DESCRIPTION
Polycystic Ovary (Ovarian) Syndrome (PCOS) usually involves ovary enlargement from many small, fluid filled cysts in their ovaries. The hormonal regulation of the ovary malfunctions resulting in a reduction or absence of ovulation (the monthly release of the egg from the ovary), irregular or absence of a menstrual cycle and high levels of male hormones, also called androgens. PCOS can affect a woman's menstrual cycle, fertility, hormones, insulin production, heart blood vessels, and appearance. Women with this problem are often infertile. PCOS is the most common hormonal reproductive problems in women of childbearing age. It is estimated that 5 to 10 percent of women of childbearing age have PCOS.
FREQUENT SIGNS & SYMPTOMS
According to the American Society for Reproductive Medicine, PCOS is defined by the presence of any two of the following characteristics:
*Lack of ovulation for an extended period of time.
*High levels of androgens (male hormones).
*Many small cysts (fluid-filled sacs) on the ovaries.
*Enlarged and/or polycystic ovaries. A woman may or may not have ovarian cysts with PCOS.
*Irregular menstrual bleeding resulting in periods of light flow along with heavy flow. Absence of a menstrual cycle.
* Infrequent menstrual periods. Increased time between periods, often up to several months.
Hirsutism which is the increased (excessive) hair growth on the face, arms, legs and from pubic area to navel from an increased level of androgens.
*Male pattern baldness or thinning hair.
Alopecia)
*Higher energy level.
*Obesity (weight gain), especially around the waist (central obesity) and abdomen.
*Infertility - the inability to produce children.
*Acne or oily skin.
*Skin tags - small pieces of skin on the neck or armpits.
*Acanthosis nigricans - darkened skin areas on the back of the neck, in the armpits, and under the breasts.
OVULATION & PCOS
Ovulation is a process in which a mature egg cell (also called an ovum), ready for fertilization by a sperm cell, is released from one of the ovaries (two female reproductive organs located in the pelvis). If the egg does not become fertilized as it travels down the fallopian tube on its way to the uterus, the endometrium (lining of the uterus) is shed and passes through the vagina (the passageway through which fluid passes out of the body during menstrual periods; also called the birth canal), in a process called menstruation.
With an ovulatory problem, the woman's reproductive system does not produce the proper amounts of hormones necessary to develop, mature, and release a healthy egg.
When the ovaries do not produce the hormones needed for ovulation and proper function of the menstrual cycle, the ovaries become enlarged and develop many small cysts which produce androgens.
Increased levels of androgens can also interfere with ovulation and normal menstrual cycles. About 20 percent of women with polycystic ovaries have normal menstrual cycles.
CAUSES
*No one knows the exact cause of PCOS. PCOS results from a combination of several related factors.
*Women with PCOS frequently have a mother or sister with PCOS. But there is not enough evidence yet to say there is a genetic link to this disorder.
*An imbalance between the pituitary gonadotropin luteinizing hormone (LH) and follicle-stimulating hormone (FSH), resulting in a lack of ovulation and an increased testosterone production, a male sex hormone. Male hormones are called androgens.
*Many women with PCOS have a weight problem. So researchers are looking at a relationship between PCOS and the body's ability to make insulin. Insulin is a hormone that regulates the change of sugar, starches and other food into energy for the body's use or for storage. Many women with PCOS have insulin resistance, in which the body cannot use insulin efficiently. Since some women with PCOS make too much insulin, this leads to high circulating blood levels of insulin, called hyperinsulinemia. It is believed that hyperinsulinemia is related to increased androgen levels and it is possible that the ovaries react by making too many male hormones, androgens. This can lead to acne, excessive hair growth, weight gain (obesity), and ovulation problems as well as type 2 diabetes. In turn, obesity can increase insulin levels, causing worsening of PCOS.
