Polycystic Ovary Syndrome (PCOS)
PCOS affects 10-20% of women with an ovulation defect (or irregular periods). Women with PCOS may have only a few periods a year, or no periods at all. Alternatively, they may bleed more often than once a month or even bleed constantly for months at a time. All of this irregular bleeding is caused by the lack of ovulation. The lack of ovulation is what also causes infertility.
There are multiple diagnostic criteria that can be used to diagnose PCOS, many of which can be evaluated by taking a thorough history. In addition to irregular cycles, many women have evidence of high male hormones, such as testosterone or DHEAS. High male hormone levels can be evidenced by either symptoms like excess body hair growth or thinning of the hair on the head, or by elevated levels of testosterone or DHEAS in your blood work.
On ultrasound, polycystic appearing ovaries have many small cysts around the periphery of the ovary. These cysts are actually follicles (small fluid filled sacs located within the ovaries that contain eggs). In general, there should be one egg per follicle. Hormones produced by the brain and pituitary gland early in the menstrual cycle should cause these follicles to mature and eventually ovulate. However, in PCOS, this process is unbalanced, and the follicle does not mature further, preventing ovulation.
Despite decades worth of research, unfortunately, we still do not know the cause of PCOS.
Besides infertility, women with PCOS are also at increased risk of developing cancer of the uterus, type II diabetes, high cholesterol, and heart disease. A balanced diet which avoids refined carbohydrates, in addition to routine exercise, can help lower the chances of a woman acquiring any of these diseases, as well as improve ovulation and fertility.
Women with PCOS often struggle with their weight and with their blood sugar and insulin levels. Our physicians will evaluate the results of your history, examination and bloodwork to determine if medications may be right for you. Some patients also have success with dietary counseling from a registered dietitian in order to achieve a healthier weight and lifestyle.