PolyCystic Ovarian Syndrome (PCOS)
According to the PolyCystic Ovarian Syndrome Foundation, this condition affects between 5 – 10% of women of childbearing age worldwide, and an estimated half million Australian girls and women, but most people have still never heard of it.
PCOS is a hormonal disorder. Many of the symptoms will cease with the menopause, but others will be life-long. The symptoms can include:
*Irregular or absent menstrual cycles
*Reduced fertility
*Obesity/ weight gain
*Polycystic ovaries
*Dark skin patches
*Excessive hair growth on the body, and male pattern hair loss on head
*Acne
*Depression
Women with PCOS are also at increased risk for the following:
*Insulin resistance
*Diabetes
*Lipid abnormalities
*Cardiovascular disease (such as heart disease, stroke, & blood clots)
*Endometrial carcinoma
To add to the confusion, not every woman with polycystic ovaries has this syndrome, and not every woman with this syndrome has polycystic ovaries. It was named in the 1930s before much was known about it. There are better names now (like hyperandrogen anovulation) but PCOS is too well established in the medical literature to successfully make a name change now.
PCOS develops when the ovaries overproduce male sex hormones (called androgens) like testosterone. That in turn triggers a number of reactions in the body such as insulin resistance, body hair growth, head hair loss, and acne. The inability to use insulin effectively frequently leads to obesity.
GP’s may know very little about PCOS so diagnosis is sometimes slow in coming. Doctors may treat the symptoms separately, which will be ineffective overall. Treating just obesity, or lack of periods, or acne will not help the background medical problem that causes each of these. It is important for a woman to report to the Doctor all of her symptoms so that patterns can be recognised and identified properly.
To be diagnosed you may need to have:
Blood tests to detect:
- High levels of androgens
- Elevated fasting insulin levels
- Any elevation in the ratio of LH to FSH hormones
Intravaginal ultrasound to detect polycystic ovaries
Because the symptoms of PCOS can also be a part of other conditions, the Doctor needs to rule out Cushing’s syndrome, congenital adrenal hyperplasia, or other disorders of the pituitary or adrenal glands. PCOS tends to run in families, so if one sister is found to have it there is a high likelihood that her sisters will have it, as well, so they should be tested, too.
Once diagnosed it is important to know there is a 40-60% risk of developing diabetes over the next 20 years, so prevention through careful diet and exercise is recommended.
PCOS treatment involves diet, exercise, weight reduction, and possibly the use of Oral Contraceptives (OCs) for the resulting regular periods, reduction of male hormone secretion, and reliable contraception. The OCs may or may not help the acne. Another drug being used to treat PCOS is Metformin, which makes the insulin response in the muscles and liver last longer, which in turn lowers the insulin level. It also helps regulate hair growth, and weight regulation.
For more information, contact:
The Polycystic Ovarian Syndrome Association of Australia
P O Box 822, Dapto NSW 2530 (02) 8250-0222
www.posaa.asn.au
