What is Polycystic Ovarian Syndrome (PCOS)?
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:
PCOS is the most common hormonal reproductive problem in women of childbearing age.
How many women have Polycystic Ovarian Syndrome (PCOS)?
An estimated five to 10 percent of women of childbearing age have PCOS.
What causes Polycystic Ovarian Syndrome (PCOS)?
Why do women with Polycystic Ovarian Syndrome (PCOS) have trouble with their menstrual cycle?
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 does not 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.
What are the symptoms of Polycystic Ovarian Syndrome (PCOS)?
These are some of the symptoms of PCOS:
What tests are used to diagnose Polycystic Ovarian Syndrome (PCOS)?
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 (lining of the uterus). The uterine lining may become thicker if there has not been a regular period.
How is Polycystic Ovarian Syndrome (PCOS) treated?
Because there is no cure for PCOS, it needs to be managed to prevent problems. Treatments are based on the symptoms each patient is having and whether she wants to conceive or needs contraception. Below are descriptions of treatments used for PCOS.
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How does Polycystic Ovarian Syndrome (PCOS) affect a woman while pregnant?
There appears to be a higher rate of miscarriage, gestational diabetes, pregnancy-induced high blood pressure, and premature delivery in women with PCOS. Researchers are studying how the medicine, Metformin, prevents or reduces the chances of having these problems while pregnant, in addition to looking at how the drug lowers male hormone levels and limits weight gain in women who are obese when they get pregnant. No one yet knows if Metformin is safe for pregnant women. Because the drug crosses the placenta, doctors are concerned that the baby could be affected by the drug. Research is ongoing.
Does Polycystic Ovarian Syndrome (PCOS) put women at risk for other conditions?
Women with PCOS can be at an increased risk for developing several other conditions. Irregular menstrual periods and the absence of ovulation cause women to produce the hormone estrogen, but not the hormone progesterone. Without progesterone, which causes the endometrium to shed each month as a menstrual period, the endometrium becomes thick, which can cause heavy bleeding or irregular bleeding. Eventually, this can lead to endometrial hyperplasia or cancer. Women with PCOS are also at higher risk for diabetes, high cholesterol, high blood pressure, and heart disease. Getting the symptoms under control at an earlier age may help to reduce this risk.
Does Polycystic Ovarian Syndrome (PCOS) change at menopause?
Researchers are looking at how male hormone levels change as women with PCOS grow older. They think that as women reach menopause, ovarian function changes and the menstrual cycle may become more normal. But even with falling male hormone levels, excessive hair growth continues, and male pattern baldness or thinning hair gets worse after menopause.
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