Description

Polycystic ovary syndrome (PCOS) is a problem with the hormones that happens during the reproductive years. If you have PCOS , you may not have periods very often. Or you may have periods that last for many days. You can also have too much of a hormone called androgen in the body.

With PCOS , many of the small sacs of fluid that develop along the outer edge of the ovary. These are called cysts. Small fluid-filled cysts that contain immature eggs. These are called follicles. The follicles are not regularly release eggs.

The exact cause of pcos is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.

Symptoms

The symptoms of PCOS often begin in the time of the first menstruation. Sometimes, the symptoms develop later after having had periods for a time.

The symptoms of PCOS vary. A diagnosis of polycystic ovary syndrome is done when you have at least two of these:

  • Irregular periods. Have a few menstrual periods or have periods that are not regular are common signs of polycystic ovarian syndrome . So is having periods that last for many days or more than is usual for a period. For example, you might have fewer than nine periods a year. And those periods that can occur more than 35 days apart. You may have trouble getting pregnant.
  • Too much androgen. The high levels of the hormone androgen may result in excess facial and body hair. This is called hirsutism. Sometimes, severe acne and male pattern baldness can happen, too.
  • Polycystic ovaries. The ovaries could be larger. Many follicles containing immature eggs can develop around the edge of the ovary. The ovaries do not work the way they should.

PCOS signs and symptoms are usually more severe in people with obesity.

When to see a doctor

Consult your health care provider if you are concerned about your periods, if you're having trouble getting pregnant, or if you have signs of androgen excess. These could include the re-growth of hair on the face and body, acne, and male pattern baldness.

Causes

The exact cause of pcos is not known. The factors that could play a role include:

  • The insulin resistance.Insulin is a hormone that the pancreas produces. This allows the cells to use the sugar, the body's primary energy supply. If the cells become resistant to the action of the insulin, sugar levels in the blood may rise. This can cause your body to produce more insulin to try to lower the level of sugar in the blood. Too much insulin can cause your body to produce too much of the male hormone androgen. You could have problems with ovulation, a process where eggs are released from the ovary. One of the signs of insulin resistance is dark, velvety patches of skin in the lower part of the neck, the armpits, the groin or under the breasts. Increased appetite and weight gain may be other signs.
  • Low-grade inflammation. White blood cells make substances in response to infection or injury. This response is called low-grade inflammation. The research shows that people with this syndrome have a type of long-term, low-grade inflammation that leads to polycystic ovaries to produce androgens. This can lead to cardiovascular problems.
  • Of the inheritance. The research suggests that certain genes may be linked to the polycystic ovary syndrome . Having a family history of polycystic ovary syndrome may play a role in the development of the condition.
  • The excess of androgens. With PCOS , the ovaries can produce high levels of androgens. Have too much androgen interferes with ovulation. This means that the eggs do not develop on a regular basis and are not released from the follicles that develop. The excess of androgens can also result in hirsutism and acne.

The insulin resistance. Insulin is a hormone that the pancreas produces. This allows the cells to use the sugar, the body's primary energy supply. If the cells become resistant to the action of the insulin, sugar levels in the blood may rise. This can cause your body to produce more insulin to try to lower the level of sugar in the blood.

Too much insulin can cause your body to produce too much of the male hormone androgen. You could have problems with ovulation, a process where eggs are released from the ovary.

One of the signs of insulin resistance is dark, velvety patches of skin in the lower part of the neck, the armpits, the groin or under the breasts. Increased appetite and weight gain may be other signs.

Complications

Complications of polycystic ovary syndrome may include:

  • Infertility
  • Gestational diabetes or pregnancy-induced high blood pressure
  • Spontaneous abortion or premature labor
  • Non-alcoholic steatohepatitis — a severe inflammation of the liver caused by the accumulation of fat in the liver
  • Metabolic syndrome-a cluster of conditions that include high blood pressure, blood sugar, and unhealthy cholesterol or triglyceride levels that significantly increase the risk of diseases of the heart and blood vessel (cardiovascular) disease
  • Type 2 diabetes or prediabetes
  • Sleep apnea
  • Depression, anxiety and eating disorders
  • The cancer of the lining of the uterus (endometrial cancer)

Obesity commonly occurs with PCOS and it can worsen the complications of the disease.

Diagnosis

There is No single test to diagnose polycystic ovary syndrome (PCOS). Your health care provider is likely to begin with a discussion of your symptoms, medications and any other medical conditions. Your healthcare provider may also ask you about your menstrual cycle, and any weight change. A physical exam will include checking for signs of excess hair growth, insulin resistance and acne.

Your health care provider may recommend:

  • Pelvic exam. During a pelvic exam, the doctor can detect their reproductive organs to the masses, lumps or other changes.
  • Blood tests. Blood tests can measure the levels of hormones. This test can exclude possible causes of the problems of menstruation or the androgen excess that mimic polycystic ovary syndrome . You may have other blood tests, such as fasting levels of cholesterol and triglycerides. A glucose tolerance test can measure your body's response to sugar (glucose).
  • Ultrasound. An ultrasound can check the appearance of your ovaries and the thickness of the lining of the uterus. A wandlike device (transducer) is placed in the vagina. The transducer emits sound waves that are translated into images on a computer screen.

