Written by Dr.M.D.Mazumdar, MD
Polycystic Ovarian Syndrome is also known as Polycystic Ovarian Disease, Stein Leventhal Disease or Ovarian Dysmetabolic Syndrome.
It is characterized by a combination of multiple symptoms like irregular and heavy periods, occasional amenorrhea, obesity, hirsutism, and sometimes infertility. These symptoms occur due to imbalance of various hormones.
PCOS occurs in about 5- 10% of all women. It occurs in all races and communities.
Although more common in women in the reproductive age group, some cases are also seen in young teenagers. But it is rare above the age of 40 years.
Causes of Polycystic Ovarian Syndrome
Symptoms of Polycystic Ovarian Syndrome(PCOS)
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Tests for Polycystic Ovarian Syndrome(PCOS)
Since the blood sugar level continues to be high even on adequate levels of insulin, the body tends to produce higher and higher quantities of insulin to convert the blood sugar. This causes a high insulin level in women with PCOS.
Ultrasonography is one of the main diagnostic aids in Polycystic Ovarian Syndrome (PCOS).
A normal ovary shows a number of follicles in various stages of growths and thus of various sizes.
In a polycystic ovary, the follicles are enlarged and form cysts arranged around the periphery of the ovary. This produces, what is called a ' necklace appearance' on ultrasound.
The ovary is also increased in size and on direct visualization, shows a thick whitish surface due to thickening of its cortex.
Treatment of PCOS
Treatment of Polycystic ovarian Syndrome can be by either medicines or surgery or a combination of both.
Since the pituitary gland receives signals from the receptors about the estrogen level in the blood, lack of signals form the receptors is perceived as a low estrogen level in the blood. The pituitary then produces more and more FSH in an attempt to stimulate development of follicles in the ovaries and increase the estrogen level.
The high FSH manages to overcome the inhibitions of hormones like LH and androgens to stimulate the ovary and cause ovulation.
The main idea behind ovarian surgery for ovulation was to puncture the cysts on the surface of the ovaries - called 'ovarian drilling'.
This was often seen to reduce the level of androgens in the blood and stimulate ovulation in more than 70% of women.
But recent research suggests that surgery can do more harm than good by promoting infections and scar formations. It is now rarely, if ever, carried out.
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