PCOS

If you have been trying to become pregnant without success and have symptoms that include no or irregular menstrual cycles, excess hair growth, male pattern baldness, acne or unexplained weight gain and obesity, you may have Polycystic Ovarian Syndrome. It also is common for patients with PCOS to have insulin resistance. In fact, many have a family history of diabetes.

PCOS affects between five and ten percent of reproductive age women. Often those with PCOS have irregular cycles starting at puberty. In many cases, these girls are given birth control pills that mask the most common symptoms by regulating their cycles. As a result, they often don’t realize there is a problem until they go off the pill.

Unfortunately, it is estimated that at least seventy percent of PCOS cases are under diagnosed and only recognized when a patient has difficulty conceiving. The earlier that PCOS is diagnosed the higher the likelihood that the signs and symptoms can be controlled and long-term adverse health risks can be avoided.

Women with eating disorders, excessive exercise habits and low body mass index may present with ovulatory dysfunction and polycystic appearing ovaries on ultrasound but do not complain of the cosmetic issues such as acne and hair growth. In fact, it has been reported that twenty percent of reproductive age women have PCOS appearing ovaries on ultrasound but do not meet criteria for the syndrome.

Some symptoms associated with PCOS instead may be related to ovulatory dysfunction, so it is important to accurately diagnose true PCOS patients as the treatment strategies vary.

In PCOS patients, an ultrasound exam usually will detect enlarged ovaries with an excessive number of follicles that form a ring around the outside of the ovary that looks like a chain of pearls.

Before confirming that PCOS is the diagnosis, we must rule out other conditions such as thyroid issues, elevated prolactin secretion and certain rare hormonal conditions. Two out of the following three criteria must be confirmed to make a PCOS diagnosis: irregular cycles, excessive secretion of androgens and PCOS appearing ovaries on ultrasound.

If you suspect you may have PCOS, it is important to get a thorough medical examination. More than three million women in the U.S. have PCOS and more than one million are diabetic. Many cases are under-diagnosed and early intervention can significantly change the course of this syndrome.

Nutritional education and exercise modification can improve the probability of pregnancy and decrease long-term health risk if PCOS is diagnosed early. PCOS patients have an excellent probability of pregnancy with therapy. If pregnancy and delivery are successful, it is critical that PCOS patients continue to address their long-term health concerns such as diabetes, coronary heart disease, and endometrial cancer. Because some PCOS patients experience weight and cosmetic issues, they may suffer poor self-confidence and depression. Their treatment team should include a nutritionist, therapist and reproductive endocrinologist/medical endocrinologist.