Polycystic Ovary Syndrome
Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders affecting approximately 5%-10% of women of reproductive age (12-45 years old) and is thought to be one of the leading causes of female subfertility.
The principal features are obesity, anovualtion (resulting in irregular menstruation) or amenorrhoea, acne, and excessive amounts or effects of androgenic (masculinizing) hormones. The symptoms and severity of the syndrome vary greatly among women. While the causes are unknown, diabetes and obesity are all strongly correlated with PCOS.
Medical treatment of PCOS is tailored to the patient’s goals. Broadly, these may be considered under four categories:
- Lowering of insulin levels
- Restoration of fertility
- Treatment of hirsutism or acne
- Restoration of regular menstruation, and prevention of endometrial hyperplasia and endometrial cancer
The diagnosis of PCOS is usually made following a pelvic ultrasound to assess the structure of the ovaries and blood test to assess whether there are higher than normal levels of ‘male’ hormones in the blood stream.
Where PCOS is associated with overweight or obesity, successful weight loss is the most effective method of restoring normal ovulation/menstruation, but many women find it very difficult to achieve and sustain significant weight loss. Reducing insulin resistance by improving insulin sensitivity through medications such as metformin.
Occasionally a laparoscopy is required in order to drill small holes in the ovary.
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