Polycystic Ovary Syndrome (PCOS)
(Stein Leventhal Syndrome)
Definition |
Causes |
Risk Factors |
Symptoms |
Diagnosis |
Treatment |
Prevention |
Organizations
Definition
Polycystic ovary syndrome (PCOS) is a chronic endocrine disorder in women. It is characterized by:
- Elevated levels of male hormones (androgens)
- Irregular menstrual periods
- Anovulation – a condition in which the ovaries produce few or no eggs
Ovaries normally produce follicles that develop into eggs. In women with PCOS, the ovaries produce the follicles but the eggs do not mature or leave the ovary. The immature follicles can develop into fluid-filled sacs called cysts. Most women with PCOS have cysts, but all women with ovarian cysts do not necessarily have PCOS.
Causes
The cause of PCOS is unknown, though genes may play a role. Recent evidence suggests the problem is related to elevated levels of insulin. These high insulin levels stimulate excess production of androgens from the ovaries. This prevents ovulation and leads to enlarged, polycystic ovaries.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
- Family members with PCOS
- Age at onset: 15-30
Symptoms
PCOS symptoms vary and can occur in any combination. Symptoms include:
- Irregular menstrual periods
- No menstrual period (amenorrhea)
- Chronic pelvic pain
- Infertility
- Hair growth on face and body
- Balding
- Weight gain
- Obesity
- Acne
- Dark patches of skin
- Skin tags
Rarely, symptoms include:
- Deep voice
- Temporal balding
Women with PCOS are also at increased risk for:
- Type 2 diabetes, due to insulin resistance
- Hyperlipidemia (increased fat and cholesterol in the blood)
- Overgrowth and thickening of uterine lining (a pre-cancerous condition)
- Endometrial cancer
- Breast cancer (possibly)
- High blood pressure
- Heart disease
Diagnosis
The doctor will ask about your symptoms and medical history, including the regularity of your periods and when they first started. The doctor will also perform a physical exam, including a pelvic exam. There is no test to diagnose PCOS. The doctor evaluates a range of test results and symptoms.
Tests may include:
Transvaginal Ultrasound – produces an image of the ovaries to see if they are enlarged or have cysts
Blood Tests – to check hormone, insulin and blood sugar levels
Biopsy of the Uterine Lining – removal of tissue from the uterine lining to test for cancer or abnormal overgrowth of tissue
Other Tests – to look for related conditions
Treatment
There is no treatment to cure PCOS. Treatment focuses on:
- Managing symptoms
- Preventing complications
- Inducing ovulation if you wish to get pregnant
Treatments include:
Medications
Drugs that help cells better use insulin may restore ovary function in some cases.
Hormonal Therapy
Birth control pills help regulate periods and control abnormal hair growth and acne. Regularly stopping the pills causes the endometrium to shed. Shedding the endometrial lining at least every three months reduces the risk of overgrowth and cancer. Other hormones may help regulate menstruation. Fertility drugs may be given instead to stimulate ovulation in women who want to become pregnant.
Lifestyle Measures
To lower cholesterol levels and reduce the risk of type 2 diabetes, high blood pressure and heart disease:
- Maintain a healthy weight.
- Eat a low fat diet.
- Exercise regularly.
- Get regular screenings for diabetes and high blood cholesterol and fat levels.
Prevention
There are no guidelines for preventing PCOS, because the cause is unknown.
Organizations
Polycystic Ovarian Syndrome Association
http://www.pcosupport.org
The InterNational Council on Infertility Information Dissemination
http://www.inciid.org
SOURCES:
Griffith's 5-Minute Clinical Consult, 1999 ed. Lippincott Williams and Wilkins, 1999.
American Academy of Family Physicians
Polycystic Ovarian Syndrome Association
The InterNational Council on Infertility Information Dissemination
Last reviewed June 2001 by Medical Review Board