If you have a diagnosis of polycystic ovary syndrome , your doctor may recommend more tests to complications. These tests may include:

  • Regular checks of blood pressure, glucose tolerance, cholesterol, and triglyceride levels
  • Screening for depression and anxiety
  • The detection of obstructive sleep apnea

Treatment

PCOS treatment focuses on the management of the things that are concerning you. This may include infertility, hirsutism, acne or obesity. The specific treatment may involve lifestyle changes or medicines.

Lifestyle changes

Your health care provider may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Even a modest reduction in weight — for example, losing 5% of your body weight may improve your condition. Weight loss can increase the effectiveness of medications that your doctor may recommend for PCOS , and can help with infertility. Your health care provider and a registered dietitian can work with you to determine the best plan for weight loss.

Drugs

To regulate the period, your health care provider may recommend:

  • The combination of birth control pills. Pills that contain estrogen and a progestin to decrease the production of androgens and the estrogens. The regulation of the hormones can reduce your risk of endometrial cancer and to correct the irregular bleeding, excess hair growth and acne.
  • Progestin therapy. Taking progestin for 10 to 14 days every 1 to 2 months can regulate your periods and protect against endometrial cancer. This progestin therapy did not improve the levels of androgens and does not prevent pregnancy. The progestin-only mini-pill or progestin-containing intrauterine device is a better option if you also want to avoid pregnancy.

To help ovulation, so that you can become pregnant, your doctor might recommend:

  • Clomiphene. This oral anti-estrogen medication is taken during the first part of your menstrual cycle.
  • Letrozole (Femara). This breast cancer treatment can work to stimulate the ovaries.
  • Metformin. This medication for type 2 diabetes that you take by mouth improves insulin resistance and lowers insulin levels. If you do not become pregnant using clomiphene, your doctor may recommend the addition of metformin to help with ovulation. If you have pre-diabetes, metformin can delay the progression of type 2 diabetes and help with weight loss.
  • The gonadotropins. These hormonal drugs are given by injection.

If necessary, talk with your health care provider about the procedures that can help to get pregnant. For example, in vitro fertilization, may be an option.

To reduce the excessive hair growth or improving acne, your health care provider may recommend:

  • Birth control pills. These pills decrease the production of androgens which can cause excessive hair growth and acne.
  • Spironolactone (Aldactone). This medication blocks the effects of androgens on the skin, including the excessive hair growth and acne. Spironolactone can cause birth defects, so effective form of birth control is necessary while taking this medicine. This medicine is not recommended if you are pregnant or plan to become pregnant.
  • Eflornithine (Vaniqa). This cream can slow the growth of facial hair.
  • The hair removal. Electrolysis and laser hair removal are two options to remove unwanted hair. Electrolysis uses a small needle that is inserted into each hair follicle. The needle sends a pulse of electric current. The current damages and then destroys the follicle. Laser hair removal is a medical procedure that uses a concentrated beam of light to remove unwanted hair. You may need several treatments, electrolysis and laser hair removal. Shaving, plucking or using creams that dissolve the unwanted hair can be other options. But these are temporary, and the hair may thicken when it grows up.
  • Treatments for acne. Medications, including pills and creams or gels, can help to improve acne. Talk with your health care provider about the options.

Lifestyle and home remedies

To help relieve the effects of pcos , try the following:

  • Stay at a healthy weight. Weight loss can reduce insulin and androgen levels. You can also restore ovulation. Ask your health care provider about a weight control program, if you need one. Meet with a dietitian to achieve weight loss goals.
  • Limit carbohydrates. Diets high in carbohydrates can cause insulin levels to go higher. Ask your doctor if a diet low in carbohydrates can help if you have PCOS . Choose complex carbohydrates, which raise your blood sugar levels more slowly. Complex carbohydrates are found in fruits, vegetables, whole grains, and cooked dry beans and peas.
  • Be active. The exercise helps to reduce levels of sugar in the blood. If you have PCOS , increasing your daily activity and regular exercise can treat or even prevent insulin resistance. Being active can also help you to keep your weight under control and to prevent the development of diabetes.

Preparing for your appointment

For PCOS , you can see a specialist in reproductive medicine of the female (gyn), a specialist in hormone disorders (endocrinologist), or a specialist in infertility (assisted reproduction).

Here's some information to help you prepare for your appointment.

What you can do

Before your appointment, make a list of:

  • The symptoms that I have had, and for how long
  • The information about their periods, including the frequency with which they occur, how long they last and how heavy they are
  • All the drugs, vitamins, herbs and other supplements that you are taking, including the dosage
  • The key to personal and medical information, including other health conditions, recent life changes, and the factors of
  • Questions to ask your health care provider

Some basic questions to ask include:

  • What tests do you recommend?
  • How does PCOS affect my chances of getting pregnant?
  • There are medications that can help to improve the symptoms or the possibility of getting pregnant?
  • What lifestyle changes can improve symptoms?
  • How does PCOS affect my health in the long term?
  • I have other medical conditions. How can I best manage them together?

Do not hesitate to ask other questions that occur to you.

What to expect from your doctor

Your health care provider is likely to ask a series of questions, including:

  • What are your symptoms? How often do they occur?
  • How bad are the symptoms?
  • When did each symptom start?
  • When was your last period?
  • Have you gained weight since the first time I began to have periods? How much weight did you gain, and when did you get this?
  • Nothing seems to improve the symptoms? Is worse?
  • You are trying to get pregnant, or want to get pregnant?
  • Have a close blood relative, such as his mother or sister, had been diagnosed with polycystic ovary syndrome ?
Symptoms and treatment of Polycystic ovary syndrome (PCOS)