Polycystic Ovary Syndrome (PCOS) is the most common hormonal disorder in women. Women with PCOS produce more testosterone (male sex hormone) than normal. This hormone imbalance causes ovulation disorders and irregular menstrual cycles. Women with this condition experience more difficulty achieving pregnancy than normal population.
Combination of following two factors is required to establish diagnosis of PCOS:
- Irregular Menstrual Cycles: Not having menstruation for more than 35 days or less than 9 times a year.
- High Male Sex Hormone (Androgen) Levels High level of male sex hormone can be determined in physical examination or blood test. Elevation of these hormones is the reason of symptoms such as abnormal hair growth, male pattern baldness and acne.
- Cysts in Ovaries Ovaries generally enlarge and contain multiple small cysts. Ovarian functions are also problematic.
What Are Signs Of Polycystic Ovary Syndrome?
Signs of polycystic ovary syndrome can vary depending on severity of disease and it may sometimes be asymptomatic. According to a study, PCOS is not diagnosed in 70 percent of patients with this condition. Some patients with mild symptoms are diagnosed with the syndrome, after they see a doctor due to unintended weight gain and difficulty getting pregnant.
Principal symptoms of PCOS are as follows:
Irregular Menstrual Cycles: Menstrual cycles delay as the innermost lining of the uterus (endometrium) does not shed every month due to lack of ovulation.
Heavy Menstrual Bleeding (Hypermenorrhea): As the innermost lining of the uterus is exposed to hormones for a prolonged time, it becomes thicker than usual and therefore, heavy bleeding occurs.
Abnormal Hair Growth in Face and Body (hirsutism): Abnormal hair growth is seen in face and body due to increased male hormones in 70 percent of patients.
Acne: Skin becomes more oily due to elevation of male sex hormones. Therefore, acne can develop especially in face, chest and upper back.
Weight Gain / Difficulty Losing Weigh: Weight gain is likely in 80 percent of patients due to hormonal imbalance.
Hair Loss / Male Pattern Baldness:Thinning and loss of hair are likely.
Dark Discoloration of Skin: Punctuate discoloration of skin can be seen
Headache: Headache is more common compared to general population.
Can Polycystic Ovary Syndrome Cause Infertility?
PCOS causes difficulty getting pregnant by impairing menstrual cycle and ovulation. Therefore, approximately 70-80 percent of patients have troubles in achieving pregnancy. This syndrome also increases complications of pregnancy. For instance, preterm labor threat, gestational hypertension and gestational diabetes are more prevalent.
Can Patients with Polycystic Ovary Syndrome Conceive?
Patients with PCOS can get pregnant thanks to medications that regulate ovulation. Unless there is no problem other than PCOS (blocked Fallopian tube, male infertility etc.), in vitro fertilization may not be needed. However, even if in vitro fertilization is necessary, induction of ovulation may cause release of more eggs than general population. Thus, this group of patients is generally deemed favourable patients without difficulty in management by physicians.
How Is Polycystic Ovary Syndrome Treated?
Generally, lifestyle changes are recommended before medications in treatment of PCOS. Even losing 5-10 percent of body weight can have positive effect on menstrual pattern. Moreover, weight loss decreases cholesterol and insulin levels and the risk of diabetes mellitus and heart disease is also reduced. Diets with low carbohydrate and low glycemic index are also effective to cope with the insulin resistance. In addition to diet, exercise is also recommended in treatment.
Although there is no curative medical treatment for PCOS, oral contraceptives ensure regular menstrual cycles and are effective on other adverse signs, such as hair growth and acne formations. Drugs that contain metformin may have positive effects in patients with PCOS by regulating insulin levels.
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