UNDERSTANDING POLYCYSTIC OVARIAN SYNDROME (PCOS)

One of the most common problem of  young women about their reproductive health is having irregular cycles.  

 

There are multiple causes of irregular cycles, one of the most common is a disease called Polycystic Ovarian Syndrome (PCOS), when symptoms occurs  that indicate infrequent ovulation and cysts on a woman’s ovaries. 

It is commonly  associated with infertility and can create a emotional burden on those who suffer with it. Every woman manifests with hormonal imbalances and symptoms of PCOS differently. 

Diagnosis of PCOS is based on the Rotterdam criteria,and  two of the following must be present for diagnosis

1. Infrequent or no ovulation (irregular or long menstrual cycles or no menstrual periods)

2. Signs or symptoms  includes acne, abnormal hair growth, hair loss, darkening of skin at skin folds

3. laboratory testing showing high androgens (testosterone or dihydrotestosterone)

4. Polycystic ovaries on ultrasound.

Although the cause of polycystic ovaries is not known, it is thought that both genetic and environmental factors can play a role in the development of PCOS and the disruption of hormones.

Symptoms of pcos

-extrabody hair on the face,belly ,chest or around the nipples.

Acne on the face ,back or chest

Skin changes like creases or marking around the groin,neck,breast and armpits.

Thinning of  hair on the head

Mood swing,anxiety or depression.

sleep problems like sleep apnea or insomnia

,weight gain.

There are some risk factors associated with developing PCOS, but women with no risk factors can also develop this syndrome.

Risk Factors for PCOS

• Genetics

• Family history of diabetes

• Obesity

• Insulin resistance

• High blood sugar

• Low blood sugar

• Use of seizure medication (valproate)

PCOS is the leading cause of infertility , because ovulation does not occured ,therefore preventing conception and stopping normal menstruation. Patient of  PCOS has also  long-term health problems including an increased risk for obesity, type 2 diabetes, cardiovascular disease, mood disorders, and a three times higher increased risk of endometrial cancer.

 Hormone imbalance  in PCOS, including higher testosterone, lower sex-binding hormone globulin (SBHG), increased insulin  and higher LH levels. 

PCOS can be difficult to diagnose, because  every woman will not have the “classic” characteristics of the syndrome. The weight gain, acne, hair growth, and irregular, prolonged, or absent cycles are all signs of PCOS, but these signs often present differently across women, and not every woman has every sign.

The conventional treatment is use of birth control pill– is doing little to solve underlying problems and restore a natural cycle.

There are other type and more cooperative treatments for PCOS.   obesity and insulin resistance in PCOS should be taken care first.

life  modification can improve insulin resistance and obesity  and  risk of developing diabetes decreases.

medical intervention leads to normal return to fertility .  

Other treatments include anti-inflammatory medicine, bio-identical progesterone, and insulin controlling agents like myo-inositol and metformin, vitamin D, and other vitamin supplementation.  For example, Myo-inositol is one newer treatment for insulin resistance in PCOS because it reduces fasting insulin levels and even improve the acne and hair growth problems in PCOS if taken for 6 months or longer.

FERTILITY TREATMENTS FOR WOMEN WITH PCOS

Depending on the patients initial testing, our fertility specialists team may suggest several options that are discussed to each individual’s unique needs. 

• Timed coitus or intrauterine insemination (IUI)

• Use of medications to stimulate ovulation

• Use of other medications such as oral contraceptives pill or insulin-sensitizing medication to improve irregular, heavy periods and other symptoms

• Recommend weight loss and a consultation with one of our fertility specialists to improve hormone imbalance

• In vitro fertilization (IVF).

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