Polycystic Ovarian Syndrome
Polycystic ovaries (PCO) and Polycystic ovarian syndrome (PCOS) are reproductive issues.
PCO is defined by multiple cystic growths on the ovaries, whereas PCOS is a syndrome that mimics the same symptoms as PCO but without the cysts! Whilst the conditions present with quite a complex set of symptoms, a common cause is insulin resistance. Insulin is a hormone with many roles, but in particular it controls the metabolism of sugars and starches, and when the cells become resistant to insulin, the body can no longer control blood glucose.
PCO SIGNS & SYMPTOMS
Common symptoms include:
- multiple cysts on the ovaries (not present in the syndrome)
- excess hair growth (hirsutism)
- acne, oily skin
- sleep apnoea
- irregular menstruation (amenorrhoea or oligomenorrhoea)
- lack of ovulation (can cause infertility)
- elevation of androgens (male hormones – testosterone, DHEAS, dehydroepiandrosterone, androstenedione)
- central obesity
- male pattern baldness
- enlarged ovaries
- chronic pelvic pain
- blood glucose dysregulation (hypoglycaemic, diabetes)
- skin tags
- hyperpigmentation of the skin (acanthosis nigricans)
Understanding Some Of The Causes
The syndrome encompasses a broad spectrum of signs and symptoms, and is considered a hyperandrogenic problem (too many androgens – that is male hormones) and ovarian failure. 50% of women with PCOS are overweight or obese and this seems to play a key role. Insulin is commonly elevated in these individuals, and insulin availability at the ovarian tissue can promote the production of androgens. Estrogen dominance, decrease in sex hormone binding globulin (SHBG) and increased activity of the opioid system of the hypothalamic-pituitary-adrenal axis may also be related.
What To Do?
Since body weight is related to improvements in hormones and closely related to the signs and symptoms, weight reduction is the focus of treatment, including strategies which further reduce insulin and lower androgens.
Ultrasounds will identify cysts, and there are many test that can be done to get a really good idea of what is happening in the body:
- antimullerin hormone
- insulin, glucose
- sex hormone binding globulin (SHBG)