- 18. 2. 2016
- Reproductive health
POLYCYSTIC OVARIAN SYNDROME, OR PCOS, IS A CONDITION IN WHICH A WOMAN’S LEVELS OF THE SEX HORMONES ESTROGEN AND PROGESTERONE ARE OUT OF BALANCE. THIS LEADS TO THE GROWTH OF OVARIAN CYSTS (BENIGN MASSES ON THE OVARIES).
PCOS CAN CAUSE PROBLEMS WITH A WOMEN’S MENSTRUAL CYCLE, FERTILITY, CARDIAC FUNCTION, AND APPEARANCE.
The three main features of PCOS are cysts developing in your ovaries (polycystic ovaries), your ovaries not regularly releasing eggs (ovulating), high levels of “male hormones” called androgens in your body.You’ll usually be diagnosed with PCOS if you have at least two of these features.
A diagnosis of PCOS can usually be made if other rare causes of the same symptoms have been ruled out and you meet at least two of the following three criteria:
- you have irregular periods or infrequent periods – this indicates that your ovaries don’t regularly release eggs (ovulate)
- blood tests show you have high levels of “male hormones” such as testosterone (or sometimes just the signs of excess male hormones, even if the blood test is normal)
- Ultrasound shows you have polycystic ovaries
Polycystic ovaries contain a large number of harmless cysts up to 8mm in size. The cysts are under-developed sacs in which eggs develop. In PCOS, these sacs are often unable to release an egg, which means that ovulation doesn’t take place.
Signs and symptoms of PCOS
Symptoms of PCOS usually become apparent during your late teens or early twenties. They can include irregular periods or no periods at all, difficulty getting pregnant (because of irregular ovulation or failure to ovulate), excessive hair growthusually on the face, chest, back or buttocks, weight gain, thinning hair and hair lossfrom the head, oily skin or acne. PCOS is also associated with an increased risk of developing health problems in later life, such as type 2 diabetes and high cholesterol levels.
What causes PCOS?
The exact cause of PCOS is unknown, but it often runs in families. The condition is associated with abnormal hormone levels in the body, including high levels of insulin. Insulin is a hormone that controls sugar levels in the body. Many women with PCOS are resistant to the action of insulin in their body and so produce higher levels of insulin to overcome this. This contributes to the increased production and activity of hormones such as testosterone. Being overweight increases the amount of insulin your body produces.
There’s no cure for PCOS, but the symptoms can be treated. If you have PCOS and you’re overweight, losing weight and eating healty can make some symptoms better. Medications are also available to treat symptoms such as excessive hair growth, irregular periods and fertility problems. If fertility medications are ineffective, a simple surgical procedure called laparoscopic ovarian drilling (LOD) may be recommended. This involves using heat or a laser to destroy the tissue in the ovaries that’s producing androgens, such as testosterone.
With treatment, most women with PCOS are able to get pregnant.
PCOS is one of the most common causes of female infertility. Many women discover they have PCOS when they’re trying to get pregnant and are unsuccessful. During each menstrual cycle, the ovaries release an egg (ovum) into the uterus (womb). This process is called ovulation and usually occurs once a month.
However, women with PCOS often fail to ovulate or ovulate infrequently, which means they have irregular or absent periods and find it difficult to get pregnant. A medication called clomifene is usually the first treatment recommended for women with PCOS who are trying to get pregnant. Clomifene encourages the monthly release of an egg from the ovaries (ovulation). If clomifene is unsuccessful in encouraging ovulation, another medication may be recommended such as Metformin/ Letrozole.
If you’re unable to get pregnant despite taking these first-line medications an alternative are Gonadotropins (hormones, given as shots, causing ovulation) a surgical procedure called laparoscopic ovarian drilling. This treatment can be as effective as using gonadotrophins, but it doesn’t increase risk of multiple pregnancies.
A fertility specialist will also check that your fallopian tubes aren’t blocked before most of these treatments are used. If you do not get pregnant with the treatments listed above, your health care provider may suggest in vitro fertilisation. IVF may offer women with PCOS the best chance of getting pregnant, and it may give health care providers better control over the risk of multiple births.