Polycystic Ovarian Disease
Posted on 02. Jun, 2009 by David Kreiner, MD in Infertility Information, PCOS
PCOS
Polycystic Ovary Syndrome (PCOS) is a condition in which a woman’s hormones are out of balance. It can cause problems with your periods and make it difficult to get pregnant. PCOS may affect the way you look and can be associated with a variety of health problems including diabetes, hyperlipidemia and hypertension.
PCOS is the most common hormonal disorder of reproductive age women, occurring in over 7% of women at some point in their lifetime. It usually develops during the teen years. Treatment can assist women attempting to conceive, help control the symptoms and prevent long term health problems.
The most common cause of PCOS is glucose intolerance resulting in abnormally high insulin levels. If a woman does not respond normally to insulin, her blood sugar levels rise triggering the body to produce more insulin. The insulin stimulates your ovaries to produce male sex hormones called androgens. Testosterone is a common androgen and is often elevated in women with PCOS. These androgens block the development and maturation of a woman’s ovarian follicles preventing ovulation resulting in irregular menses and infertility. Androgens may also trigger development of acne and extra facial and body hair. It will increase lipids in the blood. The elevated blood sugar from insulin resistance can develop into diabetes.
Symptoms may vary but the most common are acne, weight gain, extra hair on the face and body, thinning of hair on the scalp, irregular periods and infertility.
Ovaries develop numerous small follicles that look like cysts hence the name polycystic ovary syndrome. These cysts themselves are not harmful but in response to fertility treatment can result in a condition known as Hyperstimulation syndrome. Hyperstimulation syndrome involves ovarian swelling, fluid accumulating in the belly and occasionally around the lungs. A woman with Hyperstimulation syndrome may become dehydrated increasing her risk of developing blood clots. Becoming pregnant adds to the stimulation and exacerbates the condition leading many specialists to cancel cycles in which a woman is at high risk of developing Hyperstimulation. They may also prescribe aspirin to prevent clot formation.
These cysts may lead to many eggs maturing in response to fertility treatment also placing patients at a high risk of developing a high order multiple pregnancy. Due to this unique risk it may be advantageous to avoid aggressive stimulation of the ovaries unless the eggs are removed as part of an in vitro fertilization procedure.
A diagnosis of PCOS may be made by history and physical examination including an ultrasound of the ovaries. A glucose tolerance test is most useful to determine the presence of glucose intolerance and diabetes. Hormone assays will also be helpful in making a differential diagnosis.
Treatment starts with regular exercise and a diet including healthy foods with a controlled carbohydrate intake. This can help lower blood pressure and cholesterol and reduce the risk of diabetes. It can also help you lose weight if you need to.
Quitting smoking will help reduce androgen levels and reduce the risk for heart disease. Birth control pills help regulate periods and reduce excess facial hair and acne. Laser hair removal has also been used successfully to reduce excess hair.
A diabetes medicine called metformin can help control insulin and blood sugar levels. This can help lower androgen levels, regulate menstrual cycles and improve fertility. Fertility medications, in particular clomiphene are often needed in addition to metformin to get a woman to ovulate and will assist many women to conceive. The use of gonadotropin hormone injections without egg removal as performed as part of an IVF procedure may result in Hyperstimulation syndrome and/or multiple pregnancies and therefore one must be extremely cautious in its use. In vitro fertilization has been very successful and offers a means for a woman with PCOS to conceive without a significant risk for developing a multiple pregnancy especially when associated with a single embryo transfer. Since IVF is much more successful than insemination or intercourse with gonadotropin stimulation, IVF will reduce the number of potential exposures a patient must have to Hyperstimulation syndrome before conceiving.
It can be hard to deal with having PCOS. If you are feeling sad or depressed, it may help to talk to a counselor or to others who have the condition. Ask your doctor about support groups and for treatment that can help you with your symptoms. Remember, PCOS can be annoying, aggravating even depressing but it is fortunately a very treatable disorder.
Rajvinder Kaur
Jan 12th, 2010
Left & Right (both) Ovary Swelling from last 1 yr.Two times abortion,done by Dr. before 1 yr. and one of befor 6 months.After that i feel pain inside my belly and Dr.said to me that, you have Ovary swelling problem.please advise me. i have one baby girl. she is 9 yrs. old. i am 27 yrs. ols women.
