Polycystic ovarian syndrome (PCOS) is a condition that most women don’t know about until the doctor tells them they have it. It is the most common condition that affects women in their childbearing years, which by some estimates can be as many as 5 million women in the United States alone. Many women have a difficult time getting pregnant with PCOS.
What Is PCOS?
The name polycystic refers to the benign cysts that form on the ovaries. These cysts are immature eggs that were not ovulated during the woman’s menstrual cycle. When the cysts are present, they tend to form in the shape of a string of pearls on the outside of the ovary, indicating that the woman is suffering from some form of PCOS.
Characterized by imbalance in hormones, PCOS sufferers typically have a high level of androgen, a male hormone that women’s endocrine systems also produce. Androgens interfere with the egg maturation and release that is part of a woman’s natural ovulation cycle. This is the main cause of infertility for women with PCOS. The immature eggs then attach along the outer edge of the ovary.
In addition to androgens, women with PCOS tend to have problems with insulin, the hormone that helps manage blood sugars in the body. Women with PCOS often develop insulin resistance, which means the body no longer processes sugars the way it should. Insulin resistance also increases the production of even more androgens that then cause symptoms that can include weight gain, ovulation irregularities, infrequent or prolonged periods, acne and abnormal hair growth.
Causes of PCOS and Diagnosis
The cause of PCOS is unknown at this time. Most experts believe that the propensity to develop the condition is genetic, however. So if your mother or sister suffers from PCOS, there is a good chance you may as well and vice versa. Other factors that might contribute include having an excess of insulin or certain kinds of inflammation. Some experts are exploring the theory that exposure to excessive amounts of androgen in utero may contribute to the condition later in life by preventing genes from functioning the way they should.
Most women are not aware that they have PCOS. For teenage women, the absence of a period or a very infrequent one is an indication of the problem. For more mature women, it can be sudden and unexplained weight gain or the inability to become pregnant.
PCOS is easily diagnosed by a combination of tests. Your doctor may determine based on your medical history that further examination may be in order, which may include a physical exam, a pelvic exam, a blood test to look at androgen and sugar levels, and a vaginal ultrasound to check for cysts and the thickness of the endometrium lining.
Treatment Options
There is no cure for PCOS, but there are extremely effective ways to treat the symptoms. Treatment options for women who are trying to conceive include:
Lifestyle modification: By changing eating habits and improving activity levels, many women with PCOS are able to manage their blood sugar better and facilitate weight loss that can lead to a more regular period.
Fertility Medication: Since the main issue for most women is that they have irregular ovulation periods, many fertility medications can help to correct the problem. Clomiphene (commonly referred to as Clomid) and gonadotropins that are administered with injections are two of the most common medications used to stimulate ovulation.
Glucophage/Metformin: The diabetes medication that helps people with type 2 diabetes manage their symptoms has also been shown to alleviate the symptoms associated with PCOS. Many fertility experts believe that this drug in combination with Clomid can often help a woman ovulate with lower doses of hormones, which is beneficial to the patient as the hormone therapies can have side effects.
PCOS is a condition that is more common than most women know. As many as one in 10 women suffer from the condition. PCOS can affect a woman’s ovulation cycle, making it difficult to get pregnant. But with the help of their doctors, women with PCOS can manage their condition and go on to have the families they always wanted.
Sources:
“Polycystic Ovary Syndrome (PCOS).” www.mayoclinic.org. Web. 5 February 2014. http://www.mayoclinic.org/diseases-conditions/pcos/basics/definition/con-20028841
“Polycystic ovary syndrome (PCOS) fact sheet.” www.womenshealth.gov. Web. 5 February 2014. http://www.womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html