By Dele Ogunleye, M.D., Advanced Women’s Healthcare
Polycystic ovarian syndrome (PCOS) is a condition in women of reproductive age that is caused by an abnormal balance of hormones produced by the ovaries. This abnormal balance of hormones is both a cause and effect of an interplay of different changes in the body which leads to significant short and long-term consequences. The health implications are huge, and many women are not aware of this condition. Even though PCOS is slightly complicated, I hope this article will shed more light on this topic.
PCOS is diagnosed by the presence of two out of three of the following symptoms:
- Irregular menstrual periods caused by decreased ovulation. In the reproductive period, one of the main functions of the ovaries is to release an egg monthly. This facilitates the desire of many women to get pregnant when they are ready. In polycystic ovarian disease, ovulation is either decreased or comes to an absolute stop. This lack of ovulation manifests as irregular or heavy periods and difficulty with getting pregnant. Women with PCOS usually have less than eight periods a year.
- Elevated male-type hormones. All women produce “male-type” hormones like testosterone from their ovaries and other organs. In women with PCOS, for many different reasons, these hormones are produced at higher-than-normal levels. This can be determined by evaluating the symptoms or by a blood test. The characteristic symptoms include acne and increased hair growth, sometimes on the face, chest, and abdomen. Less commonly, this may be seen as male-type baldness.
- Characteristic appearance of ovaries. Polycystic ovarian syndrome gets its name from the characteristic appearance of the ovaries on ultrasound examination. “Poly — cystic” means many cysts on the ovary, and these cysts are usually arranged on the ovary like a pearl necklace or like chocolate chips in a cookie. On each ovary, some women have up to 10 to 12 cysts and are usually small, not the size that will cause pain.
PCOS is known to affect about eight to ten percent of women of reproductive age (between 18 and 45). There are some experts who believe it may be more prevalent because the symptoms vary among different women and, therefore, it may be underreported.
There is not a known cause of PCOS, but it is associated with elevated insulin levels. Insulin is a hormone that helps regulate glucose levels. Increasing levels of insulin are required to maintain normal glucose in the blood. This term known as “insulin resistance” is associated with changes in women’s metabolism that leads to difficulties with weight control and obesity and is a significant risk factor for diabetes later in life. Insulin resistance can develop in both obese women and those of normal BMI. Many studies have found that up to 50 percent of women with PCOS have obesity. Weight gain is usually gradual. However, there are many women who have PCOS and have normal or low BMI. Some of the other risks with PCOS include high cholesterol levels and sleep apnea, a condition where there are brief spells when breathing stops during sleep. This leads to daytime sleepiness and fatigue.
The treatment for PCOS depends on the symptoms manifested. The following are some examples.
- Weight loss and diet is one of the most effective ways of managing PCOS. Many overweight women with PCOS who lose five to ten percent of their body weight notice that their periods become regular.
- Oral contraceptives are important for women who have irregular or heavy periods and for those that need contraception. There are also some contraceptives that contain medications that antagonize male-type hormones and this is beneficial for patients who have symptoms like excessive hair growth or acne.
- Metformin is a medication has been traditionally used for diabetes but has been shown to be effective in treating women who have PCOS. It is known to increase the body cells more sensitive to insulin. It has been shown to help with weight loss in addition to diet and exercise in patients that are obese.
- Infertility. Women who have difficulties getting pregnant because of PCOS usually will need stimulation of their ovaries to restart the release of eggs to facilitate pregnancy. They have a good chance getting pregnant if they have no other causes for infertility.
While there is not a cure for PCOS, it can be managed to prevent serious problems.
Dele Ogunleye, M.D., provides a full range of obstetric and gynecologic services. He is subspecialized in urogynecology, so he has particular expertise in treating pelvic floor disorders. Brittany King is an advanced-practice nurse specializing in women’s health. She works alongside Dr. Ogunleye to provide a full range of obstetric and gynecologic services. You may contact Dr. Ogunleye or Brittany at Advanced Women’s Healthcare, 309-808-3068 or www.awhcare.com. The office is located at 2111 East Oakland Avenue (Next to the Jewel-Osco Plaza).