Polycystic ovarian syndrome, also known as Stein-Leventhal syndrome or functional ovarian hyperandrogenism, is a common health problem that affects women of reproductive age. PCOS is related to a long-term lack of ovulation and an excess of androgens.
It is one of the most common causes of menstrual problems, hair growth, acne, obesity and infertility. One of the most important characteristics of PCOS is hyperandrogenism, the excessive production of male hormones (androgens), particularly testosterone, by the ovaries.
Polycystic ovaries have at least twice as many developing follicles as normal ovaries. However, many of these follicles do not mature to the point of releasing an egg (ovulation). Because they have more follicles than is usual, polycystic ovaries are slightly larger than normal ovaries. It has been known to run in families.
Around 20 out of every 100 women have polycystic ovaries. Most women with polycystic ovaries have no symptoms.
Symptoms of PCOS
- Menstrual problems (infrequent periods, no periods, and/or irregular bleeding)
- Hirsutism (excessive body or facial hair)
- Endocrine abnormalities
- Diabetes with insulin resistance or hyperinsulinemia
- Ovarian cysts
- Male pattern baldness or thinning hair
- Pelvic pain
- Anxiety or depression due to appearance and/or infertility
- Sleep apnea
- Heart disease
- High blood pressure
- Endometrial or breast cancer
Diagnosis of Polycystic Ovarian Syndrome
PCOS is quite difficult to diagnose because its symptoms are similar to those of other diseases. A doctor will take a complete medical history about menstruation, reproduction, and weight gain. Physical examinations will include a pelvic exam, and visual inspection of the skin for hirsutism, acne, or any other changes. Blood tests are performed to determine the levels of luteinizing hormone, follicle stimulating hormone, estrogens, androgens, glucose, and insulin. A glucose-tolerance test may be administered. An ultrasound examination of the ovaries is performed to evaluate their size and shape.
Treatment of Polycystic Ovarian Syndrome
Treatment of PCOS consists of weight loss combined with exercise, drugs or surgery, and hair removal, depending upon which symptoms are most bothersome, and whether a woman desires pregnancy.
Medications that are used to treat PCOS include anti-androgens, which counter the effects of excess androgens on a woman’s body, and other hormone-regulating drugs like birth control pills.
A surgical operation known as laparoscopic “ovarian drilling” is also performed to treat PCOS. It is a process where between 4-30 tiny holes are made in a cystic ovary. There are newer surgical techniques that minimize the previous problems of scaring and adhesions, but they remain a risk.
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