Though it is most commonly associated with infertility, Polycystic Ovary Syndrome (PCOS) causes a variety of symptoms and health implications. Women with PCOS commonly experience a variety of the following symptoms:
-Irregular periods: The International Council on Infertility Information Dissemination (INCIID) defines this as periods in which the woman experiences 1) cycles that last more than 6 weeks 2) bleeding that is long-lasting 3) bleeding that is either unusually slight or unusually heavy 4) spotting frequently
-Irregular ovulation: Patients with PCOS may ovulate infrequently, late, or they may not ovulate at all (anovulation).
-Ovarian cysts: Most, but not all, patients have multiple fluid-filled sacs, called cysts, located on one ovary or both.
-Trouble getting pregnant: Infertility is often defined as no pregnancy after a year of trying (or after 6 months if the woman is over 30). Some women with PCOS may not experience infertility.
-Miscarriage: Both NIH and INCIID suggest a higher miscarriage rate in patients with polycystic ovarian syndrome.
-Acne: According to the National Institute of Health (NIH), most women who have severe, persistent or late onset acne also have PCOS.
-Excessive hair, dark skin patches and skin tags
-Obesity or weight gain, particularly in the waist.
-Insulin resistance or diabetes
-High blood pressure
Women who experience two or more symptoms should seek the opinion of a trusted physician.
PCOS Testing and Diagnosis
If the doctor suspects PCOS, he may perform an overall physical exam, a pelvic exam and an ultrasound to check for cysts on the ovaries. The doctor may also request labs to evaluate the patient’s glucose levels and certain hormones. High levels of male hormones is indicative of the syndrome. Disproportionate ratios of LH:FSH (luteinizing hormone; follicle stimulating hormone), may also indicate the syndrome. However, the doctor may request additional testing to rule out alternative causes for any abnormal results before diagnosing PCOS.
Once diagnosed, each symptom of PCOS is treated individually. Fertility patients may respond to ovulatory stimulants, such as clomiphene citrate or letrazole. Anti-androgens, such as spironolactone, help reduce many of the other symptoms, such as acne and hair loss. Patients with insulin resistance may be treated with insulin-sensitizing agents, such as Metformin. Based on the patient’s symptoms, the doctor will create an individual treatment plan which will assure the best chance of avoiding future, more serious complications.
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