Polycystic Ovary Syndrome– The Most Common Cause of Infertility
Physicians at Gainesville's All About Women discuss the little known disorder that affects nearly 1 in 10 women
If you don't know what Polycystic Ovary Syndrome (PCOS) is, you're not alone. PCOS is a hard to pinpoint disorder that doesn't get a lot of attention, and yet it's prevalence is alarming. According to the Office on Women's Health, PCOS is the most common cause of infertility in women. It affects an estimated 5-10% of American women (that's 5 million women), though it's estimated that less than half of cases are diagnosed.
Polycystic Ovary Syndrome is also linked to metabolic syndrome according to the PCOS Foundation. While the initial symptoms of PCOS affect a woman's hormones and reproduction, they can eventually increase a woman's risk of life-threatening conditions if not treated, including type-2 diabetes, heart disease, and cancer.
All women should learn about the complex syndrome and its symptoms as a way to protect themselves, their family members, and friends. Continue reading for more...
What is PCOS?
PCOS occurs when a woman's hormones are out of balance. A woman's body makes too much androgen, a male hormone that women usually make only a small amount of. In addition to the excess production of androgen, the ovaries don't make all of the necessary hormones to cause ovulation. Instead of an egg fully developing and releasing for ovulation, eggs only partially form and then may turn into cysts that remain in the ovary.
Researchers are unsure of what causes PCOS, though genetics may contribute. Even the symptoms of PCOS are uncertain, as they can vary from woman to woman. Symptoms may include the following:
- Infertility (due to not ovulating)
- Infrequent, irregular, or absent menstrual periods
- Cysts on the ovaries
- Pelvic pain
- Acne occurs after adolescence and doesn't respond to regular treatment
- Oily skin, dandruff
- Skin tags
- Thick, dark colored patches of skin on neck, arms, breasts, or thighs called acanthosis nigricans
- Increased hair growth on the face, chest, stomach, back, toes, or thumbs. This condition is called hirsutism and affects 70% of women with PCOS.
- Thinning hair or male-pattern baldness
- Anxiety or depression
- Obesity or weight gain around the waist
According to the American Congress of Obstetricians and Gynecologists (ACOG), up to 80% of women with PCOS are obese. But women who are lean and exhibit other symptoms could still have the disorder.
Insulin Resistance and PCOS
Women affected by Polycystic Ovary Syndrome usually also have a condition called insulin resistance. Insulin resistance is a condition where the body's cells do not properly respond to the effects of insulin, causing high blood glucose levels. These high glucose levels can lead to diabetes.
Insulin resistance may also cause the body to produce more insulin, which can lead to appetite increase, weight gain, and the hormone imbalances associated with PCOS.
Because insulin resistance can put women at risk for both type-2 diabetes as well as cardiovascular disease, it's important that these women seek out medical assistance. A diabetes medication called Metformin is often used to decrease insulin resistance. It sometimes also helps reduce androgen levels.
Risks of PCOS
There are other risks associated with Polycystic Ovary Syndrome:
- Women with PCOS sometimes have a condition where the lining of the uterus becomes too thick, called endometrial hyperplasia. Endometrial hyperplasia increases a woman's risk of endometrial cancer.
- In the case of pregnancy, women with PCOS are at higher risk for gestational diabetes and preeclampsia.
- Elevated cholesterol and high blood pressure
- Sleep Apnea
While these risks may seem overwhelming, they can be effectively managed with the help of a doctor who has experience treating PCOS.
Treatment of PCOS
There are a variety of treatment options for women with PCOS. Your treatment plan will depend on if you are trying to conceive or not.
Treatment for women who are not trying to conceive may include combination birth control pills, which helps regulate the menstrual cycle, decrease androgen levels, and help prevent endometrial cancer.
As mentioned earlier, insulin-sensitizing drugs used to treat diabetes are often used to help lessen insulin resistance in women with PCOS, which can help improved ovulation and decrease androgen levels.
Regardless of if you want to become pregnant or not, your doctor will likely stress the importance of weight loss and healthy diet. The National Institutes of Health reports that just a 5% decrease in body weight can help a woman's hormone imbalance and increase the ability to get pregnant. For a 160-pound woman, that's a weight loss of eight pounds. Your doctor may recommend a weight loss closer to 10%, depending on your situation.
Call Your Doctor
If you're experiencing any of the symptoms associated with Polycystic Ovary Syndrome, it's important to make an appointment with your infertility doctor or endocrinologist as soon as possible.
Many women who wait until they're ready for pregnancy sometimes find they're infertile. There are effective treatment options for all women with PCOS. Early diagnosis and treatment can help you reduce your risk of developing diabetes, heart disease, and cancer.
The knowledgeable infertility physicians at Gainesville's All About Women are here to provide compassionate care to women with PCOS regardless of age, etc.