Shedding Light on the Subject of Polycystic Ovary Syndrome
February 23, 2005
The most common endocrine syndrome that affects women of reproductive age, puberty to menopause, is known as Polycystic Ovary Syndrome (PCOS). It affects approximately 10 percent of women in the reproductive age group. For years, many people automatically assumed PCOS was purely an ovarian syndrome, due to its given term; however, it is now recognized as a systematic endocrine and metabolic disorder, as multiple risk factors are at work.
PCOS can be described as a total body endocrine syndrome. In fact, the abnormalities in the ovary are actually more the result of a bigger problem, rather than the cause. And although there is no set definition for PCOS, most endocrinologists would agree on a set of criteria necessary to make the diagnosis:
- The complete or almost complete lack of ovulation
- Increased androgen (male hormone) production, either facial hair and/or acne
- Hyperinsulinemia (insulin resistance with elevated serum insulin levels)
While it is clear PCOS is a complicated syndrome with many interactions combining to produce the clinical picture, it is also evident these interactions play off one another, creating a vicious cycle.
The PCOS Cycle
Any hormone problem that interferes with normal ovulation results in what is known as a "polycystic" ovary, which, regardless of the cause, will produce increased amounts of androgen. Conversely, increased androgen production interferes with normal ovulation. Evidence has also pointed to obesity as part of the androgen excess syndrome; overweight women produce increased androgens even if they have no underlying abnormality in the adrenal gland. It is not known for certain whether obesity is a cause or an effect or simply a part of PCOS.
Moreover, increased insulin found in women with PCOS stimulates ovarian androgen production; increased androgen production contributes to insulin resistance. Yet increased androgen production also leads to an increased body weight (obesity), which in turn contributes to insulin resistance. Women with PCOS who are not overweight also frequently have insulin resistance.
PCOS is an inherited, autosomal dominant trait, meaning if a woman has PCOS, it should be looked for in her mother, sisters and daughters. And, since it is autosomal dominant, male relatives can also carry the gene and can transfer the problem to their daughters. Having PCOS puts women at an increased risk of developing diabetes, coronary artery syndrome, lipid disorders (such as elevated cholesterol and high blood pressure) and possibly breast cancer.
Suggested Methods of Preventing PCOS Development
- Weight Loss
- Drugs (such as the anti-diabetic drug Metformin)
- Suppress ovarian function with oral contraceptives or other drugs
- Making an early diagnosis, which will prevent the development of a full-blown diagnosis
InfertilityPhysician.com February 4, 2005