Irregular menstrual cycles, unwanted hair growth, acne, and not being able to get pregnant may be a few of the symptoms that bring you in to see your gynecologist. What may be the problem is a condition called Polycystic Ovarian Syndrome (PCOS).
This disorder causes a female to produce an excess of the male hormone androgen. It usually begins at puberty but is a lifelong condition. Once diagnosed, it is important to be knowledgeable of the risks associated with PCOS.
Obesity is a common symptom related to PCOS, which may lead to other medical problems. About 30-40% of patients will become insulin resistant and about 10% will develop adult onset diabetes by age 40. Hypertension, heart disease, high cholesterol, and sleep apnea are other associated conditions that may develop. Endometrial hyperplasia and endometrial cancer may develop from the absence of menstrual cycles. During a regular monthly cycle, the lining of the uterus is shed. Without a menstrual cycle, the lining may become thickened, which may promote the development of abnormal cells. Infertility is another concern with PCOS. With the excess androgen, ovulation, the release of a mature egg, may be suppressed decreasing the woman’s ability to conceive.
Physical symptoms such as obesity, acne, hirsutism (abnormal hair growth on the chin, upper lip, around the nipples, and on the lower abdomen), male patterned baldness, acanthosis nigricans (patches of dark, thickened skin usually found on the back of the neck, thighs or on the vulva), amenorrhea (absence of menstrual cycles or decreased menstrual cycles), weight gain or difficulty losing weight, or infertility may be found in patients with PCOS. Patients may experience only one physical symptom or have multiple symptoms.
Treatments for this disorder include treating the symptoms and preventing the complications. Starting on an exercise program, which includes daily activities for at least 30 minutes each day, will help to maintain a healthy weight. Good nutrition, which includes a diet low in fat, cholesterol, sugars, and calories, must be followed. Hirsutism is one of the most common symptoms of PCOS and is the most distressing.
Many options are available to women to help with this problem. There are over-the-counter hair removal products including creams and bleaches. These may cause skin irritation. Some women choose to wax, pluck, or shave the unwanted hair. Electrolysis and laser hair removal are available but can be costly. Prescription medications are also an option.
Measures to promote menstrual cycle control may also be taken. This may include starting on birth control pills or other medications to keep the lining of the uterus thin. Your provider may want you to keep a menstrual calendar so you may track you cycles each month. Blood tests for diabetes, heart disease and high cholesterol should be monitored regularly. It may be necessary to start medication to manage these conditions if they develop. If pregnancy is desired a referral to an infertility specialist or an endocrinologist may be recommended.