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Polycystic ovarian syndrome (also called PCOS, polycystic ovary syndrome, or Stein Leventhal syndrome) is the most common hormonal and reproductive problem affecting women of childbearing age. It is estimated that about 8 percent to 15 percent of women experience this disorder.
According to the American Society for Reproductive Medicine, PCOS is defined by the presence of any two of the following characteristics:
The exact cause of PCOS is unclear. It is common for sisters or a mother and daughter to have PCOS, but a definite genetic link has not been found.
PCOS results from a combination of several related factors. Many women with PCOS have insulin resistance, in which the body cannot use insulin efficiently. This leads to high circulating blood levels of insulin, called hyperinsulinemia. It is believed that hyperinsulinemia is related to increased androgen levels, as well as obesity and type 2 diabetes. In turn, obesity can increase insulin levels, causing worsening of PCOS.
Ovulation is a process in which a mature egg cell (also called an ovum), ready for fertilization by a sperm cell, is released from one of the ovaries (two female reproductive organs located in the pelvis). If the egg does not become fertilized as it travels down the fallopian tube on its way to the uterus, the endometrium (lining of the uterus) is shed and passes through the vagina (the passageway through which fluid passes out of the body during menstrual periods; also called the birth canal), in a process called menstruation.
With an ovulatory problem, the woman's reproductive system does not produce the proper amounts of hormones necessary to develop, mature, and release a healthy egg.
When the ovaries do not produce the hormones needed for ovulation and proper function of the menstrual cycle, the ovaries become enlarged and develop many small cysts which produce androgens.
Increased levels of androgens can also interfere with ovulation and normal menstrual cycles. Some women with polycystic ovaries have normal menstrual cycles.
The signs and symptoms of PCOS are related to hormonal imbalance, lack of ovulation, and insulin resistance and may include:
In addition, women with PCOS may be at increased risk for developing certain health problems. These may include:
The symptoms of PCOS may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic procedures for PCOS may include:
Other tests may be used to identify problems related to PCOS and may include:
Specific treatment for PCOS will be determined by your physician based on:
Treatment for PCOS also depends on whether or not a woman wants to become pregnant.
For women who do not want to become pregnant, treatment is focused on correcting the abnormal hormone levels, weight reduction, and managing cosmetic concerns. Treatment may include:
For women who want to become pregnant, treatment is focused on weight reduction and promoting ovulation. Treatment may include:
Women sometimes struggle with the physical changes that occur with PCOS, such as weight gain, hair growth, and acne. In addition to diet and medications, cosmetic procedures such as electrolysis and laser hair removal can often help a woman feel better about her appearance.
Because of the possible long-term health risks of PCOS, including heart disease and type 2 diabetes, women with PCOS should consult their physician about appropriate treatment.