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Polycystic Ovarian Syndrome (PCOS), or Stein-Leventhal Syndrome, is a hormonal endocrine system disorder that affects almost 10 million women worldwide. Although the exact cause of PCOS is unknown, women with PCOS have a hormonal imbalance between androgen, insulin, estrogen, and progesterone. PCOS is labeled as a “silent killer” because it requires multiple tests to detect and many women are left undiagnosed.

Androgen is a male hormone that is also found in small amounts in women and is produced in the ovaries, adrenal glands, and fat cells. However, women with PCOS have heightened levels of androgen, which can lead to:

  • acne
  • excessive facial and body hair growth (hirsutism)
  • weight gain
  • irregular ovulation

Insulin is a hormone produced in the pancreas that regulates the amount of sugar in blood. In PCOS, the body is more insulin-resistant, leading to elevated blood sugar and insulin levels. Excess insulin results in overproduction of androgen and an increased risk of developing diabetes.

Progesterone is a hormone produced in the ovaries, placenta, and adrenal glands that plays a role in conception, pregnancy, and ovulation. This hormone, paired with the hormone estrogen, helps a woman’s ovaries release eggs. In PCOS, there is a low level or lack of progesterone, causing irregular periods.

The name Polycystic Ovarian Syndrome is misleading because only some of the women diagnosed with this disorder have follicles or cysts in their ovaries. The development of these cysts, as well as the struggle of regularly releasing eggs from these enlarged ovaries, contributes to infertility in women with PCOS.

PCOS can increase the risk of developing a number of diseases including diabetes, heart disease, obesity, and breast and endometrial cancers.

Image Source: Peter Dazeley

Symptoms of PCOS include:

  • acne/oily skin
  • weight gain and/or trouble losing weight (obesity)
  • patches of dark skin on the back of neck, underarms, or breasts, or between thighs
  • skin tags
  • thinning hair in a “male baldness” pattern
  • excess hair growth on the face, chest, abdomen, nipples, or extremities (hirsutism)
  • enlarged ovaries with “string of pearls” cysts
  • infertility
  • irregular periods
  • sleep apnea
  • anxiety or depression

PCOS should be diagnosed as early as possible through methods such as blood tests and pelvic ultrasounds because women with PCOS are at higher risk for health conditions such as diabetes, high cholesterol, high blood pressure, obesity, and breast and endometrial (womb) cancer. PCOS has also been linked to insulin resistance and heart disease. Women with PCOS who become pregnant have higher risks of miscarriage, premature birth, and preeclampsia.

Although there is no cure for PCOS, the symptoms can be managed by a combination of lifestyle changes (exercise and diet) and medication to regulate hormones.

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