Polycystic ovary syndrome (PCOS) is a disorder that affects approximately 5% of all women. It is the most common hormonal disorder among women of reproductive age, and is one of the leading causes of infertility.
The principal features are weight problems, lack of regularity of menstruation and the lack of ovulation, and excessive androgens. The symptoms and severity of the syndrome vary greatly among women. The causes are unknown, but insulin disorders, diabetes and overweight are strongly correlated with PCOS.
Symptoms- Risks
Common symptoms of PCOS include irregular, few, or absent menstrual circle, lack of ovulation, that causes infertility, excessive and increased body hair, typically in a male pattern affecting face, chest and legs (Hirsutism) and Acne.
One in two women with PCOS is obese.
PCOS can present in any age during the reproductive years. Due to its often vague presentation it can take years to reach a diagnosis.
Women with PCOS are at risk for the following:
Endometrial cancer: From the prolonged stimulation of the estrogens
Cardiovascular disease-Increased Blood Pressure
Diabetes
Hyper cholesterol
Overweight
Infertility
Diagnosis
Not all women with PCOS have polycystic ovaries (PCO), nor do all women with ovarian cysts have PCOS, but a transvaginal ultrasound is a major diagnostic tool, it is not the only one. The diagnosis is straightforward using the Rotterdam criteria, even when the syndrome is associated with a wide range of symptoms.
Diagnostic assessments of Polycystic Ovarian Syndrome:
History of the patient
Vaginal ultrasound: Small follicles(12 or more)
Blood level of androgens
The FSH/LH ratio is below 1/1
Laparoscopy observation of the ovaries( pearl-white surface)
Glucose tolerance test
Treatment
Lowering of insulin levels (metformin)
Restoration of fertility (clomiphane)
Treatment of hirsutism or acne (anti-androgen agents)
Restoration of regular menstruation, and prevention of endometrial hyperplasia and endometrial cancer (contraceptive pills)
Some times when a laparoscopy is performed, we can treat PCOS with ovarian drilling.