PCOS-Polycystic Ovarian Syndrome also known as Stein-Leventhal Syndrome is a common endrocrine disorder of women where the hormones are out of balance. Hormones are chemical messengers that work on different parts of the body, such as growth and energy. In PCOS the hormones go out of control and do not work normal. I am familiar with this disease as I was diagnosed with it in my middle teen years.
The sex hormones are usually out of balance female-Estrogen and Progesterone and the male hormone Androgen.The ovaries normally make a tiny amount of the male hormone-,but in PCOS you find more of the male hormone being made. The changes in the hormones make it harder for a women's ovaries to release fully grown eggs. In PCOS the mature eggs are not released from the ovaries , instead they can form cysts on the ovary. With the increase in the male hormone women have a tendency to have increase in body and facial hair, acne and they may stop ovulating. Another hormone abnormality seen is excessive production of LH which works to stimulate the ovaries to produce hormones. LH is released from the pituitary gland in the brain.
The cause of PCOs is unknown. It is believed to be genetic and can be passed down by your mother or father's side of the family. It can be diagnosed in girls in their teens as well as any woman in her reproductive years.There is no cure for PCOS as it is a lifelong condition and people need to be aware of the symptoms to be able to manage the disease. Statistics show that 1 out of 10 women will get PCOS and most people do not even know the disease exists. So now we will examine the symptoms. often seen
- Menstrual disturbances is the main symptom most women notice first. In some women they may have oligomenorrhea- which is fewer than normal menstruation. The absence of menstruation for more than three months which is secondary amenorrhea. Anovulation or oligovulation which means not ovulating or releasing a mature egg each month from the ovaries. Others may have heavy bleeding. With me I can attest to very heavy bleeding. The bleeding just would continue for over a week or more and the only thing used to manage this was the birth control pill.
- Hirsutism - which is excess hair growth is another symptom. Women tend to get more hair on the body and face. Often the excess hair is darker and thicker. One method to control this is by hair removal by Electrolysis- electric current is applied with a very fine needle-shaped electrode, or metal probe into each hair follicle to destroy the root. This is the only permanent way to remove hair and it does require multiple visits until the hair root is destroyed.
- Fertility problems is a major concern. Many women with PCOS have trouble getting pregnant which is better known as infertility. With PCOS some women do not ovulate at all. The desire to conceive and not being able to, makes a woman go to be checked out by her doctor,
- Weight gain is often seen in most women. The weight gain is usually concentrated to the mid section of the body-stomach, thighs, hips and buttocks. In PCOS it is found women have trouble losing the weight. This is not to say women who are heavy have PCOS. Many women with PCOS eat a healthy diet and still have trouble losing weight. If one needs help with weight gain and losing it, remember to talk with your doctor. Usually it Is found women with the disease have a hard time losing the weight.
- Insulin Resistance- is where the body does not respond as well as it should to insulin, which is the major hormone used to regulate glucose and sugar in the body. This can lead to Diabetes 2. Not all women with PCOS will develop this. Those who do are usually given a medication to help regular the sugar levels in the body.
- Painful cramps during your menstrual cycle. The cramps can be so severe that women will need medication ordered from their doctor. I can attest to these cramps which are different than the woman who do not PCOS. When the cramps would come it was so severe and the pain would be crippling. It was a constant cramp that would last all day. Nothing I took would help, until I got a prescription from the doctor. Women who suffer from these cramps have to talk to their doctor to get some relief.
- Fatigue- even with eight hours of sleep at night you still wake up tired.
- Mood swings/irritable
- Acne in PCOS it is concentrated more around the chin and jawline.
- high LDL “bad” cholesterol levels along with low HDL “good” cholesterol levels.
How is PCOS diagnosed? It is usually diagnosed on the symptoms that are presented. The doctor will then do tests to rule out other diseases with the same symptoms such as hypothyroidism-which is low levels of thyroid hormone in the body. Tumors of the ovary or adrenal gland will also produce excess male hormone.
Blood levels will be checked. Serum levels of testosterone will be elevated. Levels of highly elevated testosterone is not unusual in PCOS and further evaluation is usually done. Also elevated will be the hormone LH which is released from the brain. There is now a new blood tests that more doctors are using called Anti-Mullerian Hormone to help with a diagnosis. AMH is a protein released by the cells which are involved with the growth of an egg follicle each month. AMH levels go hand in hand with Antral follicle count which counts the resting follicles which are found on the ovary. High levels of antral follicle count and high levels of AMH indicates that a woman has a large number of eggs remaining in her ovary and sometimes PCOS.
Doing an ultrasound to look for cysts on the ovaries does not make a diagnosis. There are women who do not have PCOS, that have cysts on the ovaries. So hence ultrasound is not usually done to give a confirmation of the disease. The diagnosis of PCOS is usually a clinical one which is based on the patient's history, physical examination, and laboratory testing.
Treatment involves treating the symptoms. The single most important thing is to try to lose weight if you are overweight. By reducing calories and simple sugars and increasing fiber and protein along with doing regular exercise, this can help the body to regulate the insulin in the body. For women not thinking of trying to conceive having a heavy menstrual cycle or even a woman who has absent menses, the birth control pill will help regulate the cycle. The pill decreases androgen production and gives your body a break from the effects of continuous estrogen released. This helps decrease your risk of endometrial cancer and corrects abnormal bleeding.
If you are trying to become pregnant you may need a medication to help you ovulate. Clomid is an oral anti-estrogen medication that you take in the first part of your menstrual cycle. If Clomid isn't effective, your doctor may add metformin to help induce ovulation. If you still do not become pregnant your doctor may recommend using gonadotropins — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) medications which are given by injection. If all these methods do not help you become pregnant then surgery is the next best option to try. The surgery is called laparoscopic ovarian drilling.
If you have PCOS or are newly diagnosed with it, ask your doctor questions to learn more about the disease. The more informed you are the better it is to cope with the disease. Try to keep a positive attitude and just live life to the fullest. Remember you are not alone and there are support groups that can help.
© 2013 Cynthia