Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS) is a health problem that can affect a woman’s menstrual cycle, fertility, hormones, insulin production, heart, blood vessels, and appearance. Women with PCOS have these characteristics:

• high levels of male hormones, also called androgens
• an irregular or no menstrual cycle
• may or may not have many small cysts in their ovaries. Cysts are fluid-filled sacs.

PCOS is the most common hormonal reproductive problem in women of childbearing age. An estimated five to ten percent of them have PCOS.

Symptoms and Diagnosis

These are some of the symptoms of PCOS:

• infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
• infertility or inability to get pregnant because of not ovulating
• increased growth of hair on the face, chest, stomach, back, thumbs, or toes
• acne, oily skin, or dandruff
• pelvic pain
• weight gain or obesity, usually carrying extra weight around the waist
• type 2 diabetes
• high cholesterol
• high blood pressure
• male-pattern baldness or thinning hair
• patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs
• skin tags, or tiny excess flaps of skin in the armpits or neck area
• sleep apnea―excessive snoring and breathing stops at times while asleep

There is no single test to diagnose PCOS. Your doctor will take a medical history, perform a physical exam—possibly including an ultrasound, check your hormone levels, and measure glucose, or sugar levels, in the blood. If you are producing too many male hormones, the doctor will make sure it’s from PCOS. At the physical exam the doctor will want to evaluate the areas of increased hair growth, so try to allow the natural hair growth for a few days before the visit. During a pelvic exam, the ovaries may be enlarged or swollen by the increased number of small cysts. This can be seen more easily by vaginal ultrasound, or screening, to examine the ovaries for cysts and the endometrium. The endometrium is the lining of the uterus. The uterine lining may become thicker if there has not been a regular period.

Causes

No one knows the exact cause of PCOS. Women with PCOS frequently have a mother or sister with PCOS. But there is not yet enough evidence to say there is a genetic link to this disorder. Many women with PCOS have a weight problem. So researchers are looking at the relationship between PCOS and the body’s ability to make insulin. Insulin is a hormone that regulates the change of sugar, starches, and other food into energy for the body’s use or for storage. Since some women with PCOS make too much insulin, it’s possible that the ovaries react by making too many male hormones, called androgens. This can lead to acne, excessive hair growth, weight gain, and ovulation problems.

Cause of Ovulation Problems by PCOS

The ovaries are two small organs, one on each side of a woman's uterus. A woman's ovaries have follicles, which are tiny sacs filled with liquid that hold the eggs. These sacs are also called cysts. Each month about 20 eggs start to mature, but usually only one becomes dominant. As the one egg grows, the follicle accumulates fluid in it. When that egg matures, the follicle breaks open to release the egg so it can travel through the fallopian tube for fertilization. When the single egg leaves the follicle, ovulation takes place.

In women with PCOS, the ovary doesn't make all of the hormones it needs for any of the eggs to fully mature. They may start to grow and accumulate fluid. But no one egg becomes large enough. Instead, some may remain as cysts. Since no egg matures or is released, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman’s menstrual cycle is irregular or absent. Also, the cysts produce male hormones, which continue to prevent ovulation.

Reference:

National Women's Health Information Center, USA