Polycystic ovarian syndrome (PCOS) is the most common hormonal disorder affecting women -affecting 5-10% of the population. The symptoms of this disorder may be depressing to the woman and can often be embarrassing. Treatment often involves lifestyle changes as well as medications.

What is polycystic ovarian syndrome?
This common disorder can affect a woman’s hormone levels, periods, and ovulation. PCOS can affect fertility and pregnancy and also cause male-type body changes. This disorder is characterized by changes in the ovaries such that multiple follicles accumulate in the ovaries without ovulation. The ovaries secrete higher levels of testosterone and oestrogens. This results in irregular or no menses, excess body hair growth, occasional baldness and often obesity, diabetes and hypertension.

What are some of the symptoms of PCOS?
If you have polycystic ovarian syndrome you may have the following:
• No periods or irregular periods
• Infertility (difficulty getting pregnant)
• Repeated miscarriages
• High blood sugar levels (diabetes)
• Acne
• Weight gain and difficulty losing it
• Hair growth on the face, back or chest
• Male pattern baldness
• Depression
• Decrease sexual satisfaction

What causes polycystic ovarian syndrome?
The cause of PCOS is not known. Problems related to polycystic ovarian syndrome are caused by hormone changes. One hormone change triggers another, which changes another. About half the women with PCOS have a problem with how the body uses insulin, called insulin resistance. This often results in diabetes. High cholesterol levels are also found in individuals with PCOS.
Various researchers are looking to see if PCOS has a genetic component. If family members have PCOS then you are at an increased risk of developing polycystic ovarian syndrome.
Does polycystic ovarian syndrome increase your risk of other health problems?
Women with PCOS can be at an increased risk of developing several other health conditions. Irregular menstrual periods and the absence of ovulation associated with high oestrogen levels, but no progesterone, can cause the lining of the uterus (endometrium) to grow too much and undergo changes called endometrial hyperplasia. Endometrial hyperplasia is pre-cancerous and if not treated can lead to endometrial cancer.
Polycystic ovarian syndrome is also linked to diabetes mellitus, high cholesterol levels, high blood pressure, obstructive sleep apnea, heart disease and infertility.

How is PSCOS diagnosed?
No single test can show that you have PCOS. Your doctor will take a detailed history and carry out a complete physical examination. During this exam various signs may indicate PCOS. Various tests will be done as well as special investigations. Once a diagnosis is made your doctor will discus with you treatment options.

Treatment
There is no cure for polycystic ovarian syndrome at this time. There are many medications to control its symptoms. Eating a balance diet and being involved in regular physical activity can also decrease symptoms. If you are trying to become pregnant you should see a gynaecologist who may prescribe insulin-sensitizing medications and other drugs to induce ovulation. If you are not trying to become pregnant, birth control pills can help control many of the symptoms of PCOS.

Conclusion
Polycystic ovarian syndrome is one of the most common hormone disorders in women of childbearing age. The symptoms may vary from one woman another, but many of the symptoms can be discomforting especially if they are not treated. Women with symptoms suggestive of PCOS should seek professional help so that an accurate diagnosis can be may and treatment started to prevent many other health disorders that are associated with polycystic ovarian syndrome.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.

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