Polycystic Ovarian Syndrome

What is Polycystic Ovarian Syndrome?

Polycystic ovarian syndrome (PCOS) is a common endocrine disorder and one of the common causes of reduced fertility among women.

It is characterised by an ovulation dysfunction or impedance to the normal growth and release of eggs from the ovaries. It is commonly seen in women of childbearing age and is rare after menopause.

The hormonal imbalance results in enlarged ovaries containing multiple small cysts (fluid-filled sacs).

Causes of Polycystic Ovarian Syndrome (PCOS)

The exact cause of the polycystic ovarian syndrome is unknown. However, several factors including genetics have been implicated to play a role in the development of PCOS.

Women with a family history of the polycystic ovarian syndrome are at a higher risk of developing this condition.

Symptoms of Polycystic Ovarian Syndrome (PCOS)

The symptoms of the polycystic ovarian syndrome vary from person to person and depend upon the nature and severity of the condition.

Some of the symptoms of PCOS include

reduced fertility
absent or irregular menstrual cycle,
obesity or accumulation of fat usually around the waist,
abnormal facial and body hair,
adult acne, and
male pattern baldness or hair thinning may develop due to excessive androgen secretion.

In some patients, black or dark brown patches are seen around the skin of the neck, arm, breasts or thighs.

Diagnosis of Polycystic Ovarian Syndrome (PCOS)

The diagnosis of the polycystic ovarian syndrome is based on the medical history along with a physical and pelvic examination to evaluate the condition of the patient and help identify the underlying cause.

Test conducted could include:

blood tests are conducted to determine the level of various hormones.
glucose tolerance test and
evaluation of blood cholesterol may also be conducted.
pelvic ultrasound is performed to evaluate the appearance of the ovaries and the uterine lining.

Treatments for Polycystic Ovarian Syndrome (PCOS)

The treatment of polycystic ovarian syndrome is based on the symptoms and individual concerns.

If the aim is to conceive, then the treatment is directed towards inducing and or regulating the ovulation by:

Weight reduction by 5% of body weight in overweight patients can regain ovulation and menstrual rhythm.
conventional drugs like Clomiphene citrate, or Letrozole can help induce or regulate ovulation, sometimes are also given with Metformin.
surgical treatment very rarely can be used for the management of PCOS.

In patients not responding to the above pharmaceuticals and management, the doctor may consider referral to Fertility Clinic for IO with Gonal F or IVF.

If the aim is not to conceive but to achieve relief from PCOS symptoms then Oral contraceptives may be prescribed for the management of irregular menstrual cycles, effectively reducing the levels of male hormone and reducing excessive body hair growth and also minimising the risks of uterine cancer. Implanon or Mirena as well as some other treatments are used with the same purpose.

Lifestyle modifications and anti-diabetic medications may be prescribed for the management or prevention of obesity and diabetes mellitus. Patients are often advised to see a dietitian so they can have a better understanding of the glucose metabolism and food they should or should not eat. Patients with PCOS find it hard to lose weight due to insulin resistance and benefit from proper advice and understanding of the problem.