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Symptoms, Causes, and Treatments of Polycystic Ovary Syndrome (PCOS)

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    • Polycystic ovary syndrome (PCOS) is common hormonal disorder among women which are in reproductive ages(15-46years) nowadays. Polycystic ovary syndrome (PCOS)

    PCOS is thought to affect FIVE to TEN PERCENT of all U.S. women. Higher percentages are found in African-American females(8%) and Latinas(13%) than among Caucasians(4.8%).

    PCOS produce infrequent or prolonged menstrual periods or higher than normal level male hormones (Androgen). The ovaries may develops many small collection of fluid (follicles) and fail to regularly release of eggs(ova).

    What is PCOS?

    Polycystic ovary syndrome is manifested by amenorrhea(absence of menstruation), hirsutism (abnormal growth of hair on a woman’s face and body),obesity and enlarged poly cystic ovaries.

    SIGNS AND SYMPTOMS:

    • Irregular or no menstrual periods
    • Heavy periods
    • Excess body facial hair
    • Acne
    • Pelvic pain
    • Difficulty getting pregnant
    • Patches of thick, darker, velvety skin

    Other conditions:

    • Type 2 Diabetes mellitus
    • Obesity
    • Obstructive sleep apnea
    • Heart disease and
    • Endometrial cancer.

    Causes:

    1. Resistance to insulin:

    The meaning of insulin resistance is pancreas are resistant to the insulin and they are unable to use it as effectively leading to high blood sugar level.

    High levels of insulin causes the ovaries to produce too much testosterone (male hormone);which interferes with the development of the follicles(the sacs in the ovaries where eggs develop) and prevents normal ovulation.

    Insulin resistance can also leads to weight gain which can make PCOS symptoms worse become having excess fat causes the body to produce even more insulin.

    1. Hormone imbalance:

    Endocrine abnormalities seen in PCOS are:

    1. Elevated androgen
    2. Elevated LH
    3. Low FSH
    4. Elevated oestrogen in the form of oestrone
    5. Elevated insulin
    6. Elevated prolactin
    7. Genetics:

    If there is any history of PCOS in your family and relatives such as your mother,sister or aunty.Then you have a chance of developing PCOS.

    DIAGNOSIS:

    • Ultrasound
    • Blood test
    1. Cholesterol
    2. Blood pressure
    • Glucose metabolism/tolerance
    • Hormonal blood tests:
    1. Androgens(testosteron) and Free androgens index(FAI)
    2. Oestradiol (oestrogen)
    • Follicle stimulating hormone(FSH)
    1. Luteinizing hormone(LH)
    2. Thyroid stimulating hormone(TSH)
    3. Prolactine

    Treatments:

    • Obesity: Patient should change his or her life style and leads a healthy life.
    • Metformin:Metformin improve hyperandrogenism, abnormalities of gonadotropin secreation in women with PCOS and can restore menstrual cyclicity and fertility.
    • Menstrual irregularity: Better treated with low dose combine oral contraceptive pills (OCP)
    • Infertility: it is best treated with-
    1. Antioestrogens
    2. Gonadotropins
    3. Clomiphene citrate plus Gonadotropin
    4. Laporoscopic ovarian drilling(Surgical option)

    ---------------  By Harley Street Gynaecology, Private Gynaecologist London

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