Polycystic ovarian syndrome (PCOS) is a common condition that affects women of childbearing age. The key factor of PCOS is hormonal imbalance.
Most, but not all women, with PCOS have many small cysts within the outer edge of their ovaries. Oocytes (eggs) develop inside of follicles, which are small fluid-filled sacs. Each follicle breaks open once the egg has matured. The egg then travels to the fallopian tube for fertilization; ovulation has taken place. However, the ovary of a woman with PCOS does not produce all the hormones needed for an egg to mature. The follicle continues to swell with fluid but never breaks open because of the lack of ovulation and progesterone. The follicle remains as a cyst on the ovary.
The ovaries of women with the condition produce more androgen (male hormone) than normal. The high levels of androgen affect egg development and ovulation. Researchers have also found that there may be a link between PCOS and insulin resistance. The abundance of insulin increases the production of androgens.
The symptoms of PCOS vary for each woman but all have menstrual abnormalities: heavy, irregular or absent.
- Infertility due to irregular or lack of ovulation
- Infrequent or absent menstrual cycle
- Cyst on the ovaries
- Weight gain or trouble losing weight
- Androgenic alopecia (male-pattern baldness)
- Hirsutism (excess facial and body hair)
- Acne, oily skin, dandruff
- Sleep apnea
- Anxiety or depression
There is no one specific way to diagnose PCOS. The clinician uses different tests and exams to determine if PCOS is the cause of symptoms present. Test and exams may include:
- Blood test to check sex hormone levels or insulin
- Physical exam
- Pelvic exam
Restoring menstrual cycles and a healthy diet can lower blood sugar and improve insulin usage. Exercise can lower body fat, which helps lower insulin. Lower insulin levels can restore ovulation.
Metformin, a diabetic medication, can reduce the amount of androgens released by the ovaries. It also improves the body’s use of insulin. Metformin may also restore ovulation. Fertility medications, like Clomid, may be used for ovulation stimulation. Laparoscopic or minimally invasive surgery may be required. An assisted reproductive technology (ART) such as in vitro fertilization (IVF) may be used to help achieve pregnancy.
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Regional One Health Reproductive Medicine