Polycystic Ovary Syndrome (PCOS)

Women who have Polycystic Ovary Syndrome (PCOS) usually have a normal uterus and fallopian tubes. However, these women have ovaries which contain several small cysts measuring approximately 8 mm in size. These cysts can usually be detected with the use of an ultrasound. These small cysts do not require surgical removal, and are not associated with an increased risk of ovarian cancer. The cause of PCOS is not known. There may be dysregulation of the pituitary hormones LH and FSH that usually work together to stimulate ovulation. There may be an abnormality of hormone signaling in the ovaries. The end result is the development of small, abnormally functioning immature follicles that do no develop fully and ovulate.

As a result of abnormal pituitary function, the levels of LH and FSH are not regulated, and a mature egg cannot completely develop. Because of this, the ovulatory process is not completed and the partially stimulated follicle forms a cyst.

Symptoms of PCOS include:

Irregular menstruation

The constant production of estrogen causes the endometrium to become abnormally thick and to be shed spontaneously. This coupled with irregular or absent ovulation causes intermittent bouts of amenorrhea or periods of heavy bleeding.

Fertility Problems

Irregular or absent ovulation means that pregnancy is difficult or impossible to achieve.

Miscarriage

Women who have PCOS have a higher rate of miscarriage due to elevated levels of LH.

Excess Hair Growth and Acne

Women who have PCOS, often have excessive testerone production which contributes to increased hair growth and acne.

Obesity

About one-half of all women with PCOS are obese. Obesity tends to increase abnormal estrogen and androgen production which in turn increases problems with hair growth and irregular bleeding.

Abnormal Insulin Action

Women with PCOS have more resistance to the action of insulin than normal women and are at a greater risk of developing diabetes.

Cardiovascular Disease

PCOS patients may have several factors including increased weight, abnormal androgen production, abnormal cholesterol function that contribute to cardiovascular disease.

Diabetes

Sensitivity to insulin is sometimes abnormal in women with PCOS. In addition, their increased weight can contribute to diabetes.

PCOS is normally treated with ovulation inducing drugs such as clomiphene or in some case gonadotropin preparations.