Polycystic Ovarian Syndrome: Introduction, Symptoms and Treatment
PCOS is a health problem that can affect a woman's menstrual cycle, fertility, hormones, insulin production, heart, blood vessels, and appearance. According to the U.S. Department of Health & Human Services, women with PCOS have these characteristics:
- high levels of male hormones, also called androgens
- an irregular or no menstrual cycle
- may or may not have many small cysts in their ovaries. Cysts are fluid-filled sacs.
PCOS is the most common hormonal reproductive problem in women of childbearing age.
What are the symptoms of Polycystic Ovarian Syndrome (PCOS)?
These are some of the symptoms of PCOS listed by the U.S. Department of Health & Human Services:
- infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
- infertility or inability to get pregnant because of not ovulating
- increased growth of hair on the face, chest, stomach, back, thumbs, or toes
- acne, oily skin, or dandruff
- pelvic pain
- weight gain or obesity, usually carrying extra weight around the waist
- type 2 diabetes
- high cholesterol
- high blood pressure
- male-pattern baldness or thinning hair
- patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs
- skin tags, or tiny excess flaps of skin in the armpits or neck area
- sleep apnea - excessive snoring and breathing stops at times while asleep
How is Polycystic Ovarian Syndrome (PCOS) treated?
Because there is no cure for PCOS, it needs to be managed to prevent problems. According to the U.S. Department of Health & Human Services, treatments are based on the symptoms each patient is having and whether she wants to conceive or needs contraception. Below are descriptions of treatments used for PCOS.
- Birth control pills. For women who don't want to become pregnant, birth control pills can regulate menstrual cycles, reduce male hormone levels, and help to clear acne. However, the birth control pill does not cure PCOS. The menstrual cycle will become abnormal again if the pill is stopped. Women may also think about taking a pill that only has progesterone, like Provera, to regulate the menstrual cycle and prevent endometrial problems. But according to the U.S. Department of Health & Human Services, progesterone alone does not help reduce acne and hair growth.
- Diabetes Medications. The medicine, Metformin, also called Glucophage, which is used to treat type 2 diabetes, also helps with PCOS symptoms. Metformin affects the way insulin regulates glucose and decreases the testosterone production. Abnormal hair growth will slow down and ovulation may return after a few months of use. According to the U.S. Department of Health & Human Services, these medications will not cause a person to become diabetic.
- Fertility Medications. The main fertility problem for women with PCOS is the lack of ovulation. Even so, your sperm count should be checked and your spouse's tubes checked to make sure they are open before fertility medications are used. Clomiphene (pills) and Gonadotropins (shots) can be used to stimulate the ovary to ovulate. PCOS patients are at increased risk for multiple births when using these medications. In vitro Fertilization (IVF) is sometimes recommended to control the chance of having triplets or more. Metformin can be taken with fertility medications and helps to make PCOS women ovulate on lower doses of medication.
- Medicine for increased hair growth or extra male hormones. If a woman is not trying to get pregnant, some other medicines may reduce hair growth. Spironolactone is a blood pressure medicine that has been shown to decrease the male hormone's effect on hair. Propecia, a medicine taken by men for hair loss, is another medication that blocks this effect. Both of these medicines can affect the development of a male fetus and should not be taken if pregnancy is possible. Other non-medical treatments such as electrolysis or laser hair removal are effective at getting rid of hair. A woman with PCOS can also take hormonal treatment to keep new hair from growing.
- Surgery. Although it is not recommended as the first course of treatment, surgery called ovarian drilling is available to induce ovulation. The doctor makes a very small incision above or below the navel, and inserts a small instrument that acts like a telescope into the abdomen. This is called laparoscopy. The doctor then punctures the ovary with a small needle carrying an electric current to destroy a small portion of the ovary. This procedure carries a risk of developing scar tissue on the ovary. This surgery can lower male hormone levels and help with ovulation. But these effects may only last a few months. This treatment doesn't help with increased hair growth and loss of scalp hair.
- A healthy weight. Maintaining a healthy weight is another way women can help manage PCOS. Since obesity is common with PCOS, a healthy diet and physical activity help maintain a healthy weight, which will help the body lower glucose levels, use insulin more efficiently, and may help restore a normal period. Even loss of 10% of her body weight can help make a woman's cycle more regular.
