Polycystic Ovarian Syndrome (PCOS)

Causes and complications of PCOS

Signs and symptoms of PCOS

Treatment for PCOS

Polycystic ovarian syndrome (PCOS) is a common hormonal disorder characterised by irregular menstruation.

Polycystic ovarian syndrome (PCOS, a.k.a Stein-Leventhal Syndrome) is a common hormonal disorder where there is an imbalance of a woman's female sex hormones, resulting in an abnormal predominance of the male hormone androgen. It occurs in some 4–7 per cent of women of reproductive age.

The disorder is characterised by an irregularity in the menstrual cycle – the eggs in the follicles do not mature and are not released from the ovaries, but instead form very small cysts in the ovary. The ovaries are often enlarged, with numerous small cysts present on the outside.

Causes and complications of PCOS

The exact cause of PCOS is not known, although it is likely to be the result of both genetic and environmental factors associated with abnormalities in insulin production and an unusually elevated level of the male hormone androgen. However, women with this disorder may have difficulty becoming pregnant due to infrequent ovulation or non-ovulation.

It is important for PCOS to be diagnosed early. Failure to do so can lead to complications such as diabetes, high blood pressure, heart disease, depression and snoring in the long term. In addition, there is also a small increased risk of cancer of the uterus.

Signs and symptoms of PCOS

Symptoms of PCOS may surface early on, at the start of menstruation, or they may appear later on in the reproductive years. Symptoms include:

Abnormal menstrual periods. This is the most common sign, whereby there is irregular or no menstruation, or prolonged periods of very light or very heavy menstruation.
Acne, excess hair growth on the body (hirsutism), thinning of the hair on the head (male-pattern hair loss), decreased breast size and deepening of the voice. These symptoms are related to an elevated androgen level, which leads to virilisation (i.e. the development of male sex characteristics).
Oily skin
Dandruff
Obesity and weight gain
Elevated insulin level and insulin resistance, characterised by changes in skin pigmentation around the armpits, groin, neck, and breasts.
Infertility
High cholesterol
Elevated blood pressure

Treatment for PCOS

Risks associated with PCOS may be minimised with proper treatment targeted at each of the manifest symptoms.

Treatment includes:

Birth control pills: These may be prescribed (especially to young women) to stimulate a normal menstrual cycle and combat the excessive male hormones, thereby reducing the risk of uterine cancer.
Weight loss: This can help to normalise the menstrual cycle and increase the possibility of pregnancy, while reducing the risk of complications such as type 2 diabetes and heart disease.
Fertility treatment: This may be necessary if there is difficulty conceiving.

Ref: T12

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