Polycystic Ovarian Syndrome (PCOS)

Q: I’m 25 years old and I have PCOS. What can be done to improve my chances of becoming pregnant?

Overview

Polycystic ovary syndrome (PCOS) is hormonal in origin and affects up to 10% of women in the child bearing age. PCOS sufferers produce an excessive amount of male hormones (androgens). Numerous cysts (fluid-filled sacs) form in their ovaries. A small percentage with PCOS have no cysts.

Women who develop cysts don’t release an egg at the time of ovulation. Over time, this leads to the accumulation of multiple cysts within the ovaries. These cysts produce androgens which results in an elevation of the androgen levels in the blood which further disrupts the menstrual cycle and causes many of the symptoms associated with PCOS.

While the precise cause of PCOS remains unknown, however, many with PCOS have insulin resistance whereby they have lost the ability to efficiently utilise their circulating insulin. Obesity is often an associated factor. Many with PCOS also have a strong family history of PCOS- eg mother, sister, etc.

PCOS is generally treated with medications and lifestyle modification, the earlier the better, in order to reduce the potential complications associated with this condition.

Symptoms may include:

• Irregular periods
• Reduced fertility
• Excess weight, especially around the abdomen
• Body hair growth in areas such as the chin, upper lip, chest and upper back (hirsutism)
• Oily skin or acne
• Thinning of the hair on the head
• Darkening of the skin on the back of the neck, in the armpits, and below the breasts
• Skin tags.

Possible complications:

• Obesity
• Type 2 diabetes
• Metabolic syndrome
• Hypertension
• Heart disease
• Cancer of the womb/ breast
• Miscarriages
• Depression
• Dermatological/ skin – hair growth, acne and skin tags.

Diagnosis:

Your doctor will take a detailed medical history and perform a thorough physical examination, inclusive of a pelvic examination.

You will be referred for:

Pelvic ultrasound: To assess the size of the ovaries and see if they have cysts. The thickness of the lining (endometrium) of the womb (uterus) will also be checked.

Blood tests: To determine the levels of androgens and other hormones. Blood sugar and lipid levels may also be evaluated.

Treatment:

Your healthcare provider will develop a treatment plan specific to your unique circumstances. PCOS cannot be cured, its medical management is highly dependant on your:

• Feedback
• Age
• Desire to become pregnant
• General health

If you plan to become pregnant in the near future:

Exercise & Diet: Weight loss via diet and exercise not only reduces symptoms but also lowers blood sugar levels and aids with ovulation.

Ovulation medications: These improve the release of eggs from the ovaries. However, it must be noted that these medicines increase the chances of multiple births – i.e. having twins, triplets or more.

Stress reduction:

If you do not plan to become pregnant (soon):

Oral contraceptive pills

Weight loss via diet and exercise

Metformin (Diabetes medication).

Other medications may be prescribed for associated conditions – e.g. acne, elevated cholesterol and other medical conditions.
Stress reduction.

Author: Dr. C. Malcolm Grant – Family Physician, c/o Family Care Clinic, Arnos Vale, www.familycaresvg.com, clinic@familycaresvg.com, 1(784)570-9300 (Office), 1(784)455-0376 (WhatsApp)

 Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.