Polycystic Ovarian Syndrome

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Although polycystic ovaries (ovaries with multiple follicles) are discovered in about 50% of women with a regular cycle, only 5-10% of the female population is affected by polycystic ovarian syndrome (PCOS).

Ovarian cysts and PCOS are not the same thing; please see the section on Ovarian Cysts. PCOS is the most common hormonal disease for women of reproductive age and is a leading cause of infertility. Depending on your age and stage in the condition it may present differently. PCOS is associated with an increased risk of developing hypertension (high blood pressure), diabetes (high sugar level), heart disease and endometrial (uterine) cancer in the future.

The diagnosis of PCOS is made based on a combination of criteria:

  • Polycystic ovaries, as defined by on ultrasound imaging
  • Signs of excessive production (more then normal) of testosterone (male sex hormones) – acne, hirsutism (excessive growth of body hair), increased weight, infertility etc
  • Menstrual irregularities

The cause of the PCOS is not known, but there is treatment available. It is believed that the leading cause of the PCOS is insulin resistance. Excessive amount of insulin is unhealthy and may lead to diabetes, certain cancers and heart disease. PCOS might have a genetic predisposition and run in the family, but no gene associated with this condition has been discovered.

The corner stone of treatment for PCOS is to lower insulin resistance and this almost always involves life style changes like exercise and diet. The next step in treatment depends on your age and expectations and includes; medication (contraceptive pills, antiandrogens, Metformin – diabetes medication to control insulin levels), Mirena (medicated intrauterine device to protect the uterus) and surgical (used when attempts at fertility with medication have failed).

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