For most women, getting their period is a nuisance they wish they didn't have. But many women have to cope with the additional inconvenience of irregular periods, cramping, and weight gain. This can be not only an extreme annoyance but also the sign of something more serious.
These are just a few symptoms of what is called Polycystic Ovarian Syndrome, or PCOS. The main cause of PCOS is an abnormal surge of androgens that prevent a normal menstrual cycle from occurring.
The woman's ovaries contain eggs that are surrounded by fluid filled sacs. Each month during a normal menstrual cycle, an egg will mature. As it matures, the fluid surrounding it also increases in volume. Once it is ready to travel down to the uterus, the follicle surrounding the egg ruptures and the egg is released. If the egg is not fertilized within a few days, a menstrual period will occur.
For women with PCOS, however, the elevated androgen levels will interfere with this normal process. Instead of releasing each month, many eggs will remain as fluid filled sacs, and are known as cysts.
Normal ovulation and the rupturing of the follicle does not occur, and as a result it will suppress progesterone levels within the reproductive cycle. Without this necessary hormone in a woman's cycle, a menstrual period is irregular or does not occur.
The cysts continue to generate androgens, which continues the ongoing cycle of suppressed ovulation.
Furthermore, women can also suffer from growth of facial and body hair, especially on the toes, chest, stomach, hands or back, skin problems such as acne and oilier skin, male pattern balding or thinning hair, discolored patches of skin, and weight gain. Her insulin level can also be abnormal.
More serious health problems include Type II Diabetes, high blood pressure and cholesterol, which present more serious health problems in the long run.
In addition, the inability to have a normal menstrual cycle also causes the endometrium within the uterus to thicken and stagnate, leading to extremely heavy bleeding if a period occurs at all.
Repeated bouts of delayed endometrial shedding or no shedding at all can lead to endometriosis, or even cancer.
For women who want to have children in the future, PCOS can make it more difficult to conceive. There also appears to be a higher rate of miscarriage, premature delivery, gestational diabetes, and pregnancy-induced high blood pressure.
PCOS is diagnosed through a series of tests where a physician will measure a woman's hormone levels to detect the presence of elevated androgen levels.
The physician will also assess the size of the ovaries and determine if there is swelling through a pelvic exam or an ultrasound.
He or she can also determine through an ultrasound if the endometrium is unusually thick. Physicians can also evaluate the areas of hair growth to determine if the androgens are the main perpetrator.
There are a series of treatments out there for women with PCOS.
To regulate the menstrual cycle and prevent build up of the endometrial lining, a physician may recommend that a woman be put on hormonal contraceptives to regulate the hormones and stimulate a period.
Other hormonal options include antiandrogens, or agents that block the production of androgen.
Diabetes drugs such as metformin have shown to be an effective way of regulating blood glucose levels and subsequently reducing the production of androgens. However, studies have not yet confirmed whether metformin is safe for pregnant women, since it does cross the placenta.
A surgical procedure to help stimulate ovulation can be performed laparoscopically and it involves "drilling" away a part of the ovary. One setback to this procedure is that its effects only last a few months and will need to be repeated periodically.
If there is a weight problem, a recommended weight loss regimen will help decrease the risk of heart disease by lowering blood pressure and cholesterol.
Possible cosmetic symptoms of PCOS, including acne, hair loss and weight gain, can affect body image and self esteem. Treatment to correct hormone levels, as well as diet modification and stress reduction when necessary, are important, since obesity and stress can contribute to high androgen levels.
It is estimated that five to 10 percent of women of childbearing age have PCOS.
