Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder that causes cysts on a woman's ovaries. People often think of large grapefruit-sized cysts when they hear the term ‘polycystic ovaries’. However in the case of PCOS, the cysts are tiny. Using an ultrasound, they look like black dots on an ovary. These cysts are eggs that have failed to properly mature and release from the ovary.
PCOS symptoms usually present themselves during puberty but may also begin in the early to mid 20's. Certain symptoms are life-long, while others will cease at menopause.
This is a condition that has a number of symptoms however there is no simple hard and fast diagnostic test. Each woman presents with a different number of symptoms and together they make PCOS. It's rare that two women will share exactly the same symptoms.
The following is a list of some of the possible symptoms:
- hirsuitism (excessive hair growth on the face, chest, abdomen, etc.)
- hair loss ('androgenic alopecia' in a classic male baldness pattern)
- polycystic ovaries (seen on ultrasound)
- infertility or reduced fertility
- irregular or absent menstrual periods.
Diagnosis of PCOS usually involves taking a thorough medical history, conducting an ultrasound of the ovaries and blood tests to determine hormone levels. The type of ultrasound used is a transvaginal-ultrasound which involves placing a probe inside the vagina. Transvaginal ultrasounds are used in preference to the usual abdominal ultrasounds as they provide a better quality image. Blood tests will indicate if a woman has elevated levels of androgens and insulin or any other hormonal imbalances.
Treatment for PCOS depends on the symptoms experienced by the woman and on whether she is seeking to become pregnant. For women who are diagnosed with PCOS as a result of infertility investigations, the immediate treatment/s focus on re-establishing regular ovulation to improve the chance of pregnancy. The aim of treatment for women not wishing to become pregnant in the near future is to provide relief from the various symptoms. In the past, treatments for PCOS often only focused on the cosmetic symptoms like acne, excessive hair growth and obesity. However, current treatment for PCOS also seeks to address the long-term health implications such as the increased risk of diabetes and cardiovascular disease.
Overseas research suggests PCOS affects between 5% and 10% of all women of childbearing age regardless of race or nationality. However, a Melbourne study published in February 2005 suggests the figure could be much higher at 12% of Australian women or one in eight women. This is around half a million Australian women and teenagers.
Women with PCOS may be at increased risk of developing the following health problems during their lives:
- insulin resistance
- lipid abnormalities
- cardiovascular disease (heart disease, heart attacks and stroke)
- endometrial carcinoma (cancer).