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Polycystic Ovarian Syndrome (PCOS)
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What is Polycystic Ovarian Syndrome (PCOS)?
Polycystic Ovarain Syndrome or PCOS is a common gynecological disorder affecting an estimated five to 10 percent of women of childbearing age, and is a leading cause of infertility. It can affect a woman’s:
- Menstrual cycle
- Fertility
- Hormones
- Insulin production
- Heart
- Blood vessels
- Appearance
In women with PCOS, the ovary does not make all of the hormones it needs for a woman’s eggs to fully mature, and some remain as cysts. Ovulation does not occur and progesterone is not made, so the menstrual cycle is irregular or absent. The cysts produce male hormones which continue to prevent ovulation.
Common Characteristics
- Menstrual cycle disturbances and infertility
- High levels of androgens (male hormones), causing symptoms such as unwanted facial hair, acne and weight gain
- Metabolic problems, including abnormal lipid levels, insulin/glucose and hypertension
- Small cysts may or may not be present in the ovaries, but are not related to PCOS
Causes of Polycystic Ovarian Syndrome
While the exact cause of PCOS is unknown, insulin resistance and weight problems are common. For some women with PCOS, their bodies make too much insulin, which may stimulate the production of androgen from the ovaries and adrenal gland. This contributes to the unwanted male symptoms and ovulatory dysfunction by increasing the androgen environment of the oocyte (egg).
Treatment to Facilitate Pregnancy
Although there is no cure for PCOS, there are treatments to prevent problems and facilitate pregnancy:
-
Fertility medications
Ovulation induction therapy with clomiphene or gonadotropins is used to facilitate ovulation. While often successful, these therapies may increase the risk of multiple births.
- Diabetes medications
Metformin, approved for insulin resistance and type 2 diabetes, affects the way insulin regulates glucose and decreases the testosterone production. Ovulation may return after a few months of use. Combination therapy with clomiphene and metformin may be a more effective therapy than either one alone.
- Surgery
Ovarian drilling (electrosurgical incisions) can lower male hormone levels and help with ovulation, but the effects may only last a few months.
- Weight loss
A healthy weight helps the body lower glucose levels, use insulin more efficiently and may help restore a normal period.
Sources
The National Women’s Information Center, U.S. Department of Health & Human Services. Frequently Asked Questions about Polycystic Ovarian Syndrome (PCOS). www.4woman.gov. Accessed: 1/05/05.
Thatcher, Samuel S. What Is Polycystic Ovarian Syndrome (PCOS)? A Fact Sheet from the Center for Applied Reproductive Science. OBGYN.net. Accessed: 1/05/05.
Nestler JE. Jakubowicz DJ. Evans WS. Pasquali R. Effects of metformin on spontaneous and clomiphene-induced ovulation in the polycystic ovary syndrome. New England Journal of Medicine. 338(26):1876-80, 1998 Jun 25.