Polycystic Ovary Syndrome (POS)
The cause of PCOS is unknown. However, we do know the underlying problem with PCOS is a hormonal imbalance. Androgens are male hormones that females also make, and high levels affect ovulation. Researchers also think insulin is linked to PCOS. Insulin is a hormone that controls the change of sugar into energy for the body to use or store. Many women with PCOS have too much insulin.
The symptoms of PCOS can vary and include:
• Infrequent, absent, and/or irregular menstrual periods
• Increased hair growth on the face, chest, stomach, back, thumbs or toes
• Cysts on the ovaries
• Acne and oily skin
• Weight gain or obesity
• Male-pattern baldness or thinning hair
• Pelvic pain
Your Jackson Clinic visit will likely include:
• Medical history: Your menstrual periods, weight changes and other symptoms
• Physical exam: Your blood pressure, body mass index (BMI), thyroid, heart, lungs, abdomen and skin
• Pelvic exam to check your ovaries for any enlargement or swelling caused bythe increased number of follicles
• Blood tests to check hormone and insulin levels
• Pelvic ultrasound to examine your ovaries for cysts and check the endometrium (lining of the womb)
Because there is no cure for PCOS, it needs to be managed to prevent problems.
Treatment goals are based on your symptoms and whether or not you want to become pregnant. Many women will need a combination of treatments to meet these goals.
Treatment for PCOS includes:
• Lifestyle modification
You can help manage your PCOS by eating healthy and exercising to keep your weight at a healthy level.
• Birth control pills
These can help control menstrual cycles; reduce male hormone levels and clear acne.
• Diabetes medication
The medicine Metformin has been found to help with PCOS symptoms. Metformin affects the way insulin controls blood glucose (sugar) and lowers testosterone production.
Medicine for extra male hormones may reduce hair growth and clear acne. Spironolactone has been shown to reduce the impact of male hormones on hair growth in women.
• Fertility medicines
Lack of ovulation is usually the reason for fertility problems in women with PCOS. Medications that stimulate ovulation can help women with PCOS become pregnant.
Treatment options include:
• Clomiphine is the first choice therapy to stimulate ovulation for most patients.
• Metformin taken with clomiphene — may be tried if clomiphene alone fails. The combination may help women with PCOS ovulate on lower doses of medication.
"Ovarian drilling" is a surgery that may increase the chance of ovulation. Dr. Wilson was one of the first gynecological surgeons in Jackson to perform this type of surgery. He has performed it hundreds of times over the years. This laparoscopic procedure can lower male hormone levels and help with ovulation and pain associated with PCOS.
Finally, women with PCOS have greater chances of developing several serious health conditions, including life-threatening diseases.
Recent studies found that:
• More than 50 percent of women with PCOS will have diabetes or pre-diabetes (impaired glucose tolerance) before the age of 40.
• The risk of heart attack is 4 to 7 times higher in women with PCOS than women of the same age without PCOS.
• Women with PCOS are at greater risk of having high blood pressure.
• Women with PCOS have high levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol.
• Women with PCOS are at a higher risk to develop endometrial cancer. Women with PCOS have three times the risk of developing endometrial cancer.
If you, a friend or a family member has questions or would like an appointment regarding PCOS or any other women's health concern, please contact one of our OB/GYN physicians at The Jackson Clinic.