By Dr. Alisha Ware
Polycystic ovarian syndrome is one of the most common endocrine disorders in the United States. It is diagnosed with the presence of’ two of three medical components: irregular menstrual cycles, signs of elevated androgens (male-type hormones), such as unwanted hair growth or elevated blood testosterone, and small, cyst-like structures in the ovary.
The cause of PCOS is not entirely known. There is a genetic component, and symptoms of PCOS may be worse with obesity, and resolve with weight loss, suggesting that they are brought on by the excess weight.
PCOS often is suspected when women have irregular cycles.
The most common type of irregularity is a cycle that comes very infrequently, at no specific time, and may last for a varying number of davs. This happens because patients with POS do not ovulate on a regular basis. Their bodies get no signal to consistently shed the lining of the uterus once a month, so it continues to grow and thicken until something disrupts it. Then, it sheds in an irregular pattern. Women also may experience abnormal hair growth in areas such as along the jawline or on the chest. Sometimes, acne prompts an evaluation of blood testosterone levels.
Cysts on ovaries due to polvevstic ovarian svndrome are small, immature follicles left after an egg fails to ovulate. This is very different from cysts on ovaries that may enlarge and cause pain or sometimes rupture. When you see a physician for irregular periods, she may test for other conditions, such as hypothyroidism or adrenal hyperplasia. Usually testosterone levels will be checked, and possibly some other ovarian hormone levels. Screening for type 2 diabetes and elevated insulin levels usually are part of the evaluation for PCOS because these patients have an elevated risk for type 2 diabetes later in life.
PCOS symptoms can be managed, but the condition cannot be cured. It is an ongoing irregularity in how hormones are made. Irregular periods usually are managed with birth control pills to give the woman a regular cycle every month. Because part of the syndrome is lack of ovulation, patients may experience fertility issues. Ovulation-inducing medication can be used to help them achieve pregnancy.
Metformin is a diabetes medication frequently prescribed, as these patients have increased resistance to insulin. Insulin resistance causes type 2 diabetes. Use of Metformin helps to make the body more sensitive to insulin. Other medications also may help with symptoms that are related to elevated testosterone. For example, spironolactone may be prescribed for acne or abnormal hair growth. Laser hair removal may also help manage unwanted hair. Weight loss can help make the symptoms of PCOS less severe and sometimes make them regress entirely.
Although PCOS will never disappear, it can be managed successfully throughout a woman’s lifetime. Accurate diagnosis is important so that other risk factors can be addressed. If these symptoms seem familiar to you, you may want to discuss diagnostic tests for PCOS with your healthcare provider.
Dr. Alisha Ware is an obstetrics and gynecology specialist with The Woman’s Clinic PA. Reach her at (228) 864-2752.