An estimated five million women in the United States are suffering from a condition that not only has the potential to hinder fertility, but is also associated with metabolic issues that could lead to diseases like diabetes and heart disease.
Polycystic ovarian syndrome is a perplexing and sometimes devastating condition. Joseph I. Fernandez, MD, an OB/GYN on the medical staff at Baylor Scott & White Clinic – Round Rock, explains the implications of this disease and when it is important to see a doctor.
What is polycystic ovarian syndrome?
“It’s a condition that results in irregular and infrequent ovulation,” Dr. Fernandez said. “It usually begins after a woman begins her menstrual cycles or goes through puberty.”
Doctors and researchers aren’t sure exactly what causes this condition, but they suspect that genetic factors play a significant role.
The syndrome is also associated with obesity, excess hair growth, acne and infertility. These symptoms are partly a result of the overabundance of male hormones that come with PCOS.
“The name is descriptive of the very small, inactive cysts that are numerous in the ovaries,” Dr. Fernandez said. “They look like strings of pearls.”
These cysts are fluid-filled sacs called follicles. In a patient not suffering from PCOS, these sacs would break open during ovulation, allowing the egg to be released into the fallopian tube. But, in women with PCOS, the sac never matures nor breaks and the follicle remains. Ovulation does not occur and the menstrual cycle does not take place.
What are the signs or symptoms of PCOS?
“Sometimes these individuals will go months without a menstrual cycle,” Dr. Fernandez said. “That is probably going to be their initial sign.”
Other symptoms could include:
- Increased hair growth on the lower body, face or chest
- Oily skin
- Male-pattern baldness
- Pelvic pain
- Sleep apnea
How is PCOS treated?
Because this syndrome is most often associated with obesity, Dr. Fernandez said diet and exercise are vitally important to decreasing symptoms and preventing metabolic issues like diabetes or elevated lipids.
“For patients who are not ready to achieve pregnancy, oral contraceptives can be used to regulate their cycles,” he said. “It’s important for women to have their cycles because when these women don’t ovulate, they are exposed to higher levels of estrogen, which can have implications later like an elevated risk for uterine cancer.”
Other hormonal methods like the intrauterine contraceptive device, called Mirena, will protect the lining of the uterus from estrogen exposure as well.
“For those who are interested in fertility, many times the treatment requires a change in diet and exercise as well as the inclusion of an ovulation agent like the medication Clomid,” Dr. Fernandez said.
What should I do if I suspect PCOS?
The OB/GYN recommends talking with your physician as soon as you suspect the syndrome because early diagnoses are the best defense against this condition. It will help to minimize the effect of the male-like hormones on the patient’s body.
“The physician will likely take a history, do a physical examination and any appropriate lab work can be drawn,” he said. “A pelvic ultrasound is sometimes done to look at the appearance of the ovaries.”
While there are some variations in the diagnosis process, Dr. Fernandez said PCOS is often diagnosed based on the patient’s history.
“It’s certainly a condition that should be taken care of because it could cause not only fertility issues in the future but could also cause metabolic, cardiovascular and diabetic issues.”