Help for Polycystic Ovarian Syndrome

Enlarge Image Image Gallery

Article Tools

Image Gallery

Print

E-mail

Comments

RSS

Anna, age thirty, has never had regular menstrual periods. She has gone as long as one year without a period. In the past, she had been told that missed periods are fairly common in young women, and had been advised to take birth control pills to regulate her cycles.

But Anna has other symptoms, too—obesity, persistent acne, and excess facial hair growth. And she and her husband have been trying to conceive a child for three years. A visit to a fertility expert leads to extensive testing and eventually a diagnosis of polycystic ovarian syndrome (PCOS). Anna is told that if she wants to get pregnant, she will need to take fertility drugs. But she’s worried about the possible long-term side effects of these drugs, and wants to better understand her condition so that she can explore possible alternatives.

Anna (not her real name) is like an estimated 6 to 10 percent of American women who have PCOS—and they are having trouble getting help. At a meeting in October 2000 with the National Institutes of Health, patient activists for PCOS told researchers that the average woman with the disorder sees at least four doctors over a period of nine years before she gets treatment. The activists asked the assembled doctors to direct research into the role of diet and other alternative therapies for PCOS. They also believe it’s crucial to investigate the relationship between PCOS and psychological health, including eating disorders.

PCOS and its symptoms were first described in 1935. But the cause of the condition is still unknown, and diagnosis and treatment are difficult because the syndrome is so complex, and because it is so variable from woman to woman.

The name of the syndrome comes from its most common characteristic: multiple cysts, or follicles less than one-half inch in diameter, on both ovaries. These small cysts are the result of eggs that only partially develop within the ovary.

Women with PCOS may miss periods or menstruate infrequently or irregularly, or their periods may be prolonged or abnormally heavy. They may fail to ovulate; they may experience weight gain. And they may see the kind of facial and other excess hair growth that tends to occur with hormonal abnormalities. They may have acne or chronically oily skin. The hair on their heads may thin.

Worse yet are the potential complications of PCOS. Women with the syndrome are at higher risk for impaired glucose tolerance and diabetes. They are also at greater risk of hypertension and heart disease, endometrial cancer, and possibly breast cancer. This is why, if you suspect that you may have PCOS, a thorough diagnostic workup is essential. Other diseases, such as some tumors of the ovaries or ad renal glands, defects in adrenal gland functioning, thyroid dysfunction, and premature menopause can produce some of the same symptoms as PCOS.

Your diagnostic workup should include a physical exam, pelvic ultrasound, and a variety of blood tests. Findings that point to PCOS may include multiple ovarian cysts, elevated levels of androgens (male hormones such as testosterone), an elevated level of luteinizing hormone (without the usual surge of this hormone that initiates ovulation), and evidence of insulin resistance, including elevated insulin levels. Because PCOS is a highly variable disease, not all women will produce these test results.

RSS | Comments | E-mail | Print