What is Polycystic Ovarian Syndrome?

Polycystic ovarian syndrome, PCOS for short, is a health condition that can affect a woman in several different ways. Menstrual cycle irregularities, fertility problems, body hair, excess weight, diabetes, high blood pressure, and the list goes on. One of the ways to diagnose PCOS is by ultrasound of the ovaries. Polycystic ovaries look like they have a string of pearls inside them. This is because a woman with PCOS fails to produce the amount of hormones needed for ovulation. The eggs begin to develop, but are never released, or released infrequently resulting in "many cysts" in the ovaries. Because of the lack of ovulation, the menstrual cycle is irregular or non-existent.

It is possible for a woman to have polycystic ovaries without having the associated "syndrome". Syndrome in PCOS refers to the collection of symptoms that a woman with PCO has. Below is a listing of some of the symptoms of PCOS which was taken from WomensHealth.gov

What are the symptoms of polycystic ovarian syndrome?

• Infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
• Infertility or inability to get pregnant because of not ovulating
• Increased growth of hair on the face, chest, stomach, back, thumbs, or toes
• Acne, oily skin, or dandruff
• Pelvic pain
• Weight gain or obesity, usually carrying extra weight around the waist
• Type 2 diabetes
• High cholesterol
• High blood pressure
• Male-pattern baldness or thinning hair
• Patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs
• Skin tags, or tiny excess flaps of skin in the armpits or neck area
• Sleep apnea - excessive snoring and breathing stops at times while asleep

Treatments for PCOS

Treatment will depend on the woman, her symptoms, and if she is trying to conceive or avoid pregnancy. Some of the current treatment options for women that want to conceive include:

• Diabetes Medications
• Fertility Medications
• Weight Loss Program
• Surgery

Diabetes medications are needed if the woman has had her blood sugar tested and the results show that she is making too much insulin. Metformin, also known as Glucophage, is prescribed and helps to regulate the sugar in the blood and even helps to reduce the amount of male hormones that the ovaries are producing. It usually takes a few months to see the full effect of this medication, so keep taking it! *Caution!! - Metformin does cross the placenta, and research is ongoing to see if taking this while pregnant would have any serious effects on the pregnancy and fetus. If taking Metformin and you conceive, talk with your doctor about the need to continue taking it during your pregnancy!!*

Sometimes Metformin alone is not enough to get a woman ovulating again. In these cases, additional medications specifically for fertility may be prescribed. The first medication that is usually prescribed is Clomid. Clomid is a fairly common fertility medication that helps the body produce the proper amounts of hormones needed to ovulate. If Clomid at its strongest dose does not result in ovulation and/or a pregnancy, injectable fertility medications along with either IUI (intra uterine insemination) or IVF (in vitro fertilization) are the next steps. However, women with PCOS are at an increased risk of having twins or higher multiples. Therefore, any IUI done must only be performed if and when the doctor can confirm that no more than 2 or 3 eggs will be released. To reduce the risk of high order multiples, IVF is recommended as the number of fertilized eggs can be controlled.

For a woman with PCOS weight loss can feel impossible. Part of the problem is that a symptom of PCOS is being over weight most likely due to the way the body processes carbohydrates and glucose. Trying a diabetic diet or a restricted carb diet along with regular exercise can do wonders for the PCOS woman. A small amount of weight lost can equal big gains on the fertility front. By losing as little as 10% of their body weight, most women with PCOS will resume more normal cycles and being ovulating again. They may also find that they need to take less and less Metformin as their glucose and insulin levels become more normal.

If you think that 10% sounds like a lot, it might seem easier if we do the math. If a woman with PCOS weighs 185 pounds, a loss of just 18.5 pounds is 10%. Each pound is equal to 3,000 calories. If the PCOS woman could cut out just 300 calories a day (a couple of cans of soda), she could lose 1 pound every 10 days. If that same PCOS woman added 30 minutes of walking daily at a moderate pace, she burns 145 calories daily. That increases the weight loss to 1 pound every 6 to 7 days! Want to burn even more weight? Cut out the soda cans (2 equals about 300 calories), close the kitchen (no late snacking) at least 3 hours before bedtime (probably equals another 250 to 300 calories), and increase the walking to 45 minutes at the same moderate pace (equals 218 calories burned now). Our 185 pound PCOS woman will now lose 1 pound every 4 days. That's a healthy 2 pounds a week, and only 9 to 10 weeks to lose 10% of her total weight.

Surgery is listed last as it is a "last option". The surgical procedure is called ovarian drilling and it is used to help induce ovulation for what may be a short amount of time. Ovarian drilling is performed under general anesthesia with a laparoscope to help the doctor see and pin-point the exact areas of the ovaries to be destroyed. There are risks associated with this procedure including possible scarring of the ovary, or more rarely, ovarian failure (premature menopause). This procedure is successful in restoring ovulation about 80% of the time, and pregnancy rates have been reported at about 40% to 50%, so this is an option for women that have failed to respond to medications and weight loss.

Like any infertility diagnosis, PCOS can sound like a life sentence, but there are treatments and options available. No one knows for sure why some women have PCOS and some don't, but it does appear to run in families. If you have been diagnosed tell your sisters and mother, or if a close female relative has been diagnosed you may want to be tested if you are showing symptoms too.

All information contained in this web site is for informational purposes only.
Do not consider the information herein to be of a diagnostic nature.
Always consult your health care professional if you have any health concerns.