Kreinerivf
Jan 13th, 2010
Unfortunately, this is insufficient information for me to give you opinion. I would prefer to do a complete history and examination in order to have adequate information to offer helpful advice.
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Sep 17th, 2010
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Lona Hugueley
Dec 2nd, 2010
Interesting read. There’s currently quite a lot of data around this subject close to and about on the net and some are most defintely greater than others. You have caught the detail here just suitable which makes for a refreshing change – thanks.
T J B
Dec 30th, 2010
I feel so overwhelmed with many mixed emotions, from partial relief (in knowing finally what the problem is), but also inadequate and insecure because I haven’t been able to conceive. As I learn about my condition, I find comfort in knowing I am not alone, and right now I just need an outlet to express myself freely because the people closest to me are sympathetic, but cannot relate and thus down play my feelings when I attempt to share my grief. I just feel so alone.
Ovena Richard Darius
Jan 22nd, 2011
My doctor suggested that I check the sites for PCOS. I’m gld I didn’t egnore it. It help to know these information. even though it might be hard to conceive on our own, I believe God will bless us with a miracle. we just know he will bless us. Thank you for the clearity.
Meagan
Feb 8th, 2011
I am 17, and have had this disease for over a year now. This website is an interesting read & helps me understand the connection between PCOS and Diabetes (which I was diagnosed with about a month ago). It is difficult to deal with the way it changes my body, especially as a high school senior. I eat meat twice a week and eat 100% organically to avoid further hormone contamination. I also exercise daily. I continue to gain weight & have complications with diabetes. I see 4-5 regular doctors to monitor it’s progress and have 3-4 doctors appointments a week. I completely understand and sympathize with TJB in that we may feel alone, but we are not. And that it is a long road ahead of us. I find it most helpful to keep a positive outlook, surround yourself with those who care and understand & to stay strong in faith.
Nga Cochron
Jul 6th, 2011
24. Heya i’m for the first time here. I found this board and I find It really useful & it helped me out a lot. I hope to give something back and aid others like you helped me.
Vicki Kudla
Aug 24th, 2011
Acne nodules are undoubtedly one of the most terrible skin illnesses that may crush one´s social life
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CELESTE ROBERSON
Sep 26th, 2011
I found out that I had Pcos when i was 17 my father passed away in the fall of 2008 around the time of playing my first basketball game against the h.s. he played for i am the first child of my fathers 3 kids who has had the opportunity to attend college the state of FL help do that with bright futures scholarship funding along with the faculty and staff of my former high school (j.m. tate) and pensacola state college will be my former junior college I’m getting ready to transfer from pjc/psc to a college of my choice which will still be in state. But to sum this all up the insurance i did have covered me until i was 18 i havent had my medication since then.i was prescribed to aldactone and birth control. i dont take either of them.the biggest thing is i have FAITH and STRENGTH. i BELIEVE WHAT THE SCRIPTURE TEACHES AND THE GOD WILL COVER ME AND WATCH OUT FOR ME BECAUSE HIS EYE IS ON A SPARROW AND I KNOW HOW GREAT THOU ART IZ. JUST KNOW IF THERE IS A WILL THERE IS A WAY AND LET BY GONES BY BY GONES. YOU CAN NEVER CHANGE YOUR DESTINY BUT YOU DO HAVE CHOOSES SO JUST CHOICE WISELY N LET GOD TAKE CARE OF THE REST. EVEN IF YOU DONT BELIEVE IN GOD STAND FOR SOMETHING BECAUSE IF YOU DONT YOU’LL FALL FOR ANYTHING.
C.ROBERSON/TINK/TANK/PRRRICELESSPRINCESSPEACE
CELESTE ROBERSON
Sep 26th, 2011
btw i will be 21 this spring. remember life is a beach n we all are just playing in the sand. its paradise get it pair a dice lolz. love is not a game that you play to win or lose. last but not least there is nothing new underneath the sub/sun/son/sin/win/wine/winner/wine/dine/lemon/
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Mista
Oct 18th, 2011
I was diagnosed with pcos when I was 19. I have found it very difficult to not be in control of my own body. The pills and test are mind numbing. All I hear is bad news. I have been married for 5 years and trying for 1. Is there any good news for pcos?
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