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Polycystic Ovarian Syndrome (PCOS), also known as Stein-Leventhal Syndrome, is a condition in which a woman produces too many male hormones and too few female hormones, causing irregular or rare ovulation, and at times anovulation, or no ovulation at all. PCOS afflicts approximately five to ten percent of women of childbearing age.
Under normal circumstances, ovulation occurs when a follicle containing the egg grows, then releases the mature egg. PCOS prevents the follicle from growing, which results in a build-up of eggs in the ovaries. This results in the formation of small, benign, estrogen-releasing cysts in the ovaries. This release of estrogen, coupled with the presence of the male hormones, prevents two other hormones, the luteinizing hormone (LH) and the follicle-stimulating hormone (FSH), from being produced at the proper level. Without ovulation, the male hormones remain at a high level, causing a repeat in the cycle.
Although a distinct cause has not yet been determined, researchers are examining the relationship of PCOS to a woman’s ability to produce insulin. It is common for women who have PCOS to produce excess insulin, which prompts the ovaries to compensate by mass producing androgens, or male hormones. Although some women with PCOS have a mother or sister with the syndrome, there is not conclusive evidence of a genetic link.
PCOS has many symptoms. Approximately 50% of women with PCOS suffer from obesity, high blood pressure, high cholesterol, diabetes, elevated insulin levels or insulin resistance. They may have patches of thicker, dark brown or black skin on their upper body, skin tags and acne. Excessive hair growth is one of the major symptoms of PCOS, and the woman may have hair growing on her chest, lower abdomen and face. She may also experience alopecia, or thinning of the hair on the scalp.
In addition to these symptoms, women with PCOS experience nonexistent or irregular menstrual cycles. This often starts about three or four years after onset of menstruation. Due to the irregular ovulation and menstruation, women with PCOS may have trouble conceiving.
To make a diagnosis, a doctor will perform a physical exam and take blood tests to measure levels of hormones. An ultrasound may also be performed to locate any cysts in the ovaries.
Treatment of PCOS starts with the advice to lose weight. This may help regulate some of the hormonal imbalances. Fertility drugs like clomiphene and gonadotropins have a 70 to 90% success rate in causing ovulation, and 50% of women on fertility drugs successfully conceive within six months. However, one fifth of these subsequent pregnancies miscarry. Metformin, an insulin-sensitizing drug, helps women with polycystic ovarian syndrome to ovulate on their own.
Ovarian drilling is a surgical treatment for PCOS. The doctor performing it inserts a small needle with an electric current into the ovary. This destroys a small part of the ovary, which hopefully lowers the production of male hormones. Unfortunately, this is not a highly recommended procedure due to the possible formation of scar tissue and its temporary effects.
If a woman suffering from polycystic ovarian syndrome is not trying to get pregnant, taking birth control pills may help balance the hormones, resulting in less acne and excessive hair growth.