Polycystic Ovarian Syndrome
An unfortunate common cause of infertility amongst women is polycystic ovarian syndrome (PCOS). PCOS is an endocrine system disorder in women who are in their reproductive years. Women have enlarged ovaries with small, fluid filled follicles in each ovary. Patients will have irregular, infrequent or prolonged menstrual periods, excess hair growth in unwanted areas, acne, and obesity. The exact mechanism is unknown, but it is recommended these patients exercise regularly to reduce long-term complications. Some of the symptoms include:
- Irregular periods – menstrual intervals longer than 35 days
- Excess androgens – elevated male hormones in females
- Polycystic ovaries – enlarged and numerous cysts
Some causes are:
- Excess insulin – insulin allows cells to utilize sugar; resistance to insulin causes for increased risk for diabetes mellitus
- Low-grade inflammation – white blood cells (WBCs) produce substances to fight infection to inflammation. Patients with PCOS have low grade inflammation stimulating PCO to produce androgens
- Heredity – higher chance if you primary relative has had it
- Type 2 Insulin Dependent Diabetes
- High Blood Pressure
- Cholesterol and lipid abnormalities, i.e. high triglycerides or low high-density lipoprotein (HDL) cholesterol
- Metabolic syndrome – cluster of signs of symptoms indicating high risk for cardiovascular disease
- Nonalcoholic steatohepatitis – fat accumulation in the liver
- Sleep apnea
- Abnormal uterine bleeding
- Cancer of uterine lining – endometrial cancer
- Gestational diabetes → transient hypo/hyperinsulinemia in baby.
To obtain a confirmative diagnosis, a physician will have to begin with a full physical exam followed by pelvic exam, then blood tests, and an ultrasound. During the physical the physician can feel for any growths or masses. The blood test can help determine what the fasting cholesterol, glucose and some androgen levels are. Here are some treatment and drug options:
- Treatment of underlying causes
- Lifestyle changes
- Weight loss
- Low-calorie diet
- Regulate menstrual cycle – OCP, birth control
- Manage ovulation – clomiphene
- Reduce excessive hair growth – birth control pills, spironolactone, eflornithine.
PCOS is associated with changes in hormones making it difficult for ovaries to release mature eggs, and they are affected by:
- Estrogen, progesterone
- Male hormone found in women in small quantities.
The reason for the fluid filled cysts in PCOS is that the eggs are not released as they are supposed to each menstrual cycle because the cycle is irregular. For this reason, fluid accumulates and this condition is diagnosed around a woman’s second and third decade of life. Women residing in Denver should visit the Denver Holistic Center for more information. This is a manageable syndrome if treated regular and appropriately. Women should not delay seeing a physician to avoid any long term complications and irreversible infertility.