subject: What is Polycystic Ovary Syndrome ? [print this page] What is Polycystic Ovary Syndrome ? What is Polycystic Ovary Syndrome ?
Polycystic Ovarian Syndrome is also calledStein-Leventhal syndrome.
Polycystic ovarian syndrome is a disorder that is quite difficult to diagnose as the symptoms may be so similar to other conditions, but it is quite common as it affects between five and ten percent of all women of child-bearing age. The symptoms of polycystic ovarian syndrome (PCOS) usually include anovulation, irregular menstruation, hirsutism ( excessive hair growth, especially in the face ), acne, infertility, darkened areas of the skin, obesity and the presence of multiple cysts (fluid-filled sacs) on the ovaries.
The diagnosis of PCOS is done firstly by physical examination. A complete medical history of the patient is required. The physical examination is normally a pelvic examination where the size of the ovaries are determined. This is followed by a visual examination of the skin, that is for acne, hirsutism and darkened areas of the skin. The next step is the diagnostic procedure is usually blood tests where tests are done for the levels of luteinizing hormone, estrogen, follicle stimulating hormone, androgens, glucose and insulin. A glucose-tolerance test may also be done. Another test the doctor may order is an ultrasound examination of the ovaries to determine the size and shape of the ovaries.
The treatment of PCOS is primarily aimed at the correction of anovulation, restoring normal menstrual periods, improving fertility, eliminationg hirsutism and acne and preventing future complications due to high insulin,blood lipid and estrogen levels. The treatment of PCOS can include one or more of the following : weight loss, hormonal therapy, non-hormonal drug therapy or surgical treatment.
Weight loss:
In the obese patients with PCOS a weight loss of 5% through diet and exercise may normalise ovulation and menstruation and restore fertility.
Hormonal Drug Treatment:
Low dose oral contraceptive pills are used in those women with PCOS who want to avoid pregnancy. The use of low-dose oral contraceptives can regulate menstruation and correct heavy uterine bleeding. Hirsutism may also be improved but this may take up to a year to happen. In women who wish to fall pregnant the drug of choice is clomiphene citrate. Clomiphene is used to induce ovulation and is very effective and has a 70% success rate but the problem is the occurrence of multiple pregnancy. In 20-25% of women who do not respond to clomiphene citrate other drugs are used that can stimulate the follicular development and induce ovulation. One of the other problems that women with PCOS experience is the high risk they run of getting endometrial cancer due to the lack of endometrial shedding. For this reason the drug medroxyprogesterone is administered for the first ten days of each month.
Non-hormonal Drug Treatment:
The steroid hormone dexamethasone can be used to trigger ovulation.
Spironolactone, Flutamide and metformin is used for hirsutism.
Acne may be treated with antibiotics, antiandrogens and other drugs like retinoic acids or vitamin A derivatives.
Surgical Treatment.
Surgical treatment is used when the drug approach failed. A procedure called a wedge resection is performed. The wedge resection is when a portion of the ovary and some of the ovarian cysts are removed either via a laparoscope or an abdominal incision. Another procedure that may be done is laparoscopic ovarian drilling where a laser beam is used to open a cyst so that some of its fluid may be drained off. After surgical treatment it has been found that more than 50% of the women with PCOS is able to fall pregnant. Hysterectomy (surgical removal of the uterus) or oopherectomy (surgical removal of ovaries) is also beneficial in that the hirsutism is diminished by these procedures, when the procedure is followed by estrogen replacement therapy.
For the full article, including a discussion on alternative therapies visit Women's Health Today
