Polycystic Ovarian Syndrome

What is polycystic ovarian syndrome?

Polycystic (pol-e-SIS-tik) ovarian (o-VAR-e-an) syndrome (SIN-drom), also called PCOS, is a condition where the ovaries are enlarged with multiple small cysts (small fluid-filled sacs). PCOS may also include problems getting pregnant, abnormal menstruation (monthly period), or too much facial and body hair. Normally, the whole process of having menstruation and getting pregnant begins with ovulation. Ovulation occurs when the different hormones (chemicals) change levels so the ovaries can release an egg each month. With PCOS, there is a problem with ovulation. A hormone imbalance may prevent the ovaries from releasing eggs. This may lead to formation of cysts in one or both ovaries.

The ovaries are a pair of organs in the lower abdomen (stomach). Each ovary is about the size of an almond. They are attached to each side of the uterus (womb) by the fallopian tubes. Ovaries produce eggs and hormones, such as estrogen and progesterone. These hormones play an important role in how the body works.

What causes polycystic ovarian syndrome?

The exact cause of PCOS is not known. Having a family member with PCOS or other ovarian diseases may increase your chance of having PCOS. Caregivers believe that PCOS occurs when the ovaries produce higher levels of male hormones than female hormones. Increased levels of the insulin hormone may cause the ovaries to produce more male hormones. Insulin is produced in the pancreas and helps your body use sugar by allowing it to enter body cells.

What are the signs and symptoms of polycystic ovarian syndrome?

Signs and symptoms of PCOS may be seen as early as the first menstruation. You may have any of the following:

Abnormal monthly periods, such as irregular or absent periods.

Darkening or thickening of the skin with formation of skin tags. Acne (pimples) and oily skin may also be present.

Excess hair growth on the beard area, upper lip, sideburns, chest, around the nipples, or lower abdomen. Thinning of the scalp hair.

High blood sugar and high blood pressure.

Infertility (problem getting pregnant).

Pelvic (hip) or abdominal pain.

Weight gain and fatigue (more tired than usual).

How is polycystic ovarian syndrome diagnosed?

Your caregiver will take a detailed health history from you. This includes past pregnancies, length of anovulation (absence of monthly periods), and menstrual and sexual histories. Caregivers will also ask questions about your lifestyle and present medical history. You may have one or more of the following tests:

Pelvic exam:

This is also called an internal or vaginal exam. During a pelvic exam, feel free to ask for a woman to be present if one is not. Your caregiver gently puts a warmed speculum into your vagina. A speculum is a tool that opens your vagina. This lets your caregiver see your cervix (bottom part of your uterus). With gloved hands, your caregiver will check the size and shape of your uterus and ovaries.

Blood and urine tests:

Samples of your blood and urine are sent to the lab for different tests. Caregivers will check the levels of your hormones and see how well your body is working.

Ultrasonography:

An ultrasound uses sound waves to look inside your abdomen. Caregivers may want to look at your liver, kidneys, uterus, ovaries, fallopian tubes, or other organs.

How is polycystic ovarian syndrome treated?

Treatment for PCOS is aimed at relieving your signs and symptoms. You may have any of the following:

Medicines:

These are used to treat problems with your acne, excess hair growth, monthly periods, or not getting pregnant. Medicines may also be given to control high blood pressure or high blood sugar levels.

Surgery:

Your caregiver may do surgery to remove the cysts in your ovaries. Depending on the number and sizes of the cysts present, your caregiver may also remove one or both of your ovaries. Biopsies (tissue samples) of the cysts and your ovaries may also be done. This will help caregivers learn more about your condition.

Others:

Removing too much hair may be done by shaving, waxing, or applying hair removal creams. Your caregiver may also use laser (narrow beam of light) to remove the excess hair on your face or body. Your caregiver may also suggest an exercise program to help you lose weight.

What problems can polycystic ovarian syndrome cause?

Having PCOS may increase your chance of having any of the following:

Abnormal uterine bleeding.

Cancer of the endometrium (lining of the womb).

Diabetes (high blood sugar).

Heart diseases.

Hypertension (high blood pressure).

Where can I find support and more information?

Polycystic ovarian syndrome is a life-changing disease for you and your family. Accepting that you have PCOS is hard. You and those close to you may feel scared, angry, or sad. These are normal feelings. Talk to your caregivers, family, or friends about your feelings. Contact the following for more information:

American Academy of Family Physicians
PO Box 11210
Shawnee Mission, KS 66207-1210
913-906-6000
1-800-274-2237
http://www.aafp.org

The Hormone Foundation
8401 Connecticut Ave.
Suite 900Chevy Chase, MD 20815-5817
USA800-467-6663
www.hormone.org