POLYCYSTIC OVARIAN SYNDROME

(PCOS; Stein-Leventhal Syndrome)

 Basic information

description

Polycystic ovarian syndrome (PCOS) is an endocrine (hormone) condition. It is a leading cause of infertility in women. PCOS affects 5% to 10% of all women of childbearing age. It may begin during puberty and become more severe with time. It is less common in women as they get older and is rare after menopause.

FREQUENT SIGNS & SYMPTOMS

• Irregular menstrual bleeding. This results in periods of light flow along with heavy flow. There is increased time between periods, often up to several months.
• Hirsutism—increased hair growth on the face, arms, legs, and from pubic area to navel.
• Thinning of the scalp hair (alopecia).
• Overweight or obesity.
• Trouble getting pregnant; miscarriages.
• Acne and oily skin.
• Dark patches of skin or skin tags (small skin growths).
• Polycystic ovaries. These are fairly common and involve enlarged ovaries from many small cysts.
• Anovulation (absence of ovulation). The monthly release of the egg from the ovary fails to take place.
• High cholesterol levels and high blood pressure.

causes

The exact cause is unclear. Hormone imbalances, insulin production, and hereditary factors all seem to play a role.

risk increases with

• Obesity or overweight.
• Family history of PCOS or diabetes.
• Ages 20 to 30.
• Having diabetes or insulin resistance.

PREVENTIVE MEASURES

Cannot be prevented at present.

expected outcomes

Treatment, along with weight control and exercise, can relieve or eliminate symptoms. Pregnancy (if desired) can be achieved in many patients.

possible complications

• Infertility (unable to get pregnant) or miscarriages.
• Depression and anxiety.
• A decrease in HDL (the good) cholesterol.
• High triglyceride levels.
• Heart and blood vessel disease; high blood pressure.
• Diabetes or metabolic syndrome.
• Uterine bleeding.
• Endometrial cancer. There may be an increased risk of ovarian or breast cancer.

 diagnosis & treatment

general measures

• Your health care provider will usually do a physical exam and a pelvic exam. Questions will be asked about your symptoms, menstrual cycle, and pregnancies. Blood studies will be done. These measure levels of hormones, glucose, insulin, and fats (cholesterol and triglyceride). An ultrasound may be done to rule out other disorders. There is no one test to diagnose PCOS.
• Treatment goals: regulate menstrual cycle, reduce hair growth and acne problems, help with fertility (if pregnancy desired), and prevent long-term problems.
• A diet and exercise program for overweight or obese women will help improve physical and mental health.
• Infertility can be treated successfully with diet, exercise, weight loss, and drug therapy. If these steps are not helpful, surgery (ovarian drilling) may be an option.
• Quit smoking. Find a way to stop that works for you.
• Counseling may help you cope with emotional stress.
• Options for removing excess hair from your face, arms, and legs include drugs, bleaching, electrolysis, laser therapy, plucking, waxing, and depilation.
• More information is available from a variety of sites on the Internet dedicated to PCOS.

medications

• Diabetic drugs (such as metformin), birth-control pills, or other drugs may be prescribed.
• Drugs to help with fertility may be prescribed.
• Vaniqa (eflornithine cream) for excess facial hair or spironolactone for excess body hair may be prescribed.

activity

No limits on activity, including sexual intercourse. Physical activity is important. Exercise daily.

diet

A weight-loss program is often prescribed for overweight women. A dietitian can help you plan a diet.

 notify our office if

• You or a family member has symptoms of polycystic ovarian syndrome.
• New symptoms occur after treatment.

Special Notes: