31 Days of Awareness: Polycystic Ovary Syndrome

Polycystic Ovary Syndrome

Awareness Color: Teal
Awareness Month: September

Source

Polycystic Ovary Syndrome (PCOS) is a condition in which a woman’s ovaries and in some cases the adrenal glands, produce more androgens (a type of hormone, similar to testosterone) than normal. PCOS is the most common endocrine disorder of women, affecting as many as 1 in 10. While there is no cure for PCOS, the symptoms of PCOS can be managed with proper treatment by a qualified PCOS physican.

Symptoms

• Hirsutism: Increased hair growth in strange places (chest, face, back, lower abdomen, fingers, toes).
• Hair loss: Hair loss similar to male pattern baldness.
• Infertility: Difficulty in conceiving or becoming pregnant. Usually a result of irregular periods, or not ovulating each month.
• Infrequent or absent periods
• Anovulation or oligovulation: Not ovulating, or releasing a mature egg from the ovary each month. Without ovulation, periods may be irregular or absent.
• Ovarian cysts
• Obesity
• Acne
• Acanthosis nigricans: Patches of dark, thickened, velvety skin behind the neck, on the thighs, or on the vulva. This is usually a sign of insulin resistance.
• Insulin resistance: The body does not respond as well to insulin, the primary hormone which helps the body use and deal with glucose or sugar. This causes elevated blood glucose levels and is a major risk factor for Type 2 Diabetes.
• Type 2 diabetes: Prolonged exposure to high levels of glucose and the reduced sensitivity of body cells to insulin eventually make the body unable to deal with sugar. When glucose levels are persistently high, complications develop. These include problems with eye sight, kidney disease, and neuropathy, which is a loss of feeling and circulation in the body limbs.
• High cholesterol
• Skin tags: Excess flaps of skin, usually found in the armpit or groin.
• High blood pressure
• Sleep apnea or snoring

Treatment

As no two women with PCOS experience the exact same symptoms, treatment involves managing their particular symptoms. This can include diet, medication, therapy, and in some cases, surgery.

Infertility

If you want to try to have a baby, there are many options. The medication that your doctor will probably prescribe first is Clomid, which may help you ovulate. Towards the middle of your cycle, you may be able to use an ovulation predictor kit which can help you time the best days to begin trying. Keep in mind that some women with PCOS have persistently high LH levels (the hormone detected in ovulation kits), making this method of timing inappropriate.

Because of the connection between PCOS and insulin resistance, medications that are normally used to treat diabetes, namely Metformin, may be used to increase insulin sensitivity. By increasing the body’s response to insulin, it is thought that the ovary may not make as many androgens, which increases the likelihood that ovulation will occur. Metformin may also reduce the levels of circulating androgens, even if you are not trying to conceive. This will help regulate your menstrual cycle and reduce the distressing symptoms that you may be experiencing. Some women may need to take both Clomid and Metformin in order to ovulate. Clomid is a medication that is given to stimulate ovulation in women who do not regularly ovulate. Losing weight can also help accomplish this. In some people, moderate weight loss can help restore ovulation and greatly increase your odds of pregnancy.

If these do not work, the next step will most likely be injectable medications known as Gonadotropins. Each month, Follicle Stimulating Hormone (FSH) is secreted by the pituitary which makes an egg follicle grow. Gonadotropins directly increase the amount of FSH circulating in the body, promoting the growth and development of a mature egg. The doctor will most likely monitor your progress through ultrasound and blood tests. Once the doctor feels that you are close to ovulating, s/he may have you take an injection of Human Chorionic Gonadotropin (HCG) which will trigger your ovulation within 36 hours. This will allow you to more precisely time when to have intercourse, or have Intrauterine Insemination (IUI). Your doctor will help you identify which choice is better for you.

Finally, your last choice is In Vitro Fertilization (IVF), a complex process where you will undergo a controlled hyperstimulation of your ovaries through injectable medications. This produces many eggs which the doctor will then remove through a surgical procedure. Fertilization takes place outside of the body and in the more controlled environment of the lab. Growing embryos are then transferred back into the body, where they will hopefully implant in the uterus and form a viable pregnancy. There are many treatment protocols within the IVF process and your doctor will choose the best one, based on your medical history, age and diagnosis. If standard IVF does not work for you, it can be used with donor eggs, donor sperm or with a surrogate as necessary.

Coping

Coping with PCOS is a complicated, often painful challenge. From the many embarrassing symptoms, to difficulty conceiving, it’s easy for women with PCOS to feel alone. Because hormonal changes are the hallmark of this disease, almost every body system can be affected. You may have increased hair growth in strange places, or losing your hair similar to male pattern baldness. Thankfully, a number of available treatments can help you manage the symptoms, and help you conceive if you are having difficulty.

The most important thing is to initiate a conversation with your doctor as early as possible. By following his recommendations, living a healthy lifestyle and getting prompt treatment, you can minimize or eliminate many of the unwanted symptoms. Polycystic ovary syndrome has been linked to a number of health complications including type II diabetes, cardiovascular disease and endometrial cancer. So the quicker you begin to manage your disease, the sooner you monitor for abnormal symptoms.

Symptom Control
Women with PCOS frequently have to deal with annoying symptoms like acne or unwanted hair especially on the face. Thankfully, there are a number of possible interventions today that can help you deal with this. From basic home remedies like shaving, waxing and depilatory creams to procedures done in an office like electrolysis or laser therapy, there are many options to choose from. Don’t hesitate to speak with a dermatologist about the best option for you.

Support
Finally, this disease and its effects can become very overwhelming. There are a number of places where you can get support in dealing with the various concerns associated with PCOS. From education to message boards to internet chats, there are many sites on the web that provide resource or support. It’s important to educate yourself on this disease so that you can play an active role in monitoring for complications.

To learn more, or get support, please visit:
PCOSupport
SoulCysters
PCOS Challenge
PCOS Help Centre
Project PCOS