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Polycystic Ovary Syndrome

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Polycystic Ovary Syndrome is clinically referred to as the Stein-Leventhal Syndrome, and more commonly as PCOS or PCO. It is an ailment that affects the endocrine system and afflicts around 10% of the female population, regardless of race or nationality. It is a hormonal condition that is characterized by an imbalance, and often occurs when females reach their reproductive stage, also known as the age of puberty.

This hormonal imbalance is responsible for the irregularity of menstrual periods, excessive hair growth and a proliferation of acne. Polycystic Ovary Syndrome can either be mild or severe, and may even result in infertility.

Most women who have PCOS suffer from unpredictable periods (Oligomenorrhea), and sometimes the total absence of menstrual flow (Amenorrhea) due to a lack of signals sent by the pituitary gland to the ovaries. The absence of these chemical signals make it impossible for the ovaries to produce the eggs necessary for ovulation.

POLYCYSTIC OVARY SYNDROME SIGNS AND SYMPTOMS

Women suffering from Polycystic Ovary Syndrome are apt to gain weight easily and will have difficulty controlling this weight gain. They will also produce more amounts of male hormones that will endow them with androgenic or masculine qualities. Some of these masculine attributes will show up as hirsutism, or excessive growth of hair in the face, chest and leg areas. Conversely, some women develop Androgenic alopecia, which is a condition characterized by male-pattern baldness.

POLYCYSTIC OVARY SYNDROME SYMPTOMS

Females with PCOS are likely to develop dark spots of skin ranging from tan, dark brown, and even black on the backs of their necks and in other body areas. This symptom, called Acanthosis nigricans, is an indication of an insulin resistance commonly associated with PCOS. There will also be Hyperseborrhea, or extremely oily skin coupled with frequent outbreaks of acne. There will likewise be the growth of skin tags, tiny flaps of excess skin also known as Acrochordons.

Other symptoms of Polycystic Ovary Syndrome include experiencing prolonged physical symptoms of PMS (pre-menstrual syndrome), such as backaches, bloating, pelvic pain and mood swings. In some cases, sexual intercourse will be painful. This condition is known as Dyspareunia. All these symptoms can combine and result in bouts of depression for the sufferer.

While Polycystic Ovary Syndrome commonly occurs during the onset of puberty, it can afflict women of any age. It is sometimes present in younger children, or may manifest itself after a woman reaches the menopausal stage. PCOS is difficult to diagnose, and it will take a qualified medical physician experienced in the field of woman's health to be able to detect this syndrome based on the physical symptoms exhibited.

Polycystic Ovary Syndrome has been strongly associated with diabetes, obesity and resistance to insulin, and women with these conditions have a greater risk for acquiring PCOS. It is usually brought about by a hormonal imbalance triggered by the lack of chemical messengers in the brain and ovaries. PCOS also occurs when the pancreas excretes abnormally high levels of insulin, and the ovary starts to produce an excessive amount of the male hormone testosterone.
Polycystic Ovary Syndrome
Image: Polycystic Ovary Syndrome

POLYCYSTIC OVARY SYNDROME DIAGNOSIS

PCOS is generally difficult to diagnose due to the wide range of exhibited symptoms. The doctor will start by taking the history of a patient's menstrual cycle, including an evaluation of the patient's general health. The doctor will also subject the patient to a thorough physical examination to rule out other health-related illnesses.

To determine a patient's hormone levels, blood sugar and cholesterol, the doctor is likely to order a blood test. The state of the patient's uterus and ovaries will likewise be ascertained through a pelvic ultrasound. This is to check for the presence of ovarian cysts which are believed to be the products of abnormal or failed ovulation that occurs with this syndrome.

The doctor may also order an examination done via a laparoscopic procedure to view the outer surface of the ovary. Other diagnostic tests include checking of blood serum levels to verify the presence of high amounts of testosterone; fasting biochemical screen; lipid profile, and a glucose tolerance test for patients with a higher risk for PCOS, such as a personal or family history of diabetes or obesity.

Other tests may also be administered to rule out the presence of other disorders that may exhibit similar symptoms, such as Congenital Adrenal Hyperplasia, Hyperprolactinemia, Cushing's syndrome, and other adrenal and pituitary gland ailments which may also cause absent or irregular menstrual periods and hirsutism.

There is no cure for Polycystic Ovary Syndrome, however it can be successfully treated by targeting the underlying causes that trigger it. There are long-term drug treatment options available, such as hormone medications and insulin-sensitizing therapies to control the accompanying symptoms of irregular menstrual periods, excessive hair growth and acne breakouts.

POLYCYSTIC OVARY SYNDROME TREATMENT

The goal of PCOS treatment will depend on the patient's condition. Basically, medication will be geared at lowering the patient's insulin levels, restoring the patient's fertility, managing hirsutism, weight gain and acne, regularizing the patient's monthly period, and preventing the occurrence of PCOS complications like Endometrial hyperplasia or Endometrial cancer.

Doctors will recommend adapting a healthy lifestyle, good eating habits and regular physical exercise to manage obesity and control weight gain. To lower insulin levels and restore normal ovulation, medications like metformin hydrochloride (Glucophage), rosiglitazone maleate (Avandia) and pioglitazone hydrochloride (Actos) have been found to be 85% effective, combined with a low-sugar diet and exercise.

Treatment of infertility will involve the use of metformin and clomiphene citrate which were found effective in treating women who have had trouble getting pregnant due to PCOS. These drugs were also found to increase the rates of ovulation and lower the occurrence of miscarriage. To regularize the menstrual cycle, patients may be prescribed with contraceptive pills or an oral progestogen, which may also be helpful for treating hirsutism, particularly if the contraceptive medication contains the ingredient, cyproterone acetate.

POLYCYSTIC OVARY SYNDROME PREVENTION

There is no known method of preventing Polycystic Ovary Syndrome, however, early diagnosis and treatment will lower the risks of acquiring complications like heart disease, uterine cancer and diabetes. The accompanying therapy of a healthy low- cholesterol diet, regular exercise, and avoiding smoking will be beneficial in lowering insulin levels and stabilizing hormones.


With early diagnosis and treatment, PCOS symptoms can be placed under control and even disappear. While infertility problems can be reversed, hormonal imbalances and irregular ovulation may recur. Women with this syndrome will need to strictly regulate their lifestyle and have themselves checked for endometrial cancer, determine their glucose levels, and have their blood pressure and cholesterol screening on a regular basis.

There has been some research on the diabetes drug Avandia which has been found to normalize ovulation in obese women afflicted with Polycystic Ovary Syndrome. One study group achieved success with this drug within the span of three months. Avandia was also discovered to reduce testosterone levels in patients suffering from PCOS. Another medication, the diet drug Xenical was able to effectively help control weight gain in obese patients afflicted with PCOS.
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