take care of oneself